Can you get disability for CRPS? Is CRPS a disability in Canada? Are the long-term symptoms of Complex regional pain syndrome (CRPS) preventing you from doing your job?
These are some of the most pressing questions that people have when dealing with the debilitating symptoms of CRPS.
Winning disability benefits for CRPS is a tall order, yet it’s crucial for alleviating the financial strain of living with this chronic condition. This condensed guide lays out the vital steps and preparations necessary to strengthen your claim for your chronic pain condition and secure the support you rightfully deserve.
Is CRPS a disability in Canada?
Yes, CRPS is a disability in Canada under certain conditions. The Canadian government recognizes Complex regional pain syndrome as a debilitating condition that can severely impact an individual’s ability to maintain gainful employment. As such, individuals suffering from CRPS can be eligible for disability benefits.
The recognition of CRPS as a disability hinges on the profound impact it has on day-to-day functioning, including CRPS work restrictions, which severely limit a person’s ability to perform regular work tasks. Due to the severe pain and potential mobility issues, CRPS can impose significant occupational limitations.
As a former occupational therapist and current disability benefits lawyer, I can help you avoid the extra pain of bureaucratic nightmares in preparing you for the application process for long-term disability benefits.
If you are suffering from CRPS or reflex sympathetic dystrophy (RSD) in Canada, I can help you take the first steps toward securing the support to which you are entitled.
This article is part of our series on what conditions qualify for disability in Canada. To learn more about what other conditions may qualify, check out the articles linked below:
CRPS symptoms
Complex regional pain syndrome is characterized by persistent severe pain that typically affects an arm or a leg. In addition to chronic pain, common symptoms include dramatic changes in skin temperature and colour, swelling, sensitivity to touch, and, in some cases, irreversible muscle atrophy.
The symptoms can vary in intensity and duration but often lead to disturbances in sleep and significant interruptions in daily activities. Timely diagnosis and comprehensive treatment strategies are imperative in managing the progressive nature of CRPS.
CRPS treatment
Treatment for CRPS varies depending on the severity and progression of the condition. The primary goal is to relieve pain, improve function, and halt the progression of the disease. Common treatment approaches include:
- Medication: Patients may be prescribed pain relievers, from over-the-counter options like ibuprofen to prescription opioids for more severe pain. Anticonvulsants or antidepressants can also be used for nerve pain.
- Physical therapy: To maintain flexibility, improve blood flow, and reduce the atrophy of muscles, physical therapy is often recommended.
- Psychotherapy: Chronic pain can be both physically and mentally taxing, so psychotherapy can help individuals cope with the challenges associated with CRPS.
- Nerve blocks: Sympathetic nerve blocks can provide pain relief and are part of the diagnostic process.
- Surgery: In debilitating cases, surgical interventions may be considered, such as sympathectomy to destroy the affected nerves, though this is less common due to mixed results.
- Alternative treatments: Some patients seek relief through acupuncture, biofeedback, or spinal cord stimulation.
CRPS and disability employment rights 2024
In 2024, individuals living with CRPS RSD disability remain protected under Canadian employment law. This means that employers are generally not permitted to terminate employment due to an employee’s medical condition, provided it is confirmed by a doctor’s note and is not discriminatory in nature.
Under human rights legislation in Canada, employers must make reasonable accommodations for employees with medical conditions that impact their work capabilities, which includes granting sick leave. If you have such a condition and are terminated or discriminated against, then you may have grounds to file a legal case for severance pay or even have the termination overturned.
On the matter of CRPS permanent disability, it is critical for both employees and employers to understand the provisions surrounding such long-term conditions.
For any individual whose working abilities are compromised by CRPS on a long-term basis, there exists the potential to be categorized as having a permanent disability.
This recognition can lead to eligibility for specific benefits and protections, ensuring that those affected can maintain their livelihood without fear of unjust termination or discrimination.
CRPS disability rating
Currently, there isn’t a specific CRPS disability rating in Canada that applies universally.
Disability ratings, in general, are designed to quantify the degree of impairment and the consequent limitations on a person’s ability to work. For CRPS, these ratings can be particularly challenging due to the subjective and variable nature of the condition.
