confused, opinions please...
 

So the main doctor (work comp) who is treating me for crps has told me he has never seen a case of it spreading. I had a traumatic injury to my right index finger almost 1 year ago. It took several months of negative lab tests, to be diagnosed with CRPS. I always presented with the appearance of CRPS in the injured finger. Not sure if that made sense (Bone scan showed increased uptake, thermogram and QSART negative) Anyway, my finger has been the main issue.

For the last few months I have had a burning pain throughout my arm into my shoulder and also in my leg. No shiny skin or swelling just an always present burning... sorry for the rambling the last two days have been the worst yet. I'm getting ready to get fired, MMI is coming up, how will I find a job in this condition? Ughh... The only thing I feel like I have going for me right now is that hopefully the pain will die down soon.

Meanwhile I can't get an answer to why my arm and leg are on fire...

Ed,
Welcome to the forum. Don't just visit, join.
Sorry about your condition. I notice the doc says he never SAW it spread. A lot of WC doctors will say that. But it does!
Keep in mind you have the right to a second opinion. Find a neurologist who has dealt with RSD and you'll find out it does.
Once your nerves get RSD it can spread anywhere.
Mine started in my left wrist/hand and has spread up my arm, left side of my neck and head and is now starting in my left foot/leg. You'll find most folks in here have some spreading going on.
If a doctor says RSD doesn't spread he/she is the wrong doctor...

confused, opinions please...
 

I will be seeing three neuros soon. Too bad the only reason I am being sent to them is for a pension eval. Throughout the whole thing WC never sent me to one.

The pension eval is from a seperate insurance company then the WC company.

Purchasing a NOLO WC book for your state would be the first thing I'd do.

Do you have a WC attorney?

You need to learn your state WC laws and aggressively advocate for yourself, or you'll need to hire an attorney if you don't already have one. Be very, very careful with who you hire, if you go that route. At least in Cali, it's a problem replacing a bad one since both (the original and replacement attorneys) have to split the fee.

I'd do lots of research first and then interview at least 3.

Wow 4am, even my lower back has joined the burn... I talked to several lawyers. No one wanted my case becase it was just a finger and wouldnt bring them much money. I ended up with someone who seemed somewhat familiar with crps and was willing to take my case because it was the right thing to do.

Ed,
You definetley need your own doc. WC doc. work for the carrier and your employer, they will never tell the complete story. If you look under pictures on this site. There is a diagram that talks about spread. You need a dr. who will document and treat all the areas. So when you go for your MMI hearing that is included. When you get your new dr. you should discuss SSDI.
I have to agree with Jimbo and Lit love, you should have an RSD atty. I have struggled with mine personally (not sure if its my meds or just a clash)
But I have heard of people getting screwed by wc and their atty.
Anyway, Welcome to the group. It's a great place to talk, rant or rave.:welcome_sign:

Thanks, I'll look for the diagram now.

Just want to add that if the work comp has never SEEN it spread then can you ask for a referral from him to a doc with more experience with CRPS? If he hasn't seen it before then he's not really the most qualified because he is admitting that he is inexperienced with it. Just an idea in case you are unable to switch doctors with it being work comp (not knowing the laws in your state I don't know what your available options are).

If I were you...I'd see if you can find a WC attorney who specializes in RSD/CRPS. With ANY WC injury you are entitled to compensation for all injuries caused by the work accident, and that would include the spread of the RSD if you got RSD because of the work injury. If you hadn't gotten the RSD, then it wouldn't spread. But you should see if there is an attorney in your area who is familiar with RSD because they will be better equipped to fight for your needs and rights.

I am so very sorry to hear that it is getting worse. You really need treatment ASAP in the new areas if the RSD is spreading.

Oh...and MMI should not be coming up soon if there is the possibility of spread. You need to advocate for yourself on that point with the doctor.

Also, you mentioned that you are getting ready to get fired...can you explain this? It is illegal for them to fire you if it's because you filed a work comp claim. Is it just that you will be unable to perform the job now because of the injury? Because that would need to be taken into account with the work comp claim, as if you cannot perform the job that you once did they may be required to pay for retraining for something you CAN do or pay the pay differential between the job that you CAN get compared to what you did before.

And also...be wary of settlement offers. If you settle...your medical care through work comp ends. With RSD you will need continued medical care and with a settlement that cost will be on you after the settlement. The lawyers sometimes forget to mention this or take into account how this can impact someone who NEEDS ongoing medical care even at MMI.

Sorry, that's a lot to answer on a mobile device! I will be fired because I can't perform the job I was hired to do. There is a light duty policy of nine months with an additional three months of injury leave. Termination results if you can't do your essential functions at the one year mark? Doesn't sound right to me but that is the policy?? My concern is how do you prove something has spread when it barely showed on the bone scan in the obviously injured (swollen shiny purple) finger?
Meanwhile, I'm entering day three of the worst pain since day one. It would be easier to list my non burning body parts:(

Have you discussed the spread with your attorney? He should know how to get you into the right specialist to have your claim expanded.

If your spread continues and your pain causes a permanent, total disability, you'll need to apply for SSDI at some point... Early, aggressive RSD treatment is your best opportunity for remission.

Well...you can't prove RSD with anything really...it has to be diagnosed by a doctor. If your new symptoms are RSD, and you wouldn't have RSD if not for the work related injury, then it is connected. This is why you need to see a doctor who is experienced with RSD and knowledgeable about spread. RSD DOES spread so if the work injury CAUSED the RSD then anything that comes from that is considered related in the courts. It's similar to the idea that if you hurt your foot and are on crutches, and then injure your arms from using the crutches, work comp would have to pay to take care of your arm injuries too.

