Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)

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Old 02-06-2015, 01:30 PM #1
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Originally Posted by LIT LOVE View Post
CRPS is the same syndrome as RSD. I saw your post on SSDfacts and then saw this post...
I gathered that they are in the "same family" so to speak with the difference mainly between a diagnosed nerve injury and duration/progression of the disease process. Am I misunderstanding the two (RSD & CRPS)???
Hoping this diagnosis as well as increased documentation of functional ability helps my SSDI reconsideration. Time will tell...
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Old 02-06-2015, 02:11 PM #2
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RSD is the same as CRPS type 1. CRPS type 2 is Causalgia. Symptoms, diagnosis, and treatment are the same...but in type 2 there is actual damage to a nerve that is not present in type 1. It can be confusing...but both types of CRPS are the same condition. RSD is the "old" name for the condition but is the one that most of the doctors in my area (IL) seem to use. I have type 1/RSD.
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Old 02-06-2015, 02:15 PM #3
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Oh...and I've even noticed a lot of doctors use RSD for type 2 CRPS...using it interchangeably like CRPS for both types rather than specifying whether it's type 1 or type 2. I used to get frustrated by the failure of doctors to use the current name...but gave up the battle and now just use RSD myself because it's what all of my doctors have used and it's one less letter to type or say...lol.
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Old 02-06-2015, 03:02 PM #4
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Originally Posted by catra121 View Post
RSD is the same as CRPS type 1. CRPS type 2 is Causalgia. Symptoms, diagnosis, and treatment are the same...but in type 2 there is actual damage to a nerve that is not present in type 1. It can be confusing...but both types of CRPS are the same condition. RSD is the "old" name for the condition but is the one that most of the doctors in my area (IL) seem to use. I have type 1/RSD.

So because I have diagnosed nerve damage, mine would be Type 2??? My PCP is a fairly new doc...apparently IL uses the 'old' lingo. Where in IL are you? I'm in Harvard, IL
Thanks for your help! This is so confusing....
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Old 02-06-2015, 03:03 PM #5
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Having a CRPS I or II diagnosis will not make any difference to an ALJ compared to an RSD diagnosis.

If you haven't reviewed this SS ruling, start here:
https://secure.ssa.gov/poms.nsf/lnx/0424580025

I'm not sure how much this will help, but at least scan this as well: http://www.disabilitysecrets.com/soc...ility-rsd.html

I think one of the toughest issues with a RSD/CRPS diagnosis with regards to applying for SSDI is that there is often a significant amount of optimism in the doctors notes, especially in the first few years. While it is true that technically you should qualify if you're unable to work for at least a year, and SS could set your CDR at a year, it's probably more likely that it'll take a few years for approval. Of course the standard drops a bit when you turn 50, so you should definitely research the Grid Rules and determine if it would make sense to either amend your Alleged Onset Date (some ALJs will allow you to use the age 50 grid six months prior to your bday) or even start a second application.

I'm not sure if you've undergone a Functional Capacity Evaluation, but you really need as much non-subjective evidence as possible. While the ALJ does determine RFC, it sure helps to have a FCE to back up why you can't perform even SGA.

The fact that you're starting with a new doctor could also really impact how long it'll take you to amass an overwhelming amount of evidence for approval. And of course, it would be even better if your medical team could help to return your function, so that you could return to work. (You could still pursue a closed period award going back to your original Alleged Onset Date.)

Of course, I could be wrong about the likelihood of a relatively fast approval, but it's best to try and prepare for the long haul when dealing with any SSDI application, IMO.

Last edited by LIT LOVE; 02-06-2015 at 03:38 PM.
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Old 02-06-2015, 07:10 PM #6
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Glad to hear you got in with a PCP. I hope the gabapentin, amitriptyline combo brings you some relief. I find nortriptyline helpful. My neuro prefers it, saying it has fewer side effects. If the amitriptyline makes you feel bad you could always try a different TCA. At least now you might get some good sleep and we know that helps everything.

Keep hanging in there,
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Old 02-06-2015, 09:11 PM #7
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Quote:
Originally Posted by Littlepaw View Post
Glad to hear you got in with a PCP. I hope the gabapentin, amitriptyline combo brings you some relief. I find nortriptyline helpful. My neuro prefers it, saying it has fewer side effects. If the amitriptyline makes you feel bad you could always try a different TCA. At least now you might get some good sleep and we know that helps everything.

Keep hanging in there,
Littlepaw
Thank you! Anything is worth a try at this point!!
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Old 02-06-2015, 09:51 PM #8
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Just to be clear SS doesn't ever request a FCE, but when you have a diagnosis that most ALJs will have very little experience with, evidence of specific functional limitations can be a major asset--at least that was my experience.