Medical professionals use diagnostic tools, symptom assessments, and functional evaluations to understand the extent of CRPS in each person. When applying for long term disability benefits, a detailed medical assessment that outlines how CRPS limits your work and daily activities can support your claim.
Complex regional pain syndrome disability allowance: what can you claim?
When considering the financial implications of CRPS, it’s crucial to explore the various disability benefits for CRPS that may provide much-needed support.
Canadians living with CRPS may be eligible for a variety of assistance programs, each with its own set of criteria and application processes:
- CPP disability
- Long-term disability insurance
- Short-term disability
- Employment insurance (EI)
- Workers’ Compensation
- Disability tax credits
- Veterans Affairs Canada
- Provincial income support benefits
CPP disability benefits for complex regional pain syndrome
The CPP (Canada pension plan), designed to support you after retirement, also covers disability benefits that start once you become disabled and last until you are 65. After that, these disability benefits are converted into regular pensions.
To be eligible for CPP disability benefits, you have to have worked for four out of the past six years and paid payroll taxes. The CPP requires you to prove that your disability is both prolonged and severe, leaving you unable to work.
You apply for CPP disability by filling out the forms. Your doctor or nurse practitioner will have to fill out the medical report. Then, you send your CPP disability application to a designated Service Canada office for your province.
If Service Canada denies your claim for complex regional pain syndrome social security disability, you can appeal on two levels:
- Reconsideration appeal: Must be requested within 90 days of denial.
- Tribunal appeal: If denied again, you must appeal to the Social Security Tribunal within 90 days as well.
Once you appeal to the tribunal, a judge or a three-person panel will decide your claim. You can attend the hearing to give evidence and answer questions with guidance from a CPP lawyer.
If you need assistance with your CRPS disability claim, contact us today for legal advice.
Long-term disability insurance benefits for complex regional pain syndrome
Group disability insurance policies are Canada’s most common type of disability insurance. If your employer has insured you as part of a group, you are receiving your disability insurance through your job.
These group disability insurance policies provide both long-term and short-term disability benefits. If you are suffering from complex regional pain syndrome, you can apply for long-term disability benefits if eligible. If successful, these will provide you with monthly income payments during long absences from work.
You apply for CRPS type 2 disability benefits by filling out forms and sending them to the insurer. You will probably have to complete three forms, one of each for:
- You
- Your employer (if applicable)
- Your doctor
Again, it’s on you to get those forms back in. You will not get a decision until the insurer receives all the forms.
If you are denied long term disability help, your LTD plan may allow two to three internal appeals. If those fail, you will have an appeal hearing with an outside arbitrator or judge.
Short-term disability (STD) benefits
Short-term disability benefits pay 50-67% of your regular salary, typically on a weekly basis.
Typically, short term disability benefits will last anywhere from 15-17 weeks. However, some policies may offer longer coverage periods.
Employers offer these benefits through the company or a group insurance policy. In both cases, employers hire an outside agency to run the program for them.
You only qualify if your employer has one of these plans. Not all jobs offer this option. If your job doesn’t, then you may be eligible for EI sickness benefits.
To apply, you can obtain the necessary forms from your employer or the appropriate insurance company. The application consists of three forms: one for yourself, one for your doctor, and one for your employer. It is your responsibility to ensure that all forms are completed and returned to the insurer.
But, in answer to, “can I be fired if my short-term disability is denied?” the short answer is no. Your employer cannot fire you for filing a claim or taking time off due to illness or injury. In fact, it is illegal for them to do so under the Employment Standards Act.
If your application gets denied, you can ask for an appeal.
First, someone else in the company reviews your claim. This is called an internal appeal. You may have multiple of these appeals — up to three or four.
If you aren’t successful with the internal appeals, you may have to appeal outside of the company. Your options will depend on your situation, and you may have to go to an arbitrator or judge.
Our short term disability attorneys can help you with the appeals process and ensure that you have the best possible chance of success. Contact us today to find out more!
Additional reading: how long is short term disability
Employment Insurance (EI) sickness benefits
EI sickness benefits are temporary disability benefits paid through the federal government’s employment insurance program.
