[Sandel]

"The Supreme Court held that while diagnostic criteria stated in the Guides have relevance in judging the credibility of a diagnosis, there was no statutory requirement that a diagnosis must conform to the criteria listed in the Guides.

http://www.kycases.com/2009/10/worke...on-chris-.html

[fmichael]

Thank you, Sandra! This is a wonderful opinion. For those who missed it, the link to the text of the April 23, 2009 decision of the Supreme Court of Kentucky is http://opinions.kycourts.net/sc/2008-SC-000480-WC.pdf

And while the decision is only binding in one state, that's not the point. It's interpreting what is in effect a uniform statute, adopted by almost every state in the U.S. (such as the UCC - the Uniform Commercial Code) only in this case it's the AMA’s Guides to the Evaluation of Permanent Impairment (the Guides). Same effect: the opinion of any state supreme court interpreting a uniform statute is always "persuasive authority" in any other jurisdiction, unless of course the supreme court in your state has already ruled the other way on the precise question of law. If fact, I see it cited in a Canadian page for "occupationally disabled workers (D/W)" at http://iwocac.ning.com/

So, for anyone fighting for a determination of a CRPS diagnosis in a WC (or D/W) situation, I would urge you to print out and mail a copy of the opinion to your attorney. He or she may already be familiar with Tokico (USA), Inc. v. Krystal Kelly, but you never know.

Mike

[Sandel]

In BC Canada worksafebc (wbc) uses these guidelines to diagnose complex regional pain syndrome.

1. The patient must have continuing pain that is disproportionate to
any inciting event.

2. The patient must report at least one symptom in at least three out of
the following four categories in the affected extremity:

• Sensory: reports of hyperesthesia
• Vasomotor: reports of temperature asymmetry and/or skin
colour changes and/or skin colour asymmetry
• Sudomotor/edema: reports of edema (with or without joint
stiffness) and/or sweating changes and/or sweating asymmetry
• Motor/trophic: reports of decreased range of motion and/or
motor dysfunction (weakness, tremor, dystonia) and/or trophic
changes (nails, hair, skin)

3. The patient must display at least one sign in two or more of
the following categories in the affected extremity:

• Sensory: evidence of hyperalgesia (to pinprick) or allodynia
(to light touch)
• Vasomotor: evidence of temperature asymmetry and/or skin
color changes and/or asymmetry
• Sudomotor/edema: objective evidence of edema (with or
without joint stiffness) and/or sweating changes and/or
sweating asymmetry
• Motor/trophic: evidence of decreased range of motion
(including joint stiffness) and/or motor dysfunction and/or
trophic changes

[jcrewrockstar]

I myself live in Kentucky and have been battling CRPS and this AMA guidelines B.S., like everyone else, for two years now, and, even now. I cannot tell/express the feeling of relief, nor the number of tears that fell yesterday, when I went to another IME (a year after benefits have been cut off, just another extension of litigation) and the doctor said I had 7, not 8 findings. Because of that case, that was just published, and set a precendent for all other RSD/CRPS cases that come after it, my fears, all of the emotions of knowing I was "right" and the insurance companies were or could get off the hook, could evaporate. Luckily for me, this decision couldn't have come out at a better time (right in the middle of my litigation...the defense had to ask for 90 day extension of time because of it). I know how fortunate I am to be living in Kentucky with this new Supreme Court decision paving the way to my worker's comp case and it's conclusion. It gives me hope , or more hope than I have had in a long time, and, it makes me more of a believer in justice (a word I used to laugh at). While this may be just case law here in Kentucky at present, I guarantee other states will follow in its tracks. It might start with neighboring states (ie Indiana, Ohio, Illinois), and Social Security judges seeing what Kentucky law is and seeing how much common sense it makes. But, for those who do not live in Kentucky, do whatever you can to advocate, to have a voice, to shove this case, and its rationale any and everywhere you can. Make people (attorneys/ legislators, etc.) listen to you. Never stop fighting is the biggest message not only NOW, but even in this court case itself. It shows what happens when you never stop fighting. The individual involved in this case has been going through litigation and awaiting a decision for 4 years. That's just a fight the individual was fighting IN LITIGATION ITSELF...the CRPS was present well before that (which we all know is a fight in and of itself). So, we owe this case, and the individual and representing counsel our thanks for their fight for what was right, just, and fair. And, in so doing, the fight has paved the way for change, justice, and, so I HOPE, the motivation to encourage all of you, wherever you may live, to fight for this change as well. Much love,
Sara