Now...as to the work thing...that's very shaky ground they are on I think since it IS a work related injury, that is assuming that the work related injury is the cause of you not being able to do your job. Even if they did fire you, they would still have to pay you while you are unable to work until you get MMI. If, at MMI you cannot perform that job anymore they would need to assess what jobs you CAN do, provide any retraining if that is necessary, and if the new job would pay less...pay you the difference between the two salaries. At least...that is my understanding of how it works.

But a lot of this revolves around the idea of MMI...how can a doctor list you at maximum medical improvement if the condition is getting worse and they are not treating it appropriately? Sounds like there are still treatment options out there that the doctor should be recommending to get you some pain relief. Who is pushing the MMI? Work comp, the doctor, work because of their time limits with regards to being off work? Sounds like it is being rushed and that sounds shady to me.

Mean time, what is your doctor doing for your pain? It sounds awful and you NEED some relief. You have to see the doctor ASAP if it is that bad and make sure that all your complaints about spread of the condition are documented and discussed with the doctor.

Good luck.

Dump-Ed,
Are you being represented by an RSD attorney? If not, find won ASAP....

Had my two neuro appointments today for my medical pension eval. One more next week. These are seperate from my WC appts. This is getting tedious!

So an update...
I was injured just over a year ago. As per policy I was fired from a career I'd been in for over 14 1/2 years on the anniversary of my injury. In a true touch of class I received my termination letter Christmas eve.

I received a disability rating from the WC doctor which I thought was too low since my arm, leg, and back pain haven't been addressed, only my original finger injury. Meanwhile I was told another WC "doctor" had reviewed my file and they don't think I have CRPS. I only have a finger injury so they are requesting an IME. I find it interesting they do agree with the original doctors MMI decision since that means they don't pay my lost wages.

I saw three neurologists to be evaluated for my jobs private disability insurance. All three said my CRPS would be a permanent occupational disability! Strange how that differs from a WC "doctor" who read my file!

I got into yet another WC appt to get a different opinion about my new symptoms. He stressed the importance of me getting an MRI because my leg pain could be from a bulging disc due to my age. He said lacking a bulging disc they'd have to readdress whether the CRPS had spread. Of course the MRI would be on my dime not WC's.

I went to my personal doctor and ended up with blood tests, an MRI, and a shoulder x-ray. Everything came back normal and there was nothing to explain my symptoms (other then CRPS, in my opinion, duh!)

I think it is gonna be a long next several years...

Posting exact info like your Date of Injury is probably not advised with pending legal matters...

Really? I wondered about posting anything at all. My date of injury doesn't matter because this entire thread is pretty full of info to show who I am.
The reason I posted at all is because I feel totally dropped by the WC system and felt like I needed some advice or to vent. I don't know where to turn. In exactly one years time I have lost my career, I am in constant pain, and I am a totally different person. Meanwhile, as my life is spinning out of control I have WC doctors telling me all my new pain is unrelated to the CRPS in my finger.
I'll change the date if I can edit the post but really I should prob ask to have the thread deleted if it is gonna cause me problems down the road?

I was able to change the date...

You can still talk about your condition and what you are going through with the doctors...it's just usually best not to be too specific with dates or doctor's names or anything. I don't think anything you've said is bad either...though you can never tell how attorneys can take things out of context and try to use them against you.

My RSD was caused by a work injury too and this year it has spread after I had been BACK to work for a year. It will be a long, frustrating process trying to prove that the new spread is related to the original injury and I can tell you that I do not expect to get compensated for it any time soon. I am thankful that I am still employed and at least have my regular insurance to deal with the medical care I have needed this year.

I'm so sorry that you are going through all of this. I think you need to stay focused on getting the best medical care that you can right now (obviously within what you can afford). Do you have a good attorney who can work on getting you treated by work comp now that you have had the recommended MRI and it shows nothing else that would explain your pain? If that's what the last WC doc said then maybe they would approve you seeing him again based on his recommendation? Not sure if that is in the medical records or just what he told you in person....but it might be worth a shot since he at least seemed willing to discuss the idea of spread.

My dad gave me some great advice that has helped me through a lot of these hard times and that is to not worry about the things you can't control and focus on what you CAN control. If you can't get WC to step up and do the right thing, then you need to make your health the priority. If you can get your health back (at least to some degree so that you have quality of life) then you will be in a much better situation. If you cannot work at all then you will need to apply for disability and do what you need for that. I know it is very frustrating and it is SO easy to let yourself get down and feel like things are hopeless...but that's when you really need to sit down and look at all your options and just do the best that you can. Things may suck for a good long while...but they can and will get better.

This site really is an excellent resource for finding what you need to help get you through. I have gotten so much good advice from the people on here...things that the doctors could never have helped me with because they don't know what RSD is like...they don't live with it every day.

Good luck...I really hope that things work out for you. Dealing with WC myself I know just what a pain they can be..

I wouldn't be paranoid, but exact dates makes it way too easy to link you to your posts and a general timeline is just as helpful as a description.

Even if you got everything you're legally entitled to in CA in regards to WC (which is unlikely) it still doesn't amount to much after you're deemed P&S if you have a severe disability. The permanent medical care can be significant, and most people sign it away for peanuts. I'm really only familiar with CA WC law...

If you can't return to work, and if your state WC system isn't required to retrain you, then you might consider utilizing the services of your local Voc Rehab Agency. (if I've said this to you before, my apologies!) They'll provide an unbiased assessment of your ability to work in various jobs. If there are medical questions in regards to your needing accommodations, etc., they'll send you to their own docs. They will let you know about local job programs for the disabled. There is also the possibility that you might reach the point where you need to consider applying for SSDI. If approved, you'd eventually have Medicare which can be a relief if WC is denying care.

Thanks for the info! This is beyond me. Today my leg feels like it is in a block of ice!