Reflex Sympathetic Dystrophy (RSD) also called Complex Regional Pain Syndrome (CRPS) seems to be one of the most complicated and troubling medical conditions out there. Maryland workers compensation attorney’s occasionally see these conditions among injured clients. When handling these cases it is important the attorney has at least a general understanding of the severity of the condition, but also how the condition can affect the injured worker.
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What is RSD?
RSD is a chronic pain condition that causes various degrees of pain in various intervals of time. Some suffer constant burning nerve pain while others suffer from regular pain flair ups. Those who suffer from RSD often have very noticeable swelling, tremors, stiffness, abnormal cellular growth, and more. See WebMd. From what I understand the condition is really not well understood in the medical community because of its complicated nature and its rarity. With that said, it is understood to a much lesser extent in the legal community.
How does Reflex Sympathetic Dystrophy (RSD) / Complex Regional Pain Syndrome (CRPS) affect the injured worker?
This may be the first time in the injured workers life that they have experienced pain of this magnitude. Depending on their occupation the injured worker may require extensive time off from work and perhaps even a vocational rehabilitation plan if the condition gets to the point of prohibiting the injured worker from returning to the occupation on which they were injured. Maryland workers compensation attorneys can help with obtaining vocational benefits which are an option under Maryland law.
Before determining the injured workers functional capacity and considering vocational rehab they must be discharged from medical treatment. For many injuries, discharge can come within weeks or months of the original injury. Even with some surgery cases the workers are back to their job in a few months. With RSD sufferers this does not seem to be the common scenario. Simply diagnosing RSD/CRPS seems to take awhile because the condition is not very well understood by many practitioners and it is usually not expected because of the rarity. It seems treatment begins with the usual course of benign diagnostics (x-rays, mri’s, ct) then some months of therapy. Perhaps then more intrusive diagnostic tests such as nerve conduction studies or bone scans are then performed. A second course of therapy could take place for another couple of months. All the while the injured employee is not sure exactly what is happening with their body.
As the tests go on the optimism of all involved begins to dwindle. At a point a psychological component comes into play and the injured worker may be overwhelmed with emotions and feelings. While Maryland workers compensation attorney’s should strive to get their injured client back to work in order to preserve their occupation, keep them contributing to society, and keep them from entering a different mind set and accepting that resting on the couch or in bed is becoming a part of life, with RSD/CRPS it is difficult to do this and very often an impossibility. Very often those who endure this pain condition are on levels of narcotics not safe for the work place. What is more, when psychological dismay overwhelms the injured worker it may be best they seek treatment and focus on preserving their well being. It then becomes the attorney’s job to ensure continuing compensation benefits.
What can the Maryland Workers’ Compensation Attorney expect when handling RSD cases?
It is the attorney’s job to ensure that the worker suffering from this sympathetic nerve condition continues to receive temporary total disability/lost wages. Under Maryland law it is often very difficult to keep these payments flowing uninterrupted. At any given time the workers comp insurer can have an IME performed that could legally justify them to terminate the temporary total disability (ttd) payments. If this happens the injured workers attorney can file for a hearing to have the benefits reinstated. The hearing request can be filed immediately, however it may take a few months to actually get to the hearing, and a few weeks thereafter to receive a check for the back wage checks.
For the worker this could be financially devastating, for the attorney this can be frustrating. The diagnosis and treatment of RSD can take many months to years. That means many months to years of the workers comp insurer terminating benefits and necessitating a hearing. That means the injured worker may go months without compensation. Adding to the frustration is the lingering school of thought that believe RSD/CRPS to be a fabricated condition. Liken to theories about fibromyalgia, if there is doubt the condition is legitimate there is often accompanying doubt among the workers comp defense. With the worker already in a vulnerable state, suffering from regular severe pain, feelings of depression, and uncertainty, repeated attempts to terminate the ttd payments can push them to a breaking point.
When handling Reflex Sympathetic Dystrophy (RSD) / Complex Regional Pain Syndrome cases compensation lawyers must be prepared to offer some extent of emotional reassurance to clients while maintaining the professional relationship.