Can I Get Disability Coverage for Complex Regional Pain Syndrome – CRPS?

For more than two decades, Jason Newfield has represented claimants suffering from CRPS, as their claims are often denied because of the nature of this illness.  Previously identified by Reflex Sympathetic Dystrophy (RSD), this condition has complications with disability claims for many reasons.  Like Fibromyalgia (FM) and other diseases where pain is the primary symptom, long term disability insurance companies raise a red flag on claims for CRPS. They are seeking objective tests, lab tests or diagnostic imaging that proves the person is suffering from pain from a visible condition – even where the condition like CRPS will often not be visible.

What is CRPS?

Like FM, CRPS is a chronic pain disorder causing severe pain and is considered to have a mechanism of action involving dysfunction of the sympathetic nervous system. CPRS is a chronic pain disorder where severe pain occurs at a specific site after trauma, or sometimes without explanation. There may be changes to the skin or feelings of extreme heat or extreme cold. While CPRS usually occurs after an injury or surgery, sometimes it occurs without any tissue damage. CPRS is more intense than FM, marked by burning, aching pain, exhaustion and pain localized at the injury. It can be extremely debilitating to suffer from and can make life unpredictable.

According to the National Institute of Health’s National Institute of Neurological Disorders and Stroke, CRPS can be severe in nature and prevent a person from working or doing their normal activities. Cancer patients who have had chemotherapy  or those with diabetes with CRPS find recovery especially difficult. The compromised ability to engage in activity will typically result in disability.  

How Can I Protect My Disability Claim if I have CRPS?

Proving disability due to CRPS to a long term disability insurance company is not an easy task to accomplish on your own.  The symptoms suffered are typically considered subjective, and often dismissed as to severity, so you will need to have specific medical tests that indicate your condition and support the functional deficits. Also, CRPS is not as common as Fibromyalgia, so the insurance claims representative might honestly have little to no idea what to do with your claim if they have never seen one before – and the medical resources they rely upon (often nurses) likely are not familiar. 

If you suffer from CRPS, you know the physical symptoms are not the only challenge you face in trying to lead a normal life, including working. There are cognitive problems created by CRPS that will get in the way of focusing on work. You may also experience anxiety or clinical depression, not as a direct result of CRPS, but because this is a debilitating disease that impacts not just your ability to work, but your ability to enjoy your life. Extreme pain and fatigue is a constant battle to overcome, and this response is a frequent response to CRPS.  The ability to plan activities is often surrounding weather issues, which might impact one suffering from CRPS, and predictability of one’s condition is never able to be accomplished.  

An experienced long term disability attorney who has successfully represented CRPS claimants is your best resource if you are about to file a disability claim or have had your long term disability insurance claim denied or terminated. We encourage you to contact CRPS disability attorney Jason Newfield at 877-406-7883 to discuss your situation and learn about your options. 

Will I Be Able to Prove I Have CRPS to the Long Term Disability Insurance Company?

There are steps you can take to support your long term disability claim. The Newfield Law Group helps clients with preparing claims or appeals by making life easier for claimants and by providing the insurance company with the information needed to recognize disability. We are often told by insurance company representatives that our preparation of materials makes it easier for them to approve a claim. This is the advantage of working with an experienced disability insurance attorney.

We have seen cases where surveillance was utilized by the insurance company in an effort to try to undercut the credibility of the disability claimant, seeking to capture activities which were inconsistent with the claimed limitations.  

Understanding the Disease and its Treatment Will Help You Succeed on Your Disability Claim

To make a case for your disability insurance claim you’ll need diagnostic support and the involvement of your treating physician. Your doctor may wish to rule out any other conditions first, so you may need to undergo additional tests for related diseases. There are a few tests done to confirm CRPS, including a bone scan, MRI, nervous system tests and x-rays. 

The nerve tests measure the skin for temperature and blood flow comparing the affected limb with the unaffected limb. The MRI looks for changes in the tissue that are consistent with CRPS, and the bone scan and x-rays are used to see if bone structure has been impacted by CRPS. 

Once these tests have been completed and the diagnosis is clear, the next hurdle is to have a treatment plan and follow it. With any disability claim, having a disease or condition is not enough to successfully file a claim. The disability insurance company will also want to see that you are undergoing the appropriate medical treatment. Even in situations where there is no possibility of a cure, the disability claimant must demonstrate they are doing what they can to get better. 

Depending upon your diagnosis and etiology, your doctor may prescribe medication, including anti-inflammatory drugs, steroids, anti-seizure medication and pain medication. They also might prescribe a nerve block – an injection of an anesthetic into nerves to block the pain signals. This doesn’t cure CRPS, but it can make it easier to live with.

In some cases, surgical removal of the injured nerve may be recommended.

Your treatment will depend upon the severity of your CRPS, but the disability insurance company will be monitoring your claim even while benefits are being paid to ensure your compliance with your doctor’s treatment. If you stop going to appointments, it may signal to the disability insurance company that you have recovered and are no longer disabled, whether that is true or not.

One tactic used by long term disability insurance companies is to try to move your claim from one based on a physical illness –CRSP—to a mental illness claim. This is done because most long term disability insurance policies limit disability coverage for mental health claims to 24 months. 

This strategy could reduce the value of your disability benefit claim substantially and will require the representation of an experienced and aggressive long term disability insurance attorney. Your income is too important to try to manage this on your own.

Questions? Call Our Office Today at 877-406-7883

When you call Newfield Law Group, you will speak with an attorney who has more than two decades of experience in this highly focused area of the law and will be able to give you insight as to what you are up against and how you might fight back. Jason Newfield is straightforward with claimants, recognizing the need for clarity with compassion. We invite you to call today and learn more.  With so much at stake, it makes good sense to explore your options.