Inside a CPAD Assessment II: When an Insurer Tests Your Ability to Work with ME
The follow up session to my CPAD assessment for ME was effectively a carbon copy of the previous session, just without the introductory interview and history data collection.
Structure of the assessment
The session had four parts, in this order:
- Check on how I was feeling after the previous session and what I had done in the interim period
- Blood pressure and heart rate checks.
- Physical motor skills testing.
- Computerised cognitive testing.
Check-in
This was a brief check-in on what I did after the first session, how I was feeling and if I had any symptoms of note. I went to the supermarket with family and did the regular food shop, played a few games with family and watched some football and had a work meeting. All pretty normal stuff without any symptoms of note.
I imagine someone with more severe symptoms would describe rest, post-exertional malaise and as the symptoms per person and per trigger seem so varied - it would provide an opportunity to explain the impact of the first session.
Blood
This is, I guess, a basic check to see if it’s safe to continue, but at a point in time, this may not show any delayed impact at that specific moment. But useful to a degree to not proceed if a hear rate was elevated to an unusual level. My Blood pressure was ‘quite high’ again in repeated seated tests across both days and independently at home I had more varied results. Something to speak to GP about.
Physical motor skills testing
A repeat of the previous session, I believe I achieved parity or a slight improvement, I would expect to have failed miserably had I been at my worst and severe level. I could feel some pain in my hands and arms - muscular and nerve level but this was minor 3 out of 10 on a pain scale and more likely to be linked to my physical decline known as deconditioning and activation of muscles that haven’t been used much in the last year due to having had severe symptoms. I also have ongoing autonomic dysfunction issues which also align well.
Computerised test
A repeat of the same session, although I believe some of the words and images were different as some appeared new to me, some were repeats. But that could be my failure to remember some from the prior session.
Trying to remember 15 words is, from my experience and knowledge from A Level Psychology, that most people remember the first 7 items and the last few and the middle of a list is where things get vague. But for this sort of test I imagine they have an average level for people without cognitive issues and people with so you’d be assessed against a reasonable benchmark and against your previous scores.
Wrapping up
I was able to finish the session early, and opted to skip the 5 minute break to continue but there was no pressure to do so. The total length was about 75 minutes.
Notes
Finally I would have concerns as an individual with ME if my symptoms were still present, were moderate or severe, and enough to keep me out of work. This test would be effective in triggering worsening symptoms and potentially worsening outcome in the way there are examples of people being able to walk taking on graded exercise therapy and ending up in a wheelchair. so I would approach the session with caution. Consider taking an chaperone/aid to speak on your behalf if they can spot visible signs better than a stranger.
My occupational health assessor was relaxed, chatty, polite, and made me feel at ease on both sessions. Your mileage may vary however.
I was told to expect to hear from my insurance provider within 3 weeks with results and the accessor had 2 working days to write up notes for internal review before being sent on to the insurer. Given my situation I would expect to receive average scores and an end to insurance and a return to work being expected - this is in line with my own expectations.
