Social Security Disability Benefits And CRPS

This can be a complicated issue. We will share some information here that we hope will aid you in your efforts to understand obtaining SSD benefits.

THE SOCIAL SECURITY ADMINISTRATION has passed a RULING specifically for REFLEX SYMPATHETIC DYSTROPHY SYNDROME, also known as Complex Regional Pain Syndrome. In your paperwork you may have to use both terms as not all people involved in the process may be familiar with the new terminology (CRPS).

RULING SUMMARY 

Titles II and XVI: Evaluating Cases Involving Reflex Sympathetic Dystrophy Syndrome/Complex Regional Pain Syndrome

Purpose:

To explain the policies of the Social Security Administration for developing and evaluating title II and title XVI claims for disability on the basis of Reflex Sympathetic Dystrophy Syndrome (RSDS), also frequently known as Complex Regional Pain Syndrome, Type I (CRPS). These terms are synonymous and are used to describe a unique clinical syndrome that may develop following trauma. This syndrome is characterized by complaints of intense pain and typically includes signs of autonomic dysfunction.

This is a long and involved Ruling. To read this information in its’ entirety, click on the link;

Applying for SSD benefits is a long and complicated process for many. Most people will get turned down on their first application. Do you need to get a lawyer involved? Most lawyers will offer a consult for no charge. We do have a link to an excellent article that discusses FINDING AN RSD LAWYER, BY KIT BELT

STEPS IN OBTAINING SSDI
FROM PEDERSON RESEARCH

“This outline in no way guarantees that you will receive benefits. It’s purpose is purely to assist you in narrowing the odds. People, and even attorneys will tell you it’s next to impossible to get disability from a Fibromyalgia Diagnosis, (or RSD or many other pain diseases). I and many others through out the country are living proof to the contrary. The following is a compilation of what we have learned on our own and what we have learned from others who have traveled the same path.

NOTE – Remember – Your Doctor will now probably classify you as having CRPS Type I or Type II instead of RSDS but the same Ruling still applies; to see the explanation of the differences between RSD, CRPS Type I, Type II, etc. see CRPS DEFINITIONS

First, you should compile all the documentation you have on your illness. Arrange everything chronologically; doctor visits, sick leave episodes, diagnoses, etc. Make at least four copies of everything:

1. for you,
2. your attorney,
3. Social Security,
4. Your employer.

It is good to have all your ducks in a row before you go to the Social Security Office because they will ask for this information anyway. Continue to document everything. A daily Pain diary would also be a good idea.

At the SS Office, you will have to fill out a number of papers pertaining to your illness; mostly history. You will also be required to sign doctors releases so that they can access your records. ( you can have these forms mailed to you to fill out at home where you can take your time and/or have someone else help you).

You must undergo twelve months of unemployment due to illness before receiving benefits, so, if possible, it is best to start this process as quickly as possible once you and/or your doctor have decided you cannot work. You CANNOT work at all during this twelve month period or the process will have to start again from the beginning.

The Social Security Office has very stringent guidelines, especially during the first two steps. Most people, no matter what the illness, fail the first two steps. Most cases are won at the third step, or the Administrative Law Judge stage. There you will be given the opportunity to state your situation in person. That alone can have an impact on the outcome. Don’t be dismayed to learn you have to wait many, many months between each step of this process. It is a very long one, possibly taking a year or more from the time you apply to the time you start receiving benefits. In the long run it will be worth it. 

Do you have a close friend or family member who can help you? This is very important. This is a very stressful time and you really need the support of those close to you. Also, this person could be an important asset if your case comes to a hearing, particularly if he/she has known you since before the onset of your illness. Your illness has an effect on everyone who is close to you. They suffer with you and can testify to the impact it has had not only on you but also your close family and relationships.

In addition, when you go to an A.L.J. (Judge) do not try to put on the same act you do for your freinds and loved ones, where you try and hide the real depth of your pain. In other words let the real pain show through.

How familiar is your doctor with FMS (RSD etc.) ? It is important that you see at least one doctor who is familiar with your condition. Multiple diagnoses’ would offer confirmation. Your employer and possibly SS may require additional exams from their doctors. (These are called IME’s or Independent Medical Exams).

You must understand that the way SS looks at your illness differs from the way you, and even your doctor, look at it. SS is most interested in the facts of your case. Pain, though it is real to you, really does not enter into the equation, (unless you have had a McGill Pain Rating done). They are most interested in the following:

Your mobility or the lack of it, inability to do repetitive motions/actions. Without pain … how long can you stand, how long can you sit, how far can you walk, how much can you lift, how far can you carry, and how much can you carry? How much has your illness affected your concentration and dexterity, what medications are you taking and how do they inhibit your ability to work, do you have any secondary illnesses that may complicate your condition? Do you suffer from Insomnia, are you sensitive to noise, touch, light, and sound? How has this affected your ability to work, (be VERY specific). When you describe your illness, consider your worst day, but don’t lie. Always be truthful.

Don’t take it for granted that your attorney, or the Judge, is familiar with your condition. Make it a point to do the research and provide them with the proper information needed to help understand and decide your case. This affects your future and not his, so if your initiative offends him, tough!

If he is not willing to cooperate, get a different attorney. His fees are set by the state and are a percentage (usually 25%) of the back pay you will have coming following your settlement.”

Remember each time you file your papers, include a pamphlet and/or article that explains what RSDS is. Don’t assume those who have anything to do with your application even know what the initials stand for. Help them as much as possible to see your point!

You can visit the governments website for Social Security Disability for more information. 

IDC 10 CODES FOR CRPS – If you need the IDC 10 Codes for your SSD Application, the International Disease Codes for CRPS, you can click here.  We also list the IDC 9 Codes for RSDS there as well.