Reflex Sympathetic Dystrophy (RSDS), also known as Complex Regional Pain Syndrome,
Type I (CRPS)
RSD usually originates from some sort of trauma. It can be started by a sprain, muscle
pull, bruise, surgery, or other injury. For some reason the nervous system and immune system don't work properly and
send signals through the nervous system to the brain that you have constant pain. The pain is often times very severe.
The condition also sometimes spreads to other parts of the body. Some symptoms besides pain that may occur are loss
of hair, skin color change, swelling, sensitivity to cold or heat, sensitivity to touch, and may even result in decrease
range of motion or loss of use of an area. People who have this condition also often get depression as a result of dealing
with the symptoms and inability to find treatment that works. I also have found in the course of representing
RSD claims that the individuals who have the condition often contemplate suicide because of the great deal of pain involved.
So if you have the condition it would be a good idea to start seeing a psychiatrist as soon as you start to show signs
of being depressed. RSD is also most common in women.
There is not a listing for this medical condition
but one can argue that they equal one of the other
listings. In a Social Security Disability or SSI claim it is the limitations caused by Reflex Sympathetic Dystrophy Syndrome
that shows one is disabled. Some limitations that are shown in these types of cases are loss of use of extremities,
pain causing inability to focus, trouble walking or standing long, and limitations resulting from the subsequent depression.
With this conditions the number of possible limitations is enormous. The important thing to remember is that you should
be under constant medical treatment. You will need your doctors to state there opinions of your limitations and it must
be backed up by proper diagnosis and treatment records. A detailed
physical RFC is a must and a
mental RFC if you also suffer from depression as a result of your RSD.
If you are looking for more information on
RSD click on this link.
How is RSD (CRPS) SSD SSI Disability Claim Handled?
In
Social Security Ruling 03-2p SSA recognizes several things about RSD. This ruling makes it clear that pain is the biggest symptom of this
condition and that this pain may interfere with a claimants ability to work by interfering with the claimant's ability to
maintain attention and concentration in a work setting and that the medications that treat RSDS may also cause side effects
that could interfere with an individual's ability to work. This ruling was developed to give a better understanding of how
RSD affects individuals and how these claims should be handled in a Social Security disability claim for RSDS. SSR 03-2p notes
establishment of the disease can be found by "persistent complaints of pain that are typically out of proportion to the
severity of any documented precipitant". The rule also states the claimant should have one if not more of the following
in the area affected: swelling, autonomic instability (changes in the skin such as color, texture or increase or decrease
and sweating, and skin temperature changes), nail or hair growth that is faster or slower than normal, osteoporosis, or involuntary
movements of the affected region of the initial injury. The rule also specifically addresses the effects of pain and medication
on individual with RSD and how a Social Security disability claim for CRPS should be handled. "Chronic pain in many of
the medications prescribed you treated may affect an individual's ability to maintain attention and concentration, as well
as adversely affect his or her cognition, mood, and behavior, and may even reduce motor reaction times. These factors can
interfere with an individual's ability to sustain work activity over time, or preclude sustain work activity altogether. When
evaluating duration and severity, as well as when evaluating RFC, the effects of chronic pain in the use of pain medications
must be carefully considered." SSR 03-2p also states "pain is expected symptom of the disorder" as well
as "extreme sensitivity to touch or pressure or abnormal sensation of heat or cold, can also be associated with this
disorder." If you have an SSD or SSI cases for reflex sympathetic dystrophy it is extremely important that you get a
detailed opinion from your treating doctor and it should include an RFC form which shows your limitations in your ability
to work. The ruling on RSDS makes very clear the importance of the treating physician in these cases. "Opinions
from individuals medical sources, especially treating sources, concerning the effects of RSDS or CRPS on the individual's
ability to function in a sustained manner and performing work activities, or in performing activities of daily living, are
important in enabling adjudicators to draw conclusions about the severity of the impairments and the individuals RFC."