Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD) is a chronic pain syndrome that can occur after an injury, and its persistence is often significantly worse than the original injury. It is a difficult condition to diagnose and common for disability insurance companies to refute or deny as a compensable disability claim. The Social Security Administration, however, has published a guidance memorandum that describes the condition and offers instructive guidance to Social Security personnel, including administrative law judges, as to how disability claims involving CRPS should be assessed.
If an insurance company has denied your disability claim related to CRPS, you should not give up pursuing your claim. This disease can significantly affect your life for years to come, and you will need compensation to replace lost wages and medical bills. The insurance company should not treat your claim any differently than another claimant, and an attorney experienced in and knowledgeable about CRPS claims can assist you.
You may have been from doctor to doctor with no clear results except for the specialist who diagnosed you. One of those doctors may have been a so-called "independent" doctor who was hired by the insurance company to examine you after you submitted your claim, and whose conclusion stated to your insurance company that your injury was not serious and that you should be able to return to work.
The insurance company may have even sent you to a psychologist who claimed your symptoms were psychosomatic, stress-induced or otherwise "in your head" even though CRPS is a recognized medical condition.
Even though CRPS is not easy to diagnose since it cannot be seen on an x-ray or MRI and does not have a marker that appears on a blood test, a doctor experienced in treating CRPS can render an accurate diagnosis from the available symptoms and clues, including: discolored skin, sensitivity to touch, temperature variations between the areas affected and other areas of the body, swelling, or other characteristic findings.
Since CRPS Type I and II are rare but diagnosable, it is possible to receive permanent partial or total disability benefits related to CRPS but to win an appeal you will likely need legal assistance.
What you can do
- Gather medical and work history from before after the work-related injury
- Gather any injury reports you filed at work
- Follow any instructions from doctors
- Collect all test results and findings
An experienced attorney can challenge an unfair denial or litigate against the insurance company on your behalf and fight for a fair settlement. Your pain is real, and you deserve the compensation to which you are entitled.