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How to Apply for Disability Benefits with Complex Regional Pain Syndrome

by Ken Taylor

How to Apply for Disability Benefits with Complex Regional Pain Syndrome

 

While Complex Regional Pain Syndrome (CRPS) can be debilitating and prevent you from working, particularly when not diagnosed quickly. The SSA currently does not recognize CRPS in its manual of conditions that qualify for disability. That does not however mean that you cannot get Social Security Disability (SSD) benefits if your CRPS is so severe that it prevents you from working.

Qualifying Medically for SSD with CRPS

Proving disability with a chronic pain disorder can be challenging, but it is possible to be approved for disability benefits based on CRPS. The SSA typically requires extensive medical evidence to gain disability benefits, and a diagnosis of CRPS will require you have very specific evidence to support your claim for benefits.

The SSA will first need to establish that you have a “medically determinable impairment”. This simply means that the SSA needs to see medical evidence that clearly establishes an unbiased diagnosis of CRPS from a reputable, licensed physician. That evidence may include medical records that report the physical findings of any or all of the following symptoms that are often seen in CRPS:

  1. Changes in texture, temperature, or color of your skin in the affected region
  2. Swelling in the muscles in the affected area
  3. Abnormal nail or hair growth
  4. An increase in sweating, particularly in the sweat glands in the affected area

CRPS sometimes occurs after an injury or illness, especially those that include muscle or bone injuries. A preceding injury, if one exists in your case, must also be well documented in your medical record and should be reported by your treating physician as the precursory event.

CRPS can also cause osteoporosis for some patients. If this is true for you, your medical records must also include:

  1. a thorough clinical history related to your osteoporosis
  2. imaging scan results documenting the extent of the bone loss and any advancement of the condition.

There are two types of CRPS:

  1. Type I – Reflex Sympathetic Dystrophy (RSD)
  2. Type II – which was formally known as causalgia, but is now known simply as CRPS

The SSA considers both in the same manner, but CRPS is actually easier to prove, as it usually involves the presence of one or more nerve lesions that can be documented as a medically determinable cause of pain symptoms.

Pain symptoms of CRPS are the most debilitating part of the disease, and the SSA will evaluate those symptoms. However, physically apparent symptoms, like muscle wasting as well as those listed above, are crucial to being approved for benefits.

For more information on medically qualifying for disability benefits with CRPS, visit: http://www.disability-benefits-help.org/disabling-conditions/complex-regional-pain-syndrome

How to Prove Disability with CRPS

After the SSA establishes that you have a medically determinable impairment, they must assess the level of severity of your CRPS. Essentially, they need to see that your CRPS is so limiting that it prevents you from working. A residual functional capacity (RFC) evaluation is how this determination is made.

RFC looks at all your qualifications and balances those against the limitations your CRPS imposes on you. This give the SSA the ability to see if you are able to perform job related activities.

How to Financially Qualify for SSD

Two SSD benefits are potentially available to you: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Both have financial eligibility requirements of which you must be aware:

  1. For SSI, you must have very limited financial resources, including income and assets.
  2. For SSDI, you must have worked and paid Social Security taxes.

You can learn more about the different disability programs here: http://www.ssa.gov/disability/

How to Apply

When you apply for benefits, you will be considered for both SSDI and SSI. Your application will require you to provide:

  1. detailed medical information,
  2. financial data,
  3. and work and education history details.

You should submit your medical records when you apply or not long after, and make sure your records and the details you provide on the SSA’s application forms match up.

