The Challenges of Disability Claims for CRPS Injuries: A Guide for Patients

Complex Regional Pain Syndrome (CRPS) is a painful condition that can make everyday life hard. If you have CRPS injuries and need to apply for disability benefits, the process can be confusing. This article will help you understand the steps to take and how to improve your chances of getting the necessary benefits.

What Is Complex Regional Pain Syndrome (CRPS)?

CRPS (complex regional pain syndrome) is usually a life-altering condition, characterized by chronic, severe pain and commonly accompanied by other symptoms such as swelling and changes in the skin. CRPS is a long-lasting pain condition that usually affects a limb, like an arm or leg, after an injury or surgery. Until the 1990s, cases were often known as reflex sympathetic dystrophy or reflex sympathetic dystrophy syndrome (RSD or RSDS). The International Association for the Study of Pain (IASP) helped lead a name change in these cases, to complex regional pain syndrome (CRPS), in conjunction with the publication of diagnostic criteria for CRPS in 1993. CRPS has been around for a long time, first diagnosed in the American Civil War. The condition is often precipitated by some form of trauma, typically of a seemingly minor nature in comparison to the problems that follow.

Illustration depicting the challenges of CRPS injuries and disability claims. A man with visible arm discomfort reviews medical documents at a desk, surrounded by supportive figures including a doctor, family member, and lawyer. The image includes visual representations of CRPS symptoms, nervous system diagrams, and pain scales. Icons symbolizing various aspects of CRPS float around the central figure.

Doctors believe CRPS happens because the nervous system isn’t working right.  Essentially, a feedback loop in a nerve doesn’t stop, even after the original injury has healed. Knowing about CRPS is important because it can seriously affect how you live your life, making it hard to do even simple things. CRPS pain is considered the most painful kind a person can experience, even worse than childbirth. That, coupled with the chronic pain it causes, is why CRPS is sometimes called the suicide disease. 

What Are the Signs and Symptoms of CRPS?

Symptoms of complex regional pain include spontaneous pain, often described as a burning or shooting pain, at times reaching unbearable levels.

Although the pain usually appears near the area of an injury, the extent of pain typically seems excessive compared to the level of any apparent tissue damage in the area of the pain. Symptoms include pain accompanied by inflammation and swelling, tenderness, increasingly brittle nails, changes in skin color and temperature, and increased sweating and hair growth in the specifically affected extremity.

In some cases, the pain is repeatedly triggered by a light touch of soft clothing or even a breeze brushing across the skin. A decrease in the range of motion of an affected extremity and atrophy of the extremity can result, along with severe osteoporosis and thickening of joints. CRPS can also affect blood flow.

These symptoms can worsen over time, making it harder to move the affected limb. CRPS is a pain disorder that is characterized by severe pain that is unrelenting and feels like a constant burning. CRPS usually starts in the hand or foot and can spread which makes treatment very difficult.

What are the causes of CRPS?

Complex Regional Pain Syndrome occurs as a result of an injury like a wrist fracture. While CRPS usually follows an injury, some cases report that you can develop CRPS from a sprain or injection. Doctors don’t fully understand why CRPS occurs in some people but not others. The initial injury for two of our clients was a fall that broke their arm. The onset of CRPS may occur while the original injury is healing but not be noticed until the time passed for the original injury has elapsed. CRPS is a central nervous system injury, because the signal from the nerve to the brain, running along the spinal cord, doesn’t turn off. One good indication that this is a brain injury is that even after amputating a limb, the CRPS condition continues.

The diagnosis of CRPS is often done by exclusion – ruling out other issues but new methods like a bone scan are being used.

What are the treatment options?

Because CRPS can spread, treating CRPS is very difficult and limited. Pain management is the most common type of treatment and is usually heavy narcotics. Occupational therapy and physical therapy are considered the cornerstone of treatment to help reduce pain and nerve issues. A lumbar sympathetic nerve block, which is an injection into the lower back, may help with pain relief in the legs and feet.

Although doctors may routinely tell patients in pain that their condition will improve, CRPS is permanent in the majority of patients. The pain may subside for periods of time, but these are simply periods of remission. Any further trauma (including minor surgery or less) can cause a recurrence of pain that is worse than before.

How Does CRPS Affect Daily Life?

Living with CRPS can be very tough. The pain can be so severe that it makes it hard to do everyday activities like walking, working, or even getting dressed. Many people with CRPS also feel anxious, depressed, or isolated. Because CRPS can make life so difficult, many people with the condition seek disability benefits.

Key Steps in Filing a Disability Claim for CRPS

What Documentation Do You Need to Support Your Claim?

When filing a disability claim for CRPS, having the right documents is very important. You will need medical records that show your diagnosis, treatment, and how CRPS affects your daily life. Your doctor should write detailed notes about your symptoms and how treatments have worked. Keeping a diary of your pain can also help show how serious your condition is.

How Do You Know If You Qualify for Disability Benefits?