EI pays 55% of your salary for 15 weeks. As of January 1, 2024, the maximum amount you can receive in a year is $63,200. This means you can receive a maximum amount of $668 per week.
To qualify for an insurance claim for chronic complex pain syndrome, you must have paid into the EI program recently. You pay through deductions from your paycheque. These deductions are automatic. So, if you got an official paycheque, you paid into the EI program.
You apply for EI benefits online through Service Canada, from home or at any Service Canada office. You also need your doctor to fill out a form that confirms your inability to work for 15 weeks. Finally, your employer has to issue a Record of Employment (ROE) to verify your sick leave.
Workers’ Compensation
Worker’s compensation pays short- and long-term benefits to people injured on the job.
Each province has its own compensation program administered by its own WCB (Workers Compensation Board). To qualify, you must suffer a workplace injury or illness and work for an employer who is covered by the program. That’s right; not all employers have coverage.
It’s possible but highly unlikely to prove a workplace injury caused or worsened your complex regional pain syndrome. To succeed in this claim, you need a medical doctor to support your belief that a workplace injury or illness is the direct cause of your CRPS.
Workers’ compensation payments can overlap with EI, CPP, and short- and long-term disability. You should seek legal advice for any concerns about payments. Depending on your province, you may keep some (or all) of your CPP disability and the workers’ compensation.
If workers’ compensation denies your claim, you should follow the appeal procedures for your province. These programs also have two levels of appeal: the internal reconsideration and the outside tribunal. In most provinces, this tribunal is called the Workers’ Compensation Appeals Tribunal (WCAT).
CRPS disability tax credit
The disability tax credit is a type of benefit that lowers your taxable income.
To qualify, you must have a severe and prolonged impairment as defined by the program. However, this benefit has a higher standard than the others.
Qualifying for this credit can get some of your previous taxes refunded — depending on your condition’s timeline. You apply by filling out a T2201 form and sending it to Revenue Canada.
If Revenue Canada denies your claim, you can request an internal appeal. If that appeal fails, then you must go to the Tax Court of Canada to appeal again.
Veteran Affairs Canada
Veterans Affairs Canada (VAC) provides support and services to eligible veterans who have served their country. For those suffering from Complex Regional Pain Syndrome, VAC may provide disability benefits if the condition is service-related.
Benefits can include:
- Disability compensation
- Rehabilitation services
- Health care benefits
- Support for family members
To determine eligibility, a detailed medical assessment and service record review are necessary.
Veterans with service-connected CRPS need to complete and submit a disability benefits application through VAC, which includes medical documentation from their healthcare provider establishing a connection between their military service and CRPS.
Should VAC deny the claim, there are options for reassessment and appeal including review by the Veterans Review and Appeal Board (VRAB), where veterans can present new evidence or seek representation for their case.
Veterans may also access additional assistance through programs designed to support them in their post-service life, such as:
- Pain management programs
- Mental health services
- Financial aid to help adapt living spaces to better suit their reduced mobility or discomfort stemming from CRPS.
Provincial income support benefits
Each province in Canada pays income support benefits to people who can’t work because of disability. If you qualify, you can receive fixed payments for life.
You can qualify for provincial benefits even if you’ve never worked. However, they only apply if your total family income falls below a certain amount. This amount differs from province to province. Keep in mind family income doesn’t affect the approval process for other types of disability benefits.
You apply for provincial disability benefits with your local agency or program. As usual, your doctor will need to provide a report or certificate confirming you cannot work because of your medical condition.
For denials, you can appeal internally within the agency or program. In some provinces, you can also appeal to an outside tribunal for a final decision. Check with your province for the proper procedures.
Canada Disability Benefit
The Canada Disability Benefit is a proposed initiative aimed at supporting Canadians living with disabilities. As of now, specific details regarding eligibility and implementation have not been fully outlined, leaving several questions unanswered.
And so, for those wondering who is eligible for the new Canada Disability Benefit, as of the time of writing, the answer is still unclear, particularly in relation to CRPS. We are awaiting further updates, and we’ll be sure to keep you informed once the benefit is fully implemented.