Online application via the SSA’s website is usually the fastest method to apply, but you can also apply in person at your local SSA office with an appointment. You can file an online application here: http://www.ssa.gov/pgm/disability.htm

 

Article by Ram Meyyappan
Social Security Disability Help

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8 comments

brianna April 14, 2014 - 11:58 am

i am 18 and i have been diagnosed with crps and i need to find doctors that are willing to do stuff for me and i think its going to the other leg does anyone have any advise

Sarina Bachna July 27, 2016 - 3:46 am

I fell 11-12′ 2 yrs ago. I was bed ridden for 7months with a shattered foot that has 18 screws four plates and cadavier bone in much of foot and heal. My arm has plaster bone in it and have hematomia in my face. I have triminal neuragia and complex regional pain sydrome. This has completelt changed my entire life. Ive missedmuch of my 13 yr old sons life in last two yrs. Had to get a lawyer for ssi/ssdi. They denied me four times. Ive had barely any income. Child support which is 160.00 month plus food card. Worked all my life two jobs. Now bed riddenmore than not. Pain gets so intense that i blackout. Ive gotten burns on my arm from blacking out while trying to.make dinner…always bruised up…when pain gets that intense its hard to even think,see,hear hurts so much…painmeds dont help at all, had four spinal injections they did nothing, had to infusions made my head loopy for few hours but didnt touch pain in foot or legs. Im truely struggling and haveno clue what to do next

Delishia December 13, 2016 - 8:59 am

Hi Sarina my name is Delishia and finally i found someone who was going through something like me. I had ligament surgery on my ankle June 13, 2016 and now I’m told I have CRPS. I lost my job because I no longer could perform my duties. Been trying to get long term disability but they giving me the run arond. I have no money and I have a 15 year old son. I’m going to 5 doctors with no luck. No one can tell me nothing so therefore I;m major depressed. I can relate to you about the pain. If you don’t mind I would love to keep in contact

christine July 25, 2015 - 11:42 am

I have a major mass in my chest and pressing on nerves causeing pain in my left shoulder neck and arm sumtimes numbness. They are still figuring out what it is and half of its gone from a biopsy can I qaulify for ssi if the nerves were permantly damaged.

Ann December 15, 2015 - 8:57 pm

I was diagnosed with behcets syndrome. I get fevers, ulcers, in mouth, on tongue, ulcers in throat, ulcers on, vaginal, I get inflamed ulcers inside my stomach lower part of stomach by vaginal area, I’m taking prenizone that is not helping making my bones week, pain ease spray to spray ulcers. Temp relief until I need to urinate. Lidocaine For ulcers for vaginal area. Had a biopsy in 2010. I can not continue to work. I’m always in pain! I’m also taking calazapam, & catilapram for my depression, & axiety. I applied for SSA. Can anyone tell me if they are going through, or have gone through the SSA application process ,& was approved, or denied please respond. Sincerely, Ann Marie Witting-Gonzalez babya1973ag@gmail.com

Daniel January 3, 2017 - 8:41 am

Makes sure to gather all the evidence of your back conditions and prove to the SSA that you do qualify for benefits . As conditions winning disability benefits is a complicated process.

Jenna February 4, 2017 - 6:13 am

I just want to let people know… there is hope. They are finally starting to approve Ssdi for crps. My case was quick. I filled out the application in March and got approved in August. I didn’t get a denial at all, was not forced to see one of their doctors. It was a very easy process. I hope that your process is as smooth.

Document… document… document. Make sure your doctors do as well. Even if it is the same issues, document it again and again. I have had a wonderful team of doctors that I’m sure made the process easier. This is an absolutely horrible condition, sometimes makes life feel less than worth it to continue fighting. But never loose hope. Sometimes that’s all you have left.

Elizabeth March 15, 2017 - 6:30 am

I am currently waiting to schedule the stellace ganglion block injection to hopefully give me some relief and/or help to diagnose something! April of last year (2016) i ended up getting the full, and ever since then i have had such severe pain in both my (started off just in the fingers and hands-went to school for/trained and was working within my field/with my hands) now up to my elbows in both arms. I have been cleared by a neurologist and rhuemetologist. Between the pain management specialist and my pt they are leaning towards CRPS and to get a second opinion on a neurologist. Regardless I havent been able to work since september of 2016. Had to get on medicaid and have been living off the last of my saving for the past six months as the pain increases. Any advice on applying?? even though ive been cleared by a few specialists?
I want to work and am sick of being in pain and unable to properly use my fine motor skills.

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