Some doctors will fill out RFC forms without a FCE, but it certainly helps with your documentation.

http://www.disabilitysecrets.com/rfc...statement.html

In regards to your AOD, you certainly don't need to change it to reflect receiving a diagnosis. I'm not sure how familiar you are with the Grid Rules, if at all? Basically there are three ways to be approved. 1)Meet an Impaired Listing 2)The 5 step process 3)Via the Grid Rules. It can be much easier qualifying for the Grid Rules at 50 (and easier still at 55) than going through the 5 step process (which is how you were just denied.)

So long as you can prove your skills are not transferable, you no longer have the burden to prove you can't perform SGA at any job, so long as your AOD reflects your 50th bday (or possibly 6 months before your 50th bday at an ALJs discretion.)
http://www.disabilitysecrets.com/top...grid-rules-age

In my personal opinion, an ALJ is going to want to see extensive medical documentation AFTER you've been diagnosed. (By the time you appeal and hopefully receive a remand to the ALJ, you'll have time to do just that.)

You might have to decide if the fight for extra backpay is worth further delaying approval. I'm just trying to give you fair warning now.

What your doctor said to you in person will not necessarily match what is in his or her notes, as I'm sure you know. With your background you're in a much better position to self advocate than most patients.

Good luck.

Last edited by LIT LOVE; 02-06-2015 at 09:59 PM. Reason: clarification
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Old 02-06-2015, 10:55 PM #9
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Well I'm still over a year away from 50, so that part is out. My primary goal is/was/has been/forever will be to get back to work. I began bawling like a baby at the doctors office today simply because all I want is my life back!
I guess I assume that when functional ability is discussed it's actually put into your records. I'm finding that is not the case. Any suggestions on how to ensure it is included??
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Old 02-06-2015, 09:08 PM #10
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Quote:
Originally Posted by LIT LOVE View Post
Having a CRPS I or II diagnosis will not make any difference to an ALJ compared to an RSD diagnosis.
Well it's an added diagnosis since my first application. I applied (1st time) in late Oct. 2014 & received my denial Jan. 2015. Pretty much have MDI in my peroneal nerve palsy diagnosis, just not enough evidence of functional limitations


Quote:
Originally Posted by LIT LOVE View Post
I think one of the toughest issues with a RSD/CRPS diagnosis with regards to applying for SSDI is that there is often a significant amount of optimism in the doctors notes, especially in the first few years. While it is true that technically you should qualify if you're unable to work for at least a year, and SS could set your CDR at a year, it's probably more likely that it'll take a few years for approval. Of course the standard drops a bit when you turn 50, so you should definitely research the Grid Rules and determine if it would make sense to either amend your Alleged Onset Date (some ALJs will allow you to use the age 50 grid six months prior to your bday) or even start a second application.

I'm not sure if you've undergone a Functional Capacity Evaluation, but you really need as much non-subjective evidence as possible. While the ALJ does determine RFC, it sure helps to have a FCE to back up why you can't perform even SGA.

The fact that you're starting with a new doctor could also really impact how long it'll take you to amass an overwhelming amount of evidence for approval. And of course, it would be even better if your medical team could help to return your function, so that you could return to work. (You could still pursue a closed period award going back to your original Alleged Onset Date.)

Of course, I could be wrong about the likelihood of a relatively fast approval, but it's best to try and prepare for the long haul when dealing with any SSDI application, IMO.
My new doctor made it a point to say "Don't expect miracles. I can't promise functional return." One of the many reasons I stated I was there for is to have a physical form completed for nursing school. She wouldn't complete it as she is thinking I am too limited to perform the necessary tasks. However, she also did not give me a pain management referral because she is thinking the gabapentin/amitriptyline combo will be enough. Time will tell with that, but I seriously doubt it, unless the cause of my knee pain is due to another injury, in which case would be due to the peroneal nerve damage.
I did not have a FCE, nor did I even get sent a Functional Report to fill out. I feel I will have some problems on the reconsideration level due to the medical records being a bit shy on the function being addressed. However, my PT records were not obtained for my initial application either. While I can see an adjusted AOD, my AOD on initial app was 10/13/2013 relating to my knee fracture. The peroneal nerve damage would directly correlate with RSD diagnosis and the nerve damage was diagnosed 4/2014. Do you think they would want to change it to 2/2015 to reflect the RSD diagnosis? Ugh. I hate it when people that take advantage of these programs/pain medications totally ruin it for those of us who need it!!!
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