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Walking in pain

dorayme

hello everyone I just need a bit of help please.

I’m in the middle of filling out my pip forms and I’m confused about the walking bit.

I can walk more than 200 metres on a good day but walk with a stick and I’m in a great deal of pain from the first step. I walk with a stick and that helps a bit.

I have osteoarthritis and my gp has it in my care plan that I must walk as often as possible as he informs me it won’t hurt me in fact will strengthen my muscles but the reason I walk with a stick is to help with balance and pain.

As I’m in pain from the start do I count the 20 metres as how far I can walk.

I’ve seen online a judgement that says walking through pain isn’t accessible standard is that correct.

thank you for reading my post .

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dorayme

I might add on a day I have managed to walk with pain leaves me unable to walk very well for a few days afterwards.

thank you.

chiarieds

Hi @dorayme - & welcome to the community. You are correct in that such pain should be taken into account, so describe exactly where the pain is & how it affects you. Remember PIP is about how you are the majority of days, & you should describe them as relates to your walking, preferably without mentioning the words 'good' or 'bad,' as later your assessor might pick up on this wrongly, i.e. hear the word 'good,' & conclude all is well with you!

The 2nd point you raise is the difficulty you have walking after managing to walk the previous day. This comes under the concept of 'reliability' & one of the things mentioned is being able to repeat a PIP activity as often as one would reasonably expect. You should therefore mention the consequence after attempting/managing to walk.

Please look under the Mobility section in the following link for 'Moving around' where pain is mentioned. Also carefully read the 'Reliability' section. Read it all if you can.

https://www.gov.uk/government/publications/personal-independence-payment-assessment-guide-for-assessment-providers/pip-assessment-guide-part-2-the-assessment-criteria#mobility-activities

In general, when completing your form, try to give a couple of recent, detailed answers for each applicable activity/descriptor such as when did this happen, where, what happened, did anyone witness this, & those important consequences to attempting/doing an activity.

Rachel_Scope

Welcome to the community @dorayme 😊

Chiarieds has given you some great advice there. Filling in PIP forms can be quite daunting and confusing but don't worry, we'll be here to support you through the process. Be detailed and honest about what you can and can't do.

dorayme

thank you, I’ve put I have severe pain in my knee. So am I correct in thinking it’s 20 metres rather than 200 as the pain is there all the time.

my gp has said he would back me up if pip wrote to him.

chiarieds

If you're in constant pain before you start walking, then say that. For example, I'm in constant pain the moment I'm upright, so said so under the 'Moving around' section. If you can, describe exactly where the pain is, & what it feels like (so how it affects you). The more detail you give, the better, then it shows that what you describe is consistent with having osteoarthrosis. if you run out of space for any activity then continue it on some paper at the end. Ensure you say which question this is continuing from, & put your name & National Insurance number on such pages.

Be careful to say that you can walk no more than/up to 20 metres, tho this causes you pain. If you say 20 metres, then this might be thought of rather that you could do so from 20 metres, but no more than 50 metres.

It really is up to you to write everything, as the assessors rarely contact your GP/consultant. My GP said the same, & I paid to get a letter from him, but whether that helped I'll never know!

When you send your completed form off, ask for a free 'Certificate of posting' from your Post Office.

dorayme

thank you :)

My other question is how do you prove pain to pip, as pain is subjective and can’t always be seen my an onlooker.

sorry for all the questions.

dorayme

just want to make sure I know the right things to say when being assessed.

dorayme

or do I just need to describe the pain and mention my GP being able to give my medical history.

sorry for all the posts. I keep thinking of more questions but can’t see how to edit to add to my posts.

chiarieds

I wouldn't mention your GP, as the onus is really on you to give as much detail as possible……only you really know how walking affects you; your GP obviously listens to you, but him writing anything on your behalf is only from what you've told them, so hearsay.

Yes, pain is subjective, but, if you describe it in detail, then it will make your claim come alive. Giving a couple of recent, detailed descriptions such as where were you, when did this happen, what exactly happened, did anyone see this, & were there any consequences attempting/doing this activity will also help. Just saying you have pain in your knee is too vague, similarly saying you have pain due to OA, as your diagnosis won't be in dispute.

Don't worry about asking questions, that's absolutely fine. Unfortunately you can only edit your posts once you've received so many points.

dorayme

Thank you so much for taking time out of your Saturday to help me.

Another thing I noticed when I looked through the help section is fatigue.

due to pain I struggle to get good quality rest and am often walking around absolutely exhausted with brain fog, should I put that down too? I am also on Gabapentin for nerve damage after an operation and one of the side effects of that is exhaustion, should I mention that too?

poppy123456

You should put everything down because if you don't then how can they assess you properly.

Don't forget to concentrate on those real world examples that chiarieds mentioned. Just telling them you have pain in your knee isn't enough and it needs to be a lot more detail than that.

Have you had a read through that link that chaired posted? If not the please look at that because there's also the daily living descriptors included with that.

dorayme

hello poppy.

yes I did, was very helpful.

I’m going to sit down tomorrow afternoon and make lots of notes first then fill the form in.

my knee throbs and feels tender around the joint when I walk is that the kind of thing I should be putting down rather than a sore knee?

dorayme

if getting my dr involved isn’t necessary, how do I prove or give evidence to pip please.