If you’re suffering from chronic pain and need support for your claim, contact us today for a free consultation!
How can you get disability for CRPS?
There are specific challenges in preparing your long-term disability benefits to claim for complex regional pain syndrome.
Remember, the CPP disability administration will not approve your CPP disability benefits just because a doctor diagnosed you with the condition.
To win CPP disability benefits for CRPS, the true challenge is to prove that your symptoms render you unable to function in any workplace while taking into account your age and work experience.
You will have to present a well-organized application with well-documented medical evidence. Here are the main points to consider for complex regional pain syndrome, which will be expanded upon below:
- Get a diagnosis
- Get the appropriate treatment and document it
- Ensure your doctor and medical professionals identify and explain the link between CRPS and any associated psychological or mental problems
- Document limitations with sitting and standing
- Provide evidence of work-related limitations
- List requirements for assistive devices or mobility aids
- Document the objectively visible signs of your condition
- Remain credible throughout the entire process
Get a diagnosis
As you may have noticed, securing a diagnosis of complex regional pain syndrome can be challenging.
However, having a diagnosis will vastly improve your chances of winning disability benefits. Without one, you are significantly less likely to get approved.
If you haven’t already, book an appointment with your doctor to start your journey to getting diagnosed.
Get the appropriate treatment and document it
When considering your claim, disability benefits providers will look to see if you received the appropriate treatment for your condition. Not getting the right treatment is one of the most common reasons for a denial of benefits.
For therapies, you may have tried applying heat and cold, topical analgesics, physical therapy, transcutaneous electrical nerve stimulation, biofeedback, and spinal cord stimulation. Document the failure of these therapies to improve or bring you to remission of complex regional pain syndrome.
From a medication perspective, you may have tried pain relievers, antidepressants and anticonvulsants, corticosteroids, bone loss medications, sympathetic nerve-blocking medication, and intravenous ketamine.
Make sure your doctor is accurately documenting all of this as well. At the end of the day, benefit providers base their decisions on the medical documents they have received.
Even if you received world-class treatment for CRPS without the proper documentation, you received no treatment from the insurer’s standpoint.
Document visible signs and symptoms
Unlike most types of chronic pain, complex regional pain syndrome is not invisible. This means the affected area or limb will have objective signs and symptoms of the condition. You should ensure that your medical professionals document these visible signs and symptoms.
Identify the link between CRPS and psychological problems
It is crucial to have doctors and other medical professionals identify and explain the link between your CRPS and any associated psychological or mental problems, including:
- Cognitive limitations
- Impaired attention and concentration
- Impaired short-term memory
- Reduced ability to attend to tasks
- Personality changes
- Depression
- Anxiety
- Social withdrawal
Documenting this link will help improve your chances of getting approved for benefits.
Evidence of work-related limitations
You will also want to record all the ways in which you have modified your work habits in order to maintain employment while dealing with CRPS.
You should also try easier jobs within your workplace before you apply. Until you do, the disability benefits providers will always doubt you. You might show that while your job had medium duties on paper, your employer made accommodations to qualify your duties as light.
If you were forced to change jobs as a result of CRPS, make a note of that too.
Document pain from sitting and standing
It is also critical to document any limitations with sitting and standing because insurance companies will often argue that you can do sedentary or light work despite your pain being diagnosed.
So, you need to prove that you cannot sit or stand for prolonged periods.
Include requirements for assistive devices or mobility aids
Your application should include any requirements you have for assistive devices or mobility aids, as these will round out your case.
Credibility is key
It is vital that a person seeking disability benefits for CRPS maintains a level of total honesty throughout the process.
Any exaggerations or inconsistencies in descriptions of pain or disability can hurt credibility, even if the inconsistency is an honest mistake.
