Chronic Pain Abilities Determination (CPAD)
A face-to-face assessment that objectively measures capacity for work where fatigue or pain is the main barrier. Suited to conditions such as chronic fatigue syndrome, fibromyalgia and long COVID.
What it is
The Chronic Pain Abilities Determination (CPAD) is an objective, face-to-face assessment of a person's capacity to work when fatigue or pain is the main barrier. It measures functional ability against the demands of their own job, an alternative suited role, or activities of daily living.
The protocol was developed by a team of clinicians with significant experience in rehabilitation and work capacity. Following a two-year literature review, they combined the most appropriate peer-reviewed methods for testing physical and cognitive ability into a single assessment matched to the individual's job demands.
The results are free from both examiner and individual subjectivity, giving the factual evidence needed to support a medical opinion. A CPAD can be commissioned as a one-off assessment or form part of a return-to-work programme through vocational rehabilitation.
Who it is for
CPAD assessments are used by insurers, insurance brokers, occupational health providers and employers when reported fatigue or pain is preventing a return to work and objective evidence is needed to inform a decision. The findings are also of value to treating physicians and independent medical examiners.
The assessment suits conditions where fatigue or pain is the predominant reported barrier to work. These include chronic fatigue syndrome, fibromyalgia, long COVID, chronic pain, chronic regional pain, multiple sclerosis, rheumatoid and psoriatic arthritis, peripheral neuropathies, migraines and headaches, cancer, stroke, meningiomas, Lyme disease, lymphoedema, post-sepsis syndrome and vasculitis.
What is involved
Testing takes place face to face in two sessions, so the physical and cognitive components can be repeated. The repeat addresses the good day, bad day and post-exertional malaise patterns seen in these conditions, so effects of fatigue or pain that did not appear in the first session can be identified.
The physical component uses established, peer-reviewed tests of strength and range of movement, together with work simulation tasks specific to the person's occupation or a suited role. The cognitive component uses computerised neuro-cognitive tests covering domains including memory, processing speed, reaction time, attention, executive function and cognitive flexibility.
Assessments are carried out by trained functional assessors: healthcare professionals such as physiotherapists, occupational therapists, nurses and osteopaths who specialise in working with these conditions. Determining the reliability of the individual's performance is an integral part of the assessment.
What the referrer receives
The report sets out the person's current functional capability for specific work tasks and daily living activities, the measured effect of activity on their symptoms and condition, and the barriers preventing a return to work, an increase in hours or normal daily activity. Where appropriate, it includes physical and cognitive recommendations to support a return to health, function and work.
It also gives detailed conclusions on the individual's consistency of performance, symptom reporting and voluntary effort during testing, free from examiner and individual subjectivity. If a rehabilitation programme follows, the results provide a baseline for tracking progress.
Questions referrers ask
Why does the CPAD repeat the tests?
Fatigue-related conditions often follow a good day, bad day pattern, and symptoms can worsen after exertion. Repeating the physical and cognitive tests in a second session captures effects of fatigue or pain that were not present during the first.
How is the individual kept safe during the assessment?
Assessors are trained to follow set safety protocols. These include pre-assessment condition screening, monitoring of heart rate and blood pressure, watching for signs of muscle fatigue, weakness or changes in posture, and constant monitoring of pain and exertion levels. Before testing begins, the individual is told they are not expected to attempt any test they feel unable to perform and can stop any task at any stage.
Can a CPAD form part of a wider rehabilitation programme?
Yes. A CPAD can be a one-off assessment or part of a return-to-work programme through vocational rehabilitation. The results provide a baseline against which progress can be tracked if a rehabilitation programme is undertaken.
What happens after you refer
Steps
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Refer
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Logged
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Individual contacted
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Assessment
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Report to your inbox
- 1
Refer
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Logged
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Individual contacted
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Assessment
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Report to your inbox
Assessment client? See how vocational rehabilitation completes the claim.
An objective evaluation tells you where things stand. Our rehabilitation and case management take it from there, through to a sustained return to work.
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