Surely they won’t just take it on my word hense asked my dr to back me up.

chiarieds

You're very welcome.

I agree with poppy - but I'd hesitate a guess, as someone who has chronic daily pain (including neuropathic pain due to a central nervous system problem for which I've been prescribed Pregabalin, which is in the same 'family' as Gabapentin), that pain may very well be affecting your sleep, as many of us know/is well known, but how do you 'prove' that your exhaustion is also due to one of the side-effects of Gabapentin? Altho fatigue is a common side-effect of Gabapentin, unless your GP decided to slowly withdraw you from this med to see if your fatigue/exhaustion lessened, then you'd never know….unless your exhaustion & subsequent brain fog started/increased since you started taking Gabapentin….

I'd just describe your exhaustion, tho, as you do list your meds, you could say that perhaps Gabapentin contributes to this.

The 'moving around' descriptor is about being able to stand & physically put one foot in front of the other aided, or not; the consequence of doing this is where exhaustion/fatigue comes into this as you can't repeat this 'as often as would normally be expected,' as you'll see under the 'Reliability' section of the link above. If you can't do an activity 'reliably' then you're considered as not being able to do an activity at that level. This can also (possibly) be because it takes you longer to walk due to pain; you just need to describe in detail literally 'How your disability affects you.' Imagine any number of claimants with your disorders; they'll all likely be affected differently, so you need to say how you're affected in a relevant, detailed way (for all the descriptors).

I also have OA, & yes, as PIP isn't a medical assessment, rather a 'functional' one, you just say it how it is. But, whereabouts is the pain in your knee(s), what sort of pain is it, is it intermittent or constant as you walk, what is the severity like, & how does it affect you most days? A 'sore' knee wouldn't tell me anything about any difficulty you may have in walking (she says as a long-retired physio); the devil is in the detail…

dorayme

thank you again for your detail it’s very helpful.

so are you saying fatigue due to be kept awake at night due to pain doesn’t count re the fatigue/pain mobility part of the question?

I have read the information you sent and it’s quite ambiguous in parts.

chiarieds

The PIP assessment guide is what the PIP assessors use, so quite useful to know. I think re: the 'moving around' descriptor it's trying to stress any physical problems you have rather than any from mental health, learning or cognitive problems.

However, from this link it says, 'When assessing whether the activity can be carried out reliably, consideration should be given to the manner in which the activity is completed. This includes, but is not limited to, the claimant’s gait, their speed, the risk of falls and symptoms or side effects that could affect their ability to complete the activity, such as pain, breathlessness and fatigue.'

So, fatigue is definitely considered, as are pain & breathlessness, but they are trying to differentiate from problems arising from physical difficulties, which can include fatigue/increased pain impacting on your mobility from those where mainly mental health problems occur, which is looked at in the 'planning & following a journey' section. It's perhaps unfortunate (& confusing) that they mention aspects of the 'planning & following a journey' part in that about 'moving around.'

I'm fatigued due to often poor sleep. Does that stop me from 'moving around'? No, however due to the fatigue & pain I can experience, then if I walk a little better one day, then I struggle to repeat this on some subsequent days. We're all different however, & I don't know how your disabilities affect you.

The link I gave to the PIP assessor's guide does seem to relate to any pain/fatigue/breathlessness that a claimant might experience during the activity of 'moving around' to my mind, tho pain/fatigue can be a consequence of attempting/doing this activity which may cause difficulty in repeating this as often as you'd like, which I've also tried to stress.

Sinica

Hello, my husband has the same problems. I applied for PIP online and didn't give many details. I answered that he can't walk more than 20 meters because every step causes him great pain. Even if the doctor recommended exercise. The short answers have taken to a 1 hour and 40 minute and very stressful telephone evaluation. During the evaluation, I explained to him that he does not leave the house except to the GP, which is close because he avoids walking because of the pain. Although he uses a cane, he has pain in every step and he must wait to rest every 2-3 meters. He is accompanied permanently because he has to be supported by someone for 2.3 minutes. After other questions they came back and he was asked how long it would take him to reach GP. I answered 25-30 minutes and then he asked me how long I'm doing since I'm healthy. I said 5 minutes and he answered thank you, that's all I wanted to know. Pay attention to the question of how long you can stand. Although I explained that he gets out of bed leaning against the wall and that he has a cane on which he leans and can only stand leaning for 2.3 minutes when I got to the question of washing yourself and I explained to him that I help him enter the tub and I wash him because he sits with one hand supporting him, he asked how long the washing takes. I answered that it takes a few minutes and he asked me why so little. I answered that he cannot stand for more than a few minutes. He was awarded with the increased rate for mobility.

dorayme

https://forum.scope.org.uk/discussion/comment/898490#Comment_898490

I’m so sorry to hear of all his difficulties.

dorayme

Thank you again your advice is so helpful.

I’m just wondering I walk with a stick which helps my pain if I don’t use the stick the pain is worse. Do I tell them the stick helps with pain or will that make them decide against awarding me because stick makes it easier.

Sinica

The cane does not relieve your pain, but it helps you to be able to walk 2.3 meters and then lean on it to rest. He was asked which knee is the most affected and on which side he uses the cane. If the cane was recommended to him by a doctor or he uses it as he wants. Try to give as many details as possible when filling out the application to avoid questions during the evaluation.