Credibility killers
- Contradicting medical records or earlier statements
- Making excuses or blaming others for problems
- Criticizing other parties in the claim (even if they deserve it)
- Filing complaints against professionals you see as negative, biased, or unprofessional
- Using aggressive, sarcastic, or confrontational tones in your claim or testimony
- Blocking or stalling reasonable requests for information
- Fighting with doctors over your diagnosis instead of focusing on the disability
- Acting like a medical expert
Credibility boosters
- Making sure what you say matches the medical records
- Taking responsibility for errors or problems with your claim (not blaming others)
- Being cooperative and respectful of everyone in the claim
- Accepting expert advice and opinions
- Making good faith efforts to try all reasonable advice, even if you disagree with it
- Obvious efforts to keep working
Reasons for CRPS insurance denial
One of the principal reasons for an insurance claim denial for chronic complex pain syndrome is the lack of objective medical evidence. Insurance companies are rigorous in their requirements for what constitutes acceptable proof of a disability.
Claimants must ensure they provide comprehensive medical documentation that includes clear evidence of the diagnosis, treatment plans, and the impact of CRPS on their daily living and work capabilities.
Another common ground for denial is the insurance company’s assessment that despite the diagnosis, the claimant retains the ability to work in some capacity. They may argue that alternative positions or modified work duties are viable, despite the severity of the symptoms experienced by the individual.
All these factors reinforce the importance of proper and thorough documentation when seeking disability benefits for CRPS. It is crucial to have a medical team that understands the requirements and can provide accurate and comprehensive documentation to support the claimant’s case.
How we can help
You’ve filled out the forms, and you’ve compiled as much evidence as you could—and yet, the letter you get politely denies you the right to disability benefits, effectively forcing you back to work.
This is a tough time, and I know that – I’ve seen it over and over again with my clients. You don’t know what you’ve done wrong, and a rejection can feel like an unjustified slap in the face.
Being told your condition doesn’t warrant financial support to give you some space to breathe and focus on your recovery adds humiliation and frustration to the chronic pain. Having to force yourself back to work can have devastating consequences for your physical and mental health.
If you’re wondering — are there disability lawyers near me that can help? The answer is yes, and there is a light at the end of that tunnel.
The good news is that you don’t have to simply accept that your rightful claims have been denied. You can appeal the insurance company’s decision instead. I have accumulated years of experience with disability benefits claims, including cases of CRPS. I know what you are going through, and I’m confident I can help you.
You have a choice. You do not have to let insurance companies get away with denying you the support you are entitled to by law.
Call us at (888) 480-9050 to book your free consultation today.
We operate offices in Toronto, Ottawa, Moncton, and Halifax, but we support clients across all provinces except Quebec. Most of our services (90%) are provided online, and we travel to you for any necessary in-person meetings. Find out more by visiting the pages below:
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Key takeaways on is complex regional pain syndrome a disability
While there isn’t an official complex regional pain syndrome SSA listing, you can still qualify under other categories that cover neurological disorders and chronic pain.
It’s important for claimants to demonstrate how their CRPS meets or exceeds the severity of a comparable listed impairment through detailed medical documentation and by clearly explaining the impact of CRPS on their ability to perform day-to-day tasks and work duties.
Furthermore, maintaining credibility throughout the process by being honest and cooperative is key in convincing insurance companies of the severity of CRPS and its impact on an individual’s life. Seeking assistance from experienced disability benefits lawyers, such as the team here at Resolute Legal, can greatly increase the chances of a successful claim for those suffering from CRPS.
FAQs
Can you work with CRPS?
Yes, some individuals diagnosed with complex regional pain syndrome may be able to continue working, depending on the severity of their symptoms and the nature of their job. However, it is important to note that many people with CRPS often face significant challenges in maintaining employment due to chronic pain.
How long does CRPS last?
CRPS is a chronic condition that can persist throughout a person’s lifetime. Its severity, however, can vary greatly from individual to individual. While some patients may encounter intermittent symptoms that fluctuate over time, others may endure constant and relentless pain that greatly impacts their daily lives.
How do you prove you have CRPS?
To effectively establish the presence of complex regional pain syndrome, it is of utmost importance to provide thorough and comprehensive medical records. These should include diagnostic test results such as MRI or bone scans, as well as detailed reports from physicians confirming the CRPS diagnosis and symptoms.
How long does it take to get disability for CRPS?
The time frame to receive disability benefits for CRPS can vary significantly. It can take anywhere from a few months to over a year, depending on various factors. These factors include the details of each case, such as severity of the condition and level of impairment.
