Can I obtain VA disability benefits for complex regional pain syndrome?

Yes, VA disability benefits for your complex regional pain syndrome may be available.

You will need to prove that (a) you were in the military, (b) your complex regional pain syndrome originated or was aggravated while you were on active duty, (c) you were continuously treated for your complex regional pain syndrome since leaving the service (unless you are filing your disability claim within one year of leaving the service or your condition has been chronic), and (d) you are currently disabled by your complex regional pain syndrome.

About RSD / CRPS and disability

RSD stands for reflex sympathetic dystrophy. CRPS stands for complex regional pain syndrome. RSD and CRPS are two names for the same condition, but CRPS is gradually replacing RSD. CRPS is a chronic, progressive neurological syndrome, characterized by severe pain, swelling, and changes in the skin.

The National Institute of Neurological Disorders and Stroke has defined CRPS as “a chronic pain condition that is believed to be the result of dysfunction in the central or peripheral nervous systems.”
CRPS usually affects one of the extremities (arms, legs, hands, or feet). The primary symptom is intense, continuous pain. Other symptoms include:

  • Increased skin sensitivity
  • Skin temperature changes (warmer or cooler than opposing extremity)
  • Skin color changes (blotchy, purple, pale, red)
  • Skin texture changes (shiny, thin, sweaty)
  • Changes in nail and hair growth patterns
  • Stiffness and swelling in affected joints
  • Decreased ability to move affected extremity

The cause of CPRS is unknown. Most of the time the syndrome is precipitated by injury and surgery, but some cases have no demonstrable injury to the original site.

It is characteristic of this syndrome that the degree of pain reported is out of proportion to the severity of the injury sustained by the individual. When left untreated, the signs and symptoms of the disorder may worsen over time.

Although the precipitating mechanism of the signs and symptoms characteristic of CRPS has not been defined, dysfunction of the sympathetic nervous system has been strongly implicated.

The sympathetic nervous system regulates the body’s involuntary physiological responses to stressful stimuli. Sympathetic stimulation results in physiological changes that prepare the body to respond to a stressful stimulus by “fight or flight.” The so-called “fight or flight” response is characterized by constriction of blood vessels supplying skin, increase in heart rate and sweating, dilatation of bronchial tubes, dilatation of pupils, increase in level of alertness, and constriction of sphincter musculature.

Abnormal sympathetic nervous system function may produce inappropriate or exaggerated neural signals that may be misinterpreted as pain. In addition, abnormal sympathetic stimulation may produce changes in blood vessels, skin, musculature and bone. Early recognition of the syndrome and prompt treatment, ideally within 3 months of the first symptoms, provides the greatest opportunity for effective recovery.

How Is CRPS identified as a
medically-determinable impairment?

CRPS can be established in the presence of persistent complaints of pain that are typically out of proportion to the severity of any documented precipitant and one or more of the following clinically documented signs in the affected region at any time following the documented precipitant:

  • Swelling;
  • Autonomic instability–seen as changes in skin color or texture, changes in sweating (decreased or excessive sweating), changes in skin temperature, and abnormal pilomotor erection (gooseflesh);
  • Abnormal hair or nail growth (growth can be either too slow or too fast);
  • Osteoporosis; or
  • Involuntary movements of the affected region of the initial injury.

When longitudinal treatment records document persistent limiting pain in an area where one or more of these abnormal signs has been documented at some point in time since the date of the precipitating injury, rating boards can reliably determine that CRPS is present and constitutes a medically determinable impairment.

It may be noted in the treatment records that these signs are not present continuously, or the signs may be present at one examination and not appear at another. Transient findings are characteristic of CRPS, and do not affect a finding that a medically determinable impairment is present.