Question to the Ministry of Defence:

To ask the Secretary of State for Defence, pursuant to the Answer of 1 December 2023 to Question 3438 on Armed Forces Compensation Scheme: Pain, whether the tariff system within the Armed Forces Compensation Scheme allows for a separate award to be made for (a) chronic neuropathic pain, (b) chronic secondary visceral pain, (c) chronic secondary musculoskeletal pain, (d) chronic secondary headache or orofacial pain, (e) chronic postsurgical or posttraumatic pain and (f) chronic cancer-related pain where the initial injury is attributable to service but is recognised as disproportional or no longer attached to that initial injury.

The terms primary and secondary chronic pain are reflected within a new approach to pain nomenclature introduced by the 2022 World Health Organisation disease classification system (International Classification of Diseases 11 (ICD 11)). ICD 11 is not yet in widespread use in routine UK clinical practice, nor referenced in the Armed Forces Compensation Scheme (AFCS) Order, which uses the extant ICD 10.

Dependent on case specific evidence, AFCS awards have been made for pain since the introduction of AFCS in 2005. Awards for all AFCS tariff descriptors include an element for pain and suffering. Where pain is reasonably controlled with treatment of the underlying condition and AFCS entitlement criteria for that condition are met, the award covers all pain and suffering i.e. a separate standalone chronic pain diagnosis is not recognised. If, despite appropriate treatment of the accepted condition, pain remains uncontrolled, and is claimed as a separate /additional claimed condition, an award may be paid dependent on case facts.

Separate awards for the categories of secondary pain listed a-f within the question may be made in line with this approach.