Complex regional pain syndrome (CRPS) can develop after a seemingly minor workplace injury, surgery, or repetitive trauma. Because CRPS can cause severe, long-term pain and disability, injured workers often need extensive medical treatment and time away from work. Workers’ compensation may provide benefits to help cover these losses.

Can you receive workers’ compensation for CRPS?

Generally, yes. You may be able to receive workers’ compensation benefits if you developed CRPS after being injured while performing job-related duties. The key is showing that the condition is connected to your work-related injury.

In most cases, CRPS doesn’t appear on its own. It often develops after another work-related injury, like a crush injury, fracture, sprain, laceration, or even a surgery needed to treat the original injury.

When that happens, the CRPS is generally treated as part of the same workers’ compensation claim, since it grew out of a workplace injury. Keep in mind that every state has its own workers’ compensation laws and requirements. What qualifies as a compensable claim in one state may be handled differently in another, which is why it’s important to understand the rules that apply to you.

Important workers’ compensation rules to know

While the details vary from state to state, most workers’ compensation systems follow the same general rules, and missing one of them can jeopardize an otherwise valid CRPS claim.

No-fault system

Workers’ compensation is a no-fault system. You don’t have to prove your employer did anything wrong to receive benefits; you only have to show your injury is work-related. In exchange, however, you generally give up the right to sue your employer for the injury, and benefits are limited to categories set by law.

Reporting deadlines

Every state requires you to report a workplace injury to your employer within a certain window, often ranging from a few days to several months. For example, in California(opens in new tab), you generally have to report the injury to your employer within 30 days.

 

Waiting too long can give the insurer grounds to deny your claim entirely. With CRPS, this rule is especially important. Make sure you always report the original injury right away, even if it seems minor at the time, because symptoms may not develop until later.

Filing deadlines

Reporting your injury to your employer is not the same as filing a workers’ compensation claim. States also impose deadlines, often from one year to a few years, for formally filing or pursuing your workers’ compensation claim. Missing an applicable deadline can bar you from receiving benefits, no matter how strong your case is.

Authorized medical providers

Many states require you to treat with a doctor chosen or approved by your employer or its insurance company, at least initially. Seeing an unauthorized provider can result in unpaid bills or disputes over your treatment.

If you believe the company doctor is minimizing your symptoms, most states have procedures for requesting a change of physician or a second opinion, but you have to follow those procedures.

Understanding these rules and regulations is critical. Speak with a lawyer if you have any questions.

Workers’ compensation claims vs. CRPS personal injury lawsuits

Workers’ compensation and CRPS personal injury lawsuits are two different paths to compensation, and understanding the difference matters, especially in CRPS cases, where the losses can be enormous.

Fault

The biggest distinction is fault. Workers’ comp is a no-fault system, so you can get benefits even if no one was irresponsible and even if the accident was partly your fault. However, a personal injury case requires the injured person to prove that another person or entity is legally responsible for the injury. This could be from a careless driver, a property owner, or a manufacturer of defective equipment. The trade-off comes in what you can recover.

Types of compensation

Workers’ compensation benefits generally include medical treatment, a portion of your lost wages, and disability benefits. Notably, workers’ compensation does not pay for pain and suffering, which is a significant limitation for CRPS victims, whose pain is often the most devastating part of their condition.

 

A personal injury lawsuit allows you to pursue broader compensation, including lost wages, pain and suffering, emotional distress, and loss of enjoyment of life.

Third-party claims

While you generally cannot sue your employer, you may have a third-party claim if someone other than your employer contributed to your injury, such as a negligent driver who hit you while you were working, a subcontractor on a job site, or the maker of a defective tool or machine.

Because CRPS claims involve long-term, high-value losses, it’s worth having an attorney evaluate every available avenue of recovery, not just the workers’ compensation claim.

Workers’ compensation benefits available for CRPS

If your CRPS claim is accepted, workers’ compensation can provide several types of benefits. What you receive depends on your state’s laws and how severely the condition affects your ability to work.

Medical benefits

Workers’ compensation should cover all reasonable and necessary medical treatment related to your CRPS. For most workers, this is the most important benefit, because treating CRPS is expensive and ongoing. Covered care may include doctor visits, pain management, physical and occupational therapy, nerve blocks, spinal cord stimulators, medications, and mileage to and from appointments.

Temporary disability benefits

If CRPS prevents you from working while you heal, you can get temporary disability benefits to offset a percentage of your lost income (usually two-thirds of your average weekly earnings, up to a state-defined maximum). If you can work some, but make less than you used to, you may qualify for partial benefits to help make up the difference.

Permanent disability benefits

CRPS often does not totally resolve. A doctor will decide whether you have permanent limitations once you have reached maximum medical improvement (MMI), which is the stage at which your condition is not expected to improve any further.

If this is the case, then you may qualify for permanent partial or permanent total disability benefits, depending on how much CRPS limits your ability to work.

Vocational rehabilitation

Some states offer vocational rehabilitation benefits if CRPS prohibits you from returning to your prior job. These benefits may focus on retraining you, providing you with education, or helping you find a new job that considers your new physical limitations.

Reach out to The CRPS Law Firm today to schedule a free case consultation

Living with CRPS is challenging enough without having to fight an insurance provider for the benefits you deserve. Whether you’re just starting your workers’ compensation claim, dealing with a denial, or wondering if you also have a personal injury case, we can help. At The CRPS Law Firm, we have handled many CRPS claims, and we understand the medical and legal side of them. We know how to fight back when the insurance company tries to downplay your diagnosis. Contact The CRPS Law Firm today to schedule your free case evaluation.