To get disability benefits for CRPS, you need to show that your condition makes it hard to work. The Social Security Administration (SSA) has strict rules for who qualifies, so it’s important to have clear proof that CRPS limits what you can do. This includes how CRPS affects your ability to work and do daily activities.

What Forms Do You Need to Fill Out?

To apply for disability benefits, you will need to fill out forms like the Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) application. These forms ask for detailed information about your medical condition, work history, and how CRPS affects your life. Be sure to give complete and accurate answers to avoid delays.

How Can You Strengthen Your Disability Claim for CRPS?

Why Is Medical Evidence Important for Your Claim?

Medical evidence is the most important part of your disability claim for CRPS. Your medical records should clearly show your diagnosis, your symptoms, and how CRPS affects your life. Visiting your doctor regularly and following their treatment plan is important for building a strong case. The better your medical evidence, the better your chances of getting your claim approved.

How Can Personal Statements and Testimonies Help?

Personal statements and testimonies can also help your disability claim. These can come from you, your family, friends, or coworkers who have seen how CRPS affects your life. These statements help explain your situation in more detail and can make your case stronger.

What Can You Do If Your Claim Is Denied?

If your disability claim for CRPS is denied, don’t give up. Many claims are denied the first time. You can appeal the decision and provide more evidence or explanations to support your case. It may also help to talk to a disability lawyer who knows about CRPS claims. They can guide you through the appeals process and improve your chances of success.

Challenges of Filing a Disability Claim for CRPS

What Misunderstandings Exist About CRPS and Disability Claims?

One big challenge in the CRPS claims process is that many people don’t understand the condition. Because CRPS is complex and not very common, some people reviewing your claim might not realize how serious it is. They might think the pain is exaggerated or that it’s not severe enough for disability benefits. It’s important to clearly explain how CRPS affects your life.

How Does the Complexity of CRPS Affect Your Claim?

The complexity of CRPS can make it harder to get your disability claim approved. Because the condition is hard to understand, it can be difficult to prove that it limits your ability to work. This is why detailed medical evidence and personal testimonies are so important. The more you can show how CRPS impacts your life, the better your chances of getting approved.

What Emotional Barriers Can Make Claiming Disability Difficult?

The emotional challenges of living with CRPS can also make it hard to claim disability. Some people feel ashamed or guilty about asking for disability benefits. Others might feel overwhelmed by the complicated claims process. Remember, applying for disability benefits is your right, and there’s no shame in needing help. Getting support from family, friends, or advocacy groups can make the process easier.

How Can Support Systems Help with the Claims Process?

What Resources Are Available for CRPS Patients?

There are many resources available to help CRPS patients with the claims process. Advocacy groups, legal resources, and online communities can offer valuable information and support. Connecting with others who understand what you’re going through can help you navigate the process and feel less alone.

How Can Family and Friends Support You?

Family and friends can be a big help during the disability claims process. They can assist with gathering documents, filling out forms, and providing emotional support when you’re feeling stressed. A strong support system can make the process easier and help you stay focused on getting the benefits you need.

Are There Advocacy Groups or Legal Resources You Can Turn To?

If you’re having trouble with the claims process, there is help available. Advocacy groups and legal resources can support you. They can give you advice, connect you with disability lawyers, and offer emotional support. Reaching out to these resources can increase your chances of success.

What Should You Expect After Filing Your Claim for CRPS?

How Long Does the Claims Process Take?

The disability claims process can take a long time, often several months or even years. Patience is important during this time. Stay in touch with your case manager and provide any extra information they ask for. While you wait, keep gathering evidence and documenting your symptoms and treatments.

What Happens During the Review Process?

After you submit your claim, it will be reviewed by the SSA. They will look at your medical evidence and decide if you qualify for disability benefits. This might include consultations with doctors, requests for more information, and possibly a hearing. Staying organized and responding quickly to requests can help your claim go smoothly.

What Are the Possible Outcomes of Your Claim?

After your claim is reviewed, there are a few possible outcomes. Your claim might be approved, and you’ll start getting disability benefits. If your claim is denied, you can appeal the decision. Some claims are partially approved, meaning you get some benefits but not everything you asked for. Knowing what to expect can help you prepare for the next steps.

Conclusion: Key Takeaways for CRPS Patients Navigating Disability Claims

Final Tips to Make the Process Easier

Navigating the disability claims process for CRPS can be tough, but it’s possible to get the benefits you need. Keep good records, ask for help from family and friends, and consider talking to a disability lawyer if you run into problems. Being patient and persistent is key to getting through the process.

Where to Find More Information and Support

For more information and support, reach out to CRPS advocacy groups, online forums, and legal resources. These organizations can provide guidance and connect you with others who understand what you’re going through. Using these resources can make the process less overwhelming and help you succeed in getting your disability claim approved.

In summary, while the disability claims process for CRPS injuries can be difficult, understanding the steps involved and getting the right support can greatly increase your chances of success. Stay informed, stay organized, and don’t be afraid to ask for help when you need it.

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