Complex Regional Pain Syndrome (CRPS) and Social Security Disability

Complex regional pain syndrome (CRPS) is a medical condition where excess pain and inflammation lingers following an injury. People who have CRPS experience spontaneous pain that is out of proportion to the prior injury—for example, significant pain after a light touch to the affected area.

Is Complex Regional Pain Syndrome a Disability?

CRPS usually improves over time and eventually goes away, but in rare instances, severe cases can be disabling. A diagnosis of CRPS alone is not enough to get disability benefits. But if you're experiencing moderate to severe limitations that prevent you from working for 12 months or more and you have good medical records, the Social Security Administration ("Social Security") might approve you for disability benefits (more on this below).

What Are the Symptoms of Complex Regional Pain Syndrome?

Symptoms can vary over time and vary from person to person, but common symptoms include:

• continuous burning or throbbing sensations, usually in the arm, leg, hand, or foot
• sensitivity to touch or cold
• swelling in the painful area
• changes in skin temperature
• changes in skin color and texture
• changes in hair and nail growth
• joint stiffness, swelling, and damage
• muscle spasms, tremors, weakness, and
• decreased ability to move the affected body part.

If left untreated, the symptoms might spread and worsen, resulting in long-term and sometimes permanent physical and psychological problems.

What Causes Complex Regional Pain Syndrome?

Most CRPS is caused by nerve damage or dysfunction of the nervous system that sends signals from the brain and spinal cord to other parts of the body (called the peripheral nervous system).

The exact cause of CRPS is unknown, but in a majority of cases, CRPS happens after an injury to a limb that damages the thinnest sensory nerve fibers that transmit pain, itch, and temperature sensations and control the small blood vessels of the surrounding areas. Common injuries leading to CRPS include:

• fractures
• surgery
• sprains/strains
• burns or cuts, and
• limb immobilization (such as casting).

CRPS Type 1 vs. Type 2

There are two different types of CRPS: type 1 and type 2. Type 1 used to be known as reflex sympathetic dystrophy (RSD), and type 2 used to be known as causalgia. Here's the difference between CRPS type 1 and type 2.

Type 1 CRPS

Type 1 is the most common form of CRPS and happens after an illness or injury that didn't directly damage the nerves in the affected area. With CRPS type 1, doctors are unable to pinpoint which nerve specifically was damaged. CRPS1 is generally the result of trauma or surgery. With CRPS1, pain might radiate throughout the body. For example, pain from your finger can radiate throughout your arm, or even your opposite arm or your internal organs, rather than staying centralized to the injured area.

Type 2 CRPS

CRPS type 2 has the same symptoms as CRPS1, but it occurs after a specific, distinct nerve injury. CRPS2 is generally caused by burns, amputation, or a crushing injury. With CRPS2, pain generally stays in the affected area, meaning that if you experienced nerve injury in your leg, the pain remains in your leg and does not radiate to other areas of the body.

How Can I Prove Complex Regional Pain Syndrome Is a Disability?

Social Security will evaluate your claim based on medical evidence. When you claim that CRPS is a disabling medical condition, your medical records should cover a period of months or years and show ongoing medical evaluation and treatment for your medical condition. Your doctor's clinical notes (post-appointment notes) can be very helpful in proving your disabling medical condition.

Social Security might also send you for an independent exam by one of their doctors or might ask your doctor to complete a questionnaire about your limitations.

To get approved for disability for CRPS, your medical records must include complaints of persistent, intense pain causing impaired mobility of the affected body part. According to Social Security's ruling on CRPS, the complaints of pain must be associated with:

• swelling
• changes in skin color or texture
• increased or decreased sweating
• skin temperature changes or gooseflesh
• osteoporosis, or
• involuntary movements of the affected region of the initial injury.

Because CRPS symptoms tend to come and go, Social Security recognizes that these symptoms do not need to be present at every medical examination. Rather, at least one of these symptoms needs to be present at some point in time since the date of the initial injury. Your medical records should also document the following:

• a description of the ongoing medical care you're receiving
• documentation of medications you've tried and your response to them
• whether your symptoms have remained stable, improved, or worsened over time, and
• a detailed description of how the impairment limits your ability to function.

CRPS Work Restrictions

If you suffer from CRPS, Social Security might approve your application for disability benefits if your limitations make you unable to perform your previous jobs and you're unable to transition into another type of work.

To decide whether you're unable to work, Social Security will look at your medical records to see if there's enough evidence you have a serious medical condition that limits your ability to do many work-related activities.

A claims examiner will first determine your residual functional capacity (RFC), which is the most intensive work you can still do (medium, light, or sedentary), despite the limitations caused by your medical condition. For example, if you have CRPS, your doctor might limit you to standing or walking a certain number of hours per day or lifting and carrying a certain number of pounds at one time due to pain, stiffness, and weakness. Your doctor could even limit you to performing simple work tasks, due to difficulty concentrating that stems from persistent pain and medication side effects.

An RFC for someone suffering from CRPS might include the following work restrictions:

• walk and stand for four hours of an eight-hour workday
• lift and carry no more than twenty pounds occasionally (defined as one-third of an eight-hour workday) and ten pounds frequently (defined as occurring from one-third to two-thirds of an eight-hour workday)
• stoop, crouch, crawl, kneel, or bend only occasionally, and
• understand, remember, and apply simple instructions and tasks with adequate pace and persistence for one to two hours at a time for an eight-hour workday.

Someone with these limitations would likely be unable to perform most jobs, because they would be unable to perform most of the requirements required of even sit-down work. For more information on how the SSA decides whether there are jobs you can do with CRPS or if your RFC prevents you from doing any jobs, see our section on disability determinations based on RFCs.

How Do I Apply for Social Security Disability Benefits?

An easy way to apply for Social Security disability benefits is to file your claim online at www.ssa.gov/applyfordisability. You can also file a claim over the phone by contacting Social Security at 800-772-1213, but be prepared for long wait times. For more information, please see our article about applying for Social Security disability benefits

_{Updated June 6, 2022}