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CRPS - PTD or PPD?
#1
Background:
I am a 38yo Male. 37 at time of injury. Married with 3 kids. I have an 18-month old son (he was 4 weeks old when I fell). Colorado claim.
I was injured at work last summer when I fell through A roof. 15 feet. CRPS was apparent immediately in LUE. Diagnosis confirmed by positive QSART, Stress Thermogram & Sympathetic nerve block with EMG showing nerve damage for CRPS Type 2. SNB was working to diminish pain and increase mobility. IC has stopped approving that only treatment that decreased pain and increased Mobility. CRPS spread to LLE, confirmed by positive QSART and stress thermogram.
Both limbs are constantly Swollen & freezing cold to the touch, highly sensitive to touch, wind, anything.
I use an electric wheelchair to get around the house because I am not able to walk. I can’t move my toes, foot or ankle. CRPS pain extends from toes to knee.
I have no use of my wrist or fingers. Elbow ROM is about 75%. CRPS pain extends from all fingers to 3/4 up the forearm. EMG shows damage to both radial and ulnar nerves.
Left knee has torn meniscus from fall.
Right knee has partial MCL tear from trying to hop from wheelchair to toilet.
I was diagnosed with PTSD. I wake up from nightmares about the fall about three times every week. I rarely sleep and I’m constantly waking up from pain.
I’ve had 1 direct IME and 1 recent “medical records review” IME.
I have a hearing in February to address denied medical care. Current denials: wheelchair, shower bench, toilet seat bars, in home care, sympathetic nerve blocks for arm and for leg, ketamine infusion, PT/OT, massage, acupuncture, biofeedback, chiropractic, psychotherapy and several medications. All these ordered by Dr.
Questions:
1. In CO, what part of the AMA is used to determine MMI? Or WPI? Which is it for CRPS?
2. At what number is it considered total and not partial?
3. Can I seek and pay for non-approved medical treatments from IC without jeopardizing the claim? Will it be seen as patient directed care?
4. At what point does it qualify for bad faith?

I’m losing hope
 
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#2
I am not aware of your states laws. Hopefully 1171 will see this and opine.

If you have a denial from work comp and have alternative insurance usually they will cover it. Contact them to confirm.You can always pay for your own treatment.Save receipts in case there is a way to get reimbursed (unknown). Do you have an attorney?If not I highly recommend getting one.

I have come across some patients who have gotten relief from this with help help from doctors who specialize in CRPS and also help with prevent spreading. There was a patient on this forum who posted about it but I have not seen him in a while. There are forums specifically for patients with CRPS.

If you have not done so already I would recommend to apply for social security disability.

I am sorry you are going through this.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#3
there is good basic information available on the state of colorado department of labor & employment website
https://www.colorado.gov/pacific/cdle/dwc
https://www.colorado.gov/pacific/sites/d...nglish.pdf

WPI is a measurement of functional loss of a body part or system; it does not rate a diagnosis e.g. crps, burn, paralysis, fracture, sprain, etc. as such each affected body part will be rated separately and then combined--thus the term "WHOLE PERSON" impairment.

100% WPI is equivalent to permanent total disability.

maybe. you are allowed to seek treatment outside of work comp coverage but any secondary consequences or interference with covered treatment would be outside comp liability.
you did not explain what "it" is.
the term "bad faith" does not refer to any injury or medical condition but to civil liability for violation of certain state laws governing Insurer behavior.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
Reply
#4
Happy you found the information this site provided helpful.
Post again sometime.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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