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Winning Disability Benefits for Complex Regional Pain Syndrome (CRPS)

By David Brannen
Are the long-term symptoms of Complex Regional Pain Syndrome (CRPS) preventing you from doing your job?


You have already been suffering a long time from the symptoms of Complex Regional Pain Syndrome (CRPS), formerly known as Reflex Sympathetic Dystrophy (RSD), and want to learn more about gaining disability benefits.

Whether you have already started to apply for long-term disability benefits or are considering beginning the process, you probably already know that winning disability benefits is a real challenge. Although Complex Regional Pain Syndrome (CRPS) is a visible illness, you will nevertheless need to prepare well to win the benefits you deserve. If you do win, removing the financial burden from your shoulders will be worth it.

As a former occupational therapist and current disability benefits lawyer, I can help you avoid the extra pain of bureaucratic nightmares in preparing you for the application process for long-term disability benefits. If you are suffering from Complex Regional Pain Syndrome (CRPS) or Reflex Sympathetic Dystrophy (RSD) in Canada, I can help you take first steps towards securing the support that you are entitled to.

This article will highlight reminders during your diagnosis and treatment, types of disability benefits you might qualify for, specific challenges in preparing your claim for Complex Regional Pain Syndrome (CRPS), and final thoughts on approaching overall process and how to face denial of your claims. This article is part of our series examining medical conditions and disability benefits


Gaining a Well-Documented Diagnosis for Complex Regional Pain Syndrome

A successful doctor’s diagnosis of Complex Regional Pain Syndrome (CRPS) is no guarantee your disability claims will also be successful, but it is a great start. Be gradual and diligent in gaining your diagnosis. The clinical signs of Complex Regional Pain Syndrome (CRPS) must be well documented on your medical records as you approach the claims process.

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As you know, Complex Regional Pain Syndrome (CRPS) is a chronic pain usually affecting a limb, perhaps resulting from the after-effect of accident, illness, or injury. It is relatively uncommon and not clearly understood.

 

The root cause may be a result of your central and peripheral nervous systems not interacting properly and unusual inflammatory responses. No single test diagnoses it. Work carefully with your doctor and medical professionals to document all of the following as it applies to your case.

Symptoms (usually in your hand, arm, leg, or foot) might include throbbing or burning pain, cold or touch sensitivity, swelling, changes up and down in skin temperature, skin color alterations from red or blue to white and blotchy, skin texture changes, joint stiffness, muscle spasms or atrophy, changes in hair and nail growth, and decreased mobility. Advanced signs of Complex Regional Pain Syndrome (CRPS) include tissue wasting and muscle tightening, also known as atrophy and contracture.


A doctor’s diagnosis will be guided by a physical exam and your medical history. No single test guarantees diagnosis. However, bone scans, sympathetic nervous system tests, x-rays, and magnetic resonance imaging provide important clues.

You will ultimately have been diagnosed with Type 1 (this type occurs when an illness or injury does not damage the nerves in your limb) or Type 2 (includes distinct nerve injury).

It can be difficult to secure a diagnosis, get acknowledgment from your employer, or understanding from family and friends. But once you are properly diagnosed with Complex Regional Pain Syndrome (CRPS), you’ve taken a critical step toward winning your disability benefits. The next step is preparing a successful disability insurance claim. You’ve spent a long time fighting chronic pain and meeting with perhaps multiple doctors to gain the diagnosis—now it’s time to get the financial help you deserve.

You could be up against insurance companies willing to confuse your illness to avoid paying the benefits you paid for. Before I share details about insurance claims specifically related to Complex Regional Pain Syndrome (CRPS), you should be aware of which disability benefits you qualify for in general.

 

Determining Which Long-Term Disability Benefits You Qualify For


As a worker, you might be eligible for one of two types of disability benefits in Canada. These are the Canada Pension Plan (CPP) disability benefits and the long-term disability insurance benefits.


