Alabama Workers Compensation — Complex Regional Pain Syndrome Is A Whole Body Injury
Reflex Sympathetic Dystrophy (RSD). Sometimes it is referred to as Chronic (or Complex) Regional Pain Syndrome. Either way, it can be a devastating pain condition for patients. I’ve written a couple articles discussing RSD and the disabling toll it has on people. You can read my prior posts here:
For each post, I added a picture of fire. Why? Why fire? RSD patients often describe a constant pain as if they “are on fire” or an “unrelenting burning pain” that never ends.
I’ve represented numerous clients who suffered RSD. Some had mild versions and could function. Others suffered such unrelenting pain that living moment-to-moment was a difficult task. For those clients, the slightest touch caused horrible pain. It was heart wrenching to hear their stories in court.
Because these cases involve such a high level of pain, they are difficult. Patients are often met with skepticism from family, friends and even doctors who don’t understand the condition. Because of this skepticism, it’s not surprising that insurance companies dispute the injury. We’ve tried and won a number of these cases because the insurance company would not take the injury seriously. These are unique cases that require extensive preparation. Want to prepare and present these cases? Then, you must understand the medical research and you must engage medical professionals experienced in treating this disabling condition.
I’m writing today because the Alabama Supreme Court recently addressed RSD in a workers’ compensation claim. That case, Turner v. Baggett (Release February 5, 2021), is an important one.
What Is Reflex Sympathetic Dystrophy?
I recently took the deposition of a pain doctor in Birmingham. In his testimony, the doctor described RSD as a neuropathic pain response. Neuropathic pain is typically caused by damage or injury to the nerves that transfer information from the brain and spinal cord to our body.
Because RSD involves neuropathic pain, the most common problem is a burning, stinging pain. At the same time, the injured body area can become hypersensitive to touch as well as numb. The nerve damage can also affect your sensation and ability to control heat and temperature in the injured area. Because the patient suffers damage to the nerves that control heat and temperature, the injured body part can sweat or appear different from the rest of the person’s body. It’s a horrible condition. Some patients become disabled and deeply depressed from the unrelenting pain.
Scheduled Member Versus Whole Body Injury? Why Does It Matter?
How are workers’ compensation benefits calculated? In Alabama, our work comp law provides several different compensation formulas for permanent injuries. One formula is typically referred to as the “schedule” or scheduled member provisions. This formula is basically a listing of certain body parts. The primary listed parts include your arms, hands, fingers, legs, feet and toes. If you permanently injure one of these listed body parts, then benefits are very limited. This formula is very unfair and treats injured workers poorly. Think about it — What if you spent your whole working life as a carpenter. You’ve worked nowhere else. You’ve studied for nothing else. Suddenly, you suffer an injury that destroys your dominant hand. That injury would devastate your career. You should be entitled to work comp benefits based on your future loss of earning capacity from the injury. Justice demands it. Yet, Alabama law denies it. Instead, you are limited to the benefits listed for a loss of a hand. I can guarantee those benefits are unjust and do not properly consider your loss. It’s shameful that the Alabama legislature has not addressed this issue in recent years. Working men and women deserve better.
A different formula applies to “whole body” injuries. Yes, it’s a much better formula for injured workers. For example, an injury to your back or hips or neck is considered a whole body injury.
I understand all this talk of formulas may sound like a foreign language if you don’t know workers compensation law. Trust me, I get calls from attorneys asking questions about the formulas. What you need to remember — The formula for a whole body injury is much, much better for injured workers than the formula for listed scheduled members.
Why does RSD matter for these formulas? Let’s look at another example. Let’s say you permanently injure your knee. Since your leg is a scheduled member, you are limited to benefits under that formula. What if that permanent knee injury causes you to limp and now your back is hurting and limited because of that. It’s related. And, your back is considered a whole body injury. So, now you can and should argue for benefits as a whole body impairment. I’ve never understood why so many lawyers ignore this situation. With that in mind, think of RSD.
RSD usually starts and impacts a specific quadrant of the body. A specific arm or leg. In other words, a “listed” body part. Since it essentially starts and disables an arm or leg, is it a scheduled member loss? Through the years, I’ve argued successfully numerous times that RSD is a “whole body” injury because it impacts your nervous system from the spine to the injured body part. We’ve won many of these claims at trial.
The recent Alabama Court of Civil Appeals decision endorses our argument. In that case, the court concluded RSD is a whole body injury not a scheduled loss. In the recent Turner decision, medical testimony by the treating doctor revealed the following:
In his deposition, Dr. Hinton explained that complex-regional-pain syndrome occurs when a chronic injury causes permanent damage, or, as he put it, a “remodeling” of the nervous system in the spinal cord, that results in increased pain to the sufferer from even minor stimulation. Dr. Hinton testified that he had diagnosed the employee with that condition based on four classic signs the employee exhibited, including hypersensitivity, color and temperature changes in the affected extremity, and swelling.
RSD (or Complex Regional Pain Syndrome) is a whole body injury. Yes, most of the pain, swelling, hypersensitivity, color changes, and other symptoms, occur in the listed body part that was originally hurt. In other words, we see most of the issues in the person’s initially injured arm or leg. But, the injury itself is a complex and permanent damage to the nervous system from the spinal cord to the body part. It is a whole body injury.
RSD Patient? Three Quick Tips For You.
If you suffered an injury and now you have symptoms like hypersensitivity, color and temperature changes, and swelling, here are three quick tips:
Seek Medical Treatment As Soon As Possible. Do NOT wait. Seek medical care. Why? In many cases, treating RSD as soon as possible can make a huge difference to you, your ability to function and whether you will improve.
Find Specialized Medical Care. Through the years, I’ve seen lots of medical records. Many medical people do NOT understand RSD. Instead of taking these issues seriously, these medical people sometimes view the patient as if he or she is exaggerating their pain or problems.
Hire Legal Counsel With Experience Handling Chronic Pain Cases. These cases do NOT involve simple issues. They are NOT simple injury cases. They involve pain that invades and impacts every part of the person’s life. They involve questions of credibility and complicated medicine. Seek legal counsel experienced in preparing and presenting these claims in court.
RSD can be a disabling and devastating condition. Get the support you and your family need.
From its office in Huntsville, the Blackwell Law Firm handles cases involving serious personal injury across Alabama. Whether the cases involve car accidents, workplace injuries or defective product issues, our focus is the same. We prepare every case with the goal of obtaining the maximum compensation for our injured clients.