Complex Regional Pain Syndrome and Long-Term Disability Benefits in Canada

Living with Complex Regional Pain Syndrome (CRPS) can be debilitating, affecting various aspects of daily life and work. For individuals facing challenges in managing CRPS symptoms and maintaining employment, accessing long-term disability (LTD) benefits can provide crucial financial support.

Understanding Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition characterized by severe and persistent pain in one limb, often triggered by trauma or injury. CRPS can lead to sensory changes, swelling, motor dysfunction, and autonomic disturbances in the affected limb, significantly impacting mobility, function, and quality of life.

CRPS can present a range of symptoms that may significantly impact an individual’s ability to work. These symptoms can vary in severity and duration from person to person. Here are some common CRPS symptoms that can make it challenging for someone to work at their job:

Chronic Pain:

Persistent and severe pain is a hallmark symptom of CRPS. The pain is often described as burning, stabbing, throbbing, or shooting in nature. It can be constant or fluctuate in intensity, making it difficult to focus on tasks or perform physical activities required for work.

Sensory Changes:

CRPS can cause abnormal sensations such as hypersensitivity to touch (allodynia), where even light touch or pressure on the affected limb can cause extreme pain. Additionally, individuals may experience tingling, numbness, or a “pins and needles” sensation.

Motor Dysfunction:

CRPS may lead to motor disturbances in the affected limb, such as weakness, muscle spasms, tremors, and difficulty coordinating movements. These motor symptoms can interfere with tasks requiring fine motor skills, strength, or dexterity.

Swelling and Changes in Skin Temperature/Color:

The affected limb may show signs of swelling, changes in skin temperature (warmer or cooler than the unaffected limb), and changes in skin color (redness or mottling). These physical changes can affect mobility and make it challenging to use the limb effectively.

Limited Range of Motion:

Stiffness, joint contractures, and decreased flexibility in the affected limb can limit range of motion, making it difficult to perform tasks that require reaching, grasping, or moving the limb in specific ways.

Fatigue and Weakness:

Chronic pain and the physical demands of CRPS can lead to fatigue, lack of energy, and generalized weakness. Fatigue can impact cognitive functioning, concentration, and the ability to sustain activities over time.

Emotional and Mental Health Impact:

Dealing with chronic pain, functional limitations, and uncertainty about the future can contribute to emotional distress, anxiety, depression, mood swings, and difficulty coping with work-related stressors. Mental health symptoms can further affect work performance and productivity.

Sleep Disturbances:

Many individuals with CRPS experience sleep disturbances, including difficulty falling asleep, staying asleep, or obtaining restorative sleep. Poor sleep quality can exacerbate pain, fatigue, and cognitive difficulties during working hours.

Cognitive Impairments:

Some individuals with CRPS may experience cognitive impairments such as difficulty concentrating, memory problems (short-term or long-term), brain fog, and slowed processing speed. These cognitive challenges can impact productivity, decision-making, and multitasking at work.

Functional Limitations:

Overall, the combination of pain, sensory changes, motor dysfunction, fatigue, cognitive impairments, and emotional distress can lead to significant functional limitations that make it hard to perform job duties, meet deadlines, maintain regular attendance, and participate in work-related activities effectively.

Complex Regional Pain Syndrome and Long-Term Disability

When CRPS symptoms become severe and disabling, individuals may be eligible for long-term disability (LTD) benefits. LTD benefits offer financial assistance to individuals unable to work due to the debilitating effects of CRPS, allowing them to focus on treatment, rehabilitation, and improving overall well-being.

Does Long-Term Disability Cover Complex Regional Pain Syndrome?

Most LTD insurance policies in Canada cover disabilities resulting from chronic pain conditions such as CRPS. However, coverage eligibility depends on policy terms, medical evidence documenting the severity of CRPS symptoms, functional limitations, and their impact on the ability to perform essential job duties.

Complex Regional Pain Syndrome Disability Benefits

To support a disability insurance claim for CRPS, comprehensive medical documentation is essential. This documentation may include medical records, specialist evaluations (pain management, neurology), diagnostic tests (imaging studies, nerve conduction tests), treatment history, functional assessments, and statements from healthcare providers detailing CRPS-related impairments and limitations.

Can My Disability Benefits Be Denied?

Insurance companies may deny disability benefits for CRPS-related disabilities due to various reasons such as insufficient medical evidence, policy exclusions, or administrative issues.

After two years on a LTD policy, you will be subject to a “change of definition” clause.

Own Occupation

For the first two years, you are subject to the “own occupation” definition, which considers the insured person disabled if they are unable to perform the substantial and material duties of their own occupation.

Any Occupation

After that first two-year period is over, insured people then have to meet the “any occupation” definition of disability, which considers the insured person disabled if they are unable to perform the substantial and material duties of any gainful occupation for which they are reasonably suited by education, training, or experience.

If benefits are denied, individuals have the right to appeal the decision, provide additional supportive evidence, and seek legal assistance to strengthen their case.

What To Do If My LTD Benefits Have Been Denied?

If LTD benefits for CRPS are denied, it is crucial to seek legal representation from an LTD disability lawyer experienced in handling chronic pain and complex disability claims. A disability lawyer can review the case, gather necessary medical and legal evidence, navigate the appeals process, challenge denials based on policy violations or unfair practices, and advocate for the benefits individuals deserve.

Contact Our Long-Term Disability Lawyers For Legal Help If You Have Complex Regional Pain Syndrome

Navigating LTD claims for CRPS can be complex, especially when facing denials or challenges from insurance companies. Our long-term disability lawyers understand the legal complexities, protect individuals’ rights, ensure fair treatment, and help secure the disability benefits needed for financial stability during challenging times of CRPS-related disability. Get started with your free consultation today.