The Canada Pension Plan (CPP) for Complex Regional Pain Syndrome:

The CPP, designed to support you after retirement, also covers disability benefits that start once you become disabled and last until you are 65. After that, these disability benefits are converted into regular pensions. In order to be eligible for the CPP disability benefits, you have to have worked for four out of the past six years and paid payroll taxes. The CPP requires you to prove that your disability is both prolonged and severe, leaving you unable to work.
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Long-term disability insurance benefits for Complex Regional Pain Syndrome


Group disability insurance policies are the most common type of disability insurances in Canada. If your employer has insured you as part of a group, you are receiving your disability insurance through your job. These group disability insurance policies provide both long-term ad short-term disability benefits. If you are suffering from a Complex Regional Pain Syndrome (CRPS), you can apply for the long-term disability benefits if eligible. If successful, these will provide you with monthly income payments during long absences from work to ease the financial pressure weighing you down.

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Preparing to Apply for Long-Term Disability Benefits for Complex Regional Pain Syndrome


There are specific challenges in preparing your long-term disability benefits claim for Complex Regional Pain Syndrome (CRPS).

I’ve already described the steps you should take to gain a firm diagnosis for Complex Regional Pain Syndrome (CRPS). Remember, the CPP disability administration will not approve your CPP disability benefits just because a doctor diagnosed you with the condition. To win CPP disability benefits for Complex Regional Pain Syndrome (CRPS), the true challenge is to prove that your symptoms render you unable to function in any workplace while taking into account your age and work experience.

You will have to present a very well organized application that includes well-documented medical evidence. Here are the main points to consider for Complex Regional Pain Syndrome (CRPS). These will be expanded upon below.

  • Ensure your doctor and medical professionals identify and explain the link between Complex
  • Regional Pain Syndrome (CRPS) and any associated psychological or mental problems
  • Document limitations with sitting and standing
  • List requirements for assistive devices or mobility aids
  • Document the objectively visible signs of your condition
  • Explain that you have tried all recommended therapies and treatments without success
  • Explain the Link to Psychological or Mental Problems

 

It is is crucial to have doctors and other medical professionals identify and explain the link between your Complex Regional Pain Syndrome (CRPS) and any associated psychological or mental problems, including cognitive limitations, impaired attention and concentration, impaired short-term memory, reduced ability to attend to tasks, personality changes, depression, anxiety, and social withdrawal.


Document Sitting and Standing

It is critical to document any limitations with sitting and standing because the insurance companies will often argue that you can do sedentary or light work despite the fact that your pain has been diagnosed.

Assistive Devices or Mobility Aids

List any requirements you have as these will round out your case.

CRPS is visible

Unlike most types of chronic pain, Complex Regional Pain Syndrome (CRPS) is not invisible. This means the affected area or limb will have objective signs and symptoms of the condition. Dutifully document these.

Therapies and Treatments Have Had No Success

You must demonstrate you have done all the recommended therapy and treatments, and they have not worked.

For therapies, you may have tried applying heat and cold, topical analgesics, physical therapy, transcutaneous electrical nerve stimulation, biofeedback, and spinal cord stimulation. Document the failure of these therapies to improve or bring you to remission of Complex Regional Pain Syndrome (CRPS).

From a medication perspective, you may have tried pain relievers, antidepressants and anticonvulsants, corticosteroids, bone loss medications, sympathetic nerve-blocking medication, and intravenous ketamine. Document the failure of these medications to help you.


Denied Disability Benefits for Complex Regional Pain Syndrome? What You Should Do Next

You’ve filled out the forms, and you’ve compiled as much evidence as you could—and yet, the letter you get politely denies you the right to disability benefits, effectively forcing you back to work.

This is a tough time, and I know that – I’ve seen it over and over again with my clients. You don’t know what you’ve done wrong, and a rejection can feel like an unjustified slap in the face. Being told your condition doesn’t warrant financial support to give you some space to breathe and focus on your recovery adds humiliation and frustration to the chronic pain. Having to force yourself back to work can have devastating consequences for your physical and mental health.


Still Feeling Unsure About Your Disability Claim? Sometimes a quick call with us can answer your concerns and help you move forward with confidence. Call us now at 888-732-0470 for a free consultation or click here to request a free consultation.

Tags: Disabling Medical Conditions

David Brannen
Founder & Managing Lawyer, Resolute Legal
As Resolute Legal's managing lawyer, David spends his days representing people with disability claims and overseeing other disability lawyers within the firm. David is a former occupational therapist and is one of the few lawyers in Canada who focus exclusively on disability-related claims. David is the author of A Beginner's Guide to Disability Insurance Claims in Canada and The Beginner's Guide to CPP Disability.

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