Understanding Complex Regional Pain Syndrome and Workers’ Compensation Claims

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that typically affects one limb after an injury. It can result in debilitating pain and significant challenges for those who suffer from it, especially in the context of a workplace injury. If you have developed CRPS due to a work-related accident, navigating a workers’ compensation claim in Colorado can be particularly complex. Colorado laws govern workers’ compensation claims, including those for conditions like CRPS, which can be more difficult to diagnose and treat than other work-related injuries.

In this blog post, we’ll discuss what CRPS is, how it relates to workers’ compensation claims in Colorado, and the specific legal considerations for workers suffering from this condition. If you suffered a work injury, it’s important to give Boesen Law a call today to discuss your case. We offer free consultations and have helped secure large settlements for our clients in Colorado. 

What is Complex Regional Pain Syndrome (CRPS)?

Complex Regional Pain Syndrome (CRPS) is a chronic and progressive condition characterized by severe pain, swelling, and changes in the skin, often triggered by an injury. There are two types of CRPS:

• CRPS Type I (Reflex Sympathetic Dystrophy, or RSD): This type occurs without a direct injury to a nerve.
• CRPS Type II (Causalgia): This occurs after a distinct nerve injury.

The pain associated with CRPS is disproportionate to the initial injury and can lead to long-term physical impairments. Symptoms can include:

• Severe, burning pain in the affected area
• Swelling and stiffness in the joints
• Sensitivity to touch or temperature
• Changes in skin color or texture
• Loss of mobility or strength in the affected limb

CRPS typically affects the arms, legs, hands, or feet, and the symptoms can worsen over time. For workers who develop CRPS following a workplace accident, the condition can be disabling, limiting their ability to work or even function in daily life.

How CRPS Relates to Workers’ Compensation Claims

Workers’ compensation is designed to help employees who suffer injuries on the job by providing coverage for medical expenses, lost wages, and rehabilitation. However, conditions like CRPS present unique challenges in the workers’ compensation system due to their complex nature and difficulty in diagnosis. If you develop CRPS after a workplace injury, it’s essential to understand how to approach your claim.

Workplace Injuries That Can Trigger CRPS

CRPS is often triggered by a relatively minor injury, such as a sprain, fracture, or soft tissue injury. However, it can also result from more serious incidents, including:

• Falls at work
• Machinery accidents
• Car accidents while on the job
• Repetitive strain injuries

The key issue in a workers’ compensation claim is proving that the CRPS developed as a direct result of a workplace injury. This can be challenging since CRPS can take weeks or even months to manifest, and its symptoms are sometimes dismissed or misdiagnosed.

Challenges in Proving CRPS

Since CRPS is a complex condition that does not always show up on traditional imaging tests like X-rays or MRIs, proving that your condition is work-related can be more difficult than with a typical injury. Insurance companies may attempt to argue that CRPS is unrelated to your workplace injury or that it stems from a pre-existing condition.

To strengthen your claim:

• Document your symptoms thoroughly from the onset of your injury.
• Seek medical treatment from a doctor who is familiar with CRPS and its connection to work-related injuries.
• Obtain medical testimony from specialists, such as pain management physicians or neurologists, who can link your CRPS to your workplace injury.

It’s crucial to have a knowledgeable workers’ compensation attorney on your side who understands the medical complexities of CRPS and can advocate for your right to compensation.

Workers’ Compensation Laws in Colorado and CRPS

Colorado’s workers’ compensation system covers injuries and illnesses arising from the course of employment, including conditions like CRPS. However, there are specific legal considerations to be aware of when pursuing a claim for CRPS.

Filing a Workers’ Compensation Claim in Colorado

In Colorado, you must report a workplace injury to your employer within four days of the injury. Failure to do so can impact your ability to claim workers’ compensation benefits. While this reporting period applies to the initial injury that may lead to CRPS, it’s essential to continue updating your employer and the workers’ compensation insurer if new symptoms like CRPS arise later.

Once your injury is reported, your employer’s workers’ compensation insurer will be responsible for covering:

• Medical treatment related to the injury
• Temporary disability benefits if you’re unable to work while recovering
• Permanent disability benefits if the injury results in lasting impairment

Medical Benefits for CRPS

Under Colorado law, workers’ compensation covers medical expenses that are “reasonable and necessary” for treating a work-related injury. This includes treatments for CRPS, such as:

• Physical therapy
• Medications (such as pain relievers or nerve stabilizers)
• Nerve blocks or injections
• Psychological counseling (since CRPS can have mental health impacts)
• Surgical interventions in severe cases

However, because CRPS can be difficult to treat, insurers may challenge the necessity or cost of some treatments. Having detailed medical records and a treating physician who supports your diagnosis and treatment plan is crucial to receiving adequate medical benefits.

Temporary vs. Permanent Disability

CRPS can result in both temporary and permanent disabilities, depending on the severity of the condition. In Colorado, workers are entitled to temporary disability benefits if they are unable to work due to a workplace injury. These benefits typically cover two-thirds of your average weekly wage while you are recovering.

If CRPS leads to a long-term or permanent impairment, you may qualify for permanent partial disability (PPD) or permanent total disability (PTD) benefits. PPD applies if you can still work but suffer from permanent limitations, while PTD is reserved for cases where you are completely unable to return to any form of employment.

CRPS often falls under the category of permanent disability if it severely restricts your ability to perform work tasks or requires ongoing medical treatment.

Impairment Rating for CRPS

In Colorado, if your condition results in a permanent impairment, you will be given an impairment rating based on the American Medical Association (AMA) guidelines. This rating determines the amount of compensation you are entitled to for a permanent disability. Since CRPS can affect multiple body systems, determining an accurate impairment rating can be complicated and may require input from multiple medical professionals.

If you disagree with the impairment rating assigned by your employer’s workers’ compensation insurer, you have the right to request an independent medical examination (IME) to obtain a second opinion.

Legal Considerations and the Role of a Workers’ Compensation Attorney

CRPS cases can be particularly contentious in workers’ compensation claims due to the condition’s elusive nature and long-term effects. Insurance companies may attempt to minimize the extent of your disability or dispute whether CRPS is directly related to your workplace injury. This is where having an experienced workers’ compensation attorney becomes essential.

Building a Strong Case

A workers’ compensation attorney will help you gather the medical evidence needed to prove that your CRPS is work-related and that it warrants appropriate compensation. This includes working with medical experts, gathering documentation of your treatment, and advocating for a fair impairment rating.

Negotiating for Maximum Compensation

Because CRPS can lead to significant long-term medical costs and disability, it’s important not to rush into accepting a settlement offer. A Denver personal injury law firm can negotiate with the insurance company to ensure that any settlement covers future medical expenses, lost wages, and disability compensation, protecting your financial stability in the long term.

Next Steps if Your Claim is Denied 

If your workers’ compensation claim is denied or you receive inadequate benefits, your attorney can help you file an appeal and represent you in front of the Colorado Division of Workers’ Compensation to ensure your rights are upheld.

In Conclusion

Complex Regional Pain Syndrome (CRPS) can have life-altering effects on workers who suffer from it as a result of a workplace injury. In Colorado, navigating the workers’ compensation system for conditions like CRPS requires an understanding of the medical, legal, and procedural complexities involved. If you’ve been diagnosed with CRPS after a work-related injury, it’s critical to consult with our workers’ compensation attorney, Jon Boesen, who can guide you through the process and help you secure the benefits and compensation you deserve. With proper legal support from Boesen Law, you can ensure that your rights are protected and that you receive the medical care and financial assistance necessary to manage this challenging condition.