Complex Regional Pain Syndrome (CRPS) workers’ compensation claims in Queensland

Complex Regional Pain Syndrome (CRPS) can develop after a physical work injury and may lead to severe, long-term chronic pain. In Queensland, workers with CRPS may be eligible for workers’ compensation through WorkCover Queensland or a self-insurer.

This article explains how CRPS is assessed, what evidence is needed and what workers can expect during the claim and recovery process.

Understanding the Queensland workers’ compensation system when claiming for CRPS

Under Queensland workers’ compensation law, an injury is compensable if employment is a significant contributing factor. CRPS is usually a secondary condition, meaning it develops from an accepted work-related injury such as a fracture, sprain, crush injury or soft tissue damage.

To be accepted by WorkCover for a CRPS claim, the worker must demonstrate:

• a primary physical injury which is ultimately accepted by WorkCover as an ‘injury’ under the Act;
• that CRPS developed as a direct or consequential result of that injury;
• symptoms are consistent with recognised medical criteria.

CRPS claims can be complex because symptoms will typically appear disproportionate to the initial primary injury. Essential medical evidence (in the form of approved medical certificates, then usually medical reports) is required.

Injuries that commonly lead to CRPS 

CRPS can arise from injuries such as:

• fractures from falls, slips or equipment accidents;
• soft tissue injuries from lifting, pushing or manual handling;
• crush injuries involving machinery or tools;
• repetitive strain injuries affecting nerves;
• post-surgical complications following treatment for a work injury;
• prolonged immobilisation in casts or splints.

Industries with higher instances of CRPS risk include construction, mining, healthcare, warehousing, transport and manufacturing.

Recognising symptoms and obtaining a diagnosis

CRPS needs to be diagnosed clinically, often using the Budapest Criteria. Common symptoms include:

• persistent burning or severe pain;
• swelling, temperature changes or altered skin colour;
• extreme sensitivity to light touch or movement;
• stiffness, tremors or reduced mobility;
• changes in hair or nail growth;
• functional limitations affecting everyday tasks.

WorkCover will usually refer the worker to an independent medical examiner to confirm the diagnosis and determine whether the condition is linked to the work injury.

Lodging a workers’ compensation claim for CRPS

The steps for making a CRPS claim, whilst similar to other injuries, do require more detailed medical evidence. The process will usually include:

• reporting the original injury to your employer as soon as possible;
• seeing a GP for a Work Capacity Certificate;
• describing the onset of CRPS symptoms clearly during medical appointments;
• lodging the claim with WorkCover Queensland or the relevant self-insurer;
• providing medical reports or specialist notes supporting the diagnosis.

WorkCover will then investigate whether CRPS developed as a consequence of the primary physical work injury.

What WorkCover Queensland may cover for CRPS

If WorkCover accepts the primary injury and resulting CRPS, a worker may be entitled to benefits such as:

• GP appointments, specialist consultations and pain management programs;
• physiotherapy, occupational therapy and psychological treatment;
• medications and interventional pain procedures;
• weekly compensation payments if unable to work;
• equipment or workplace modifications;
• travel costs for medical appointments;
• a statutory lump sum for permanent impairment, if eligible.

Because CRPS can severely impact daily functioning, support needs are often ongoing.

Permanent impairment assessment for CRPS in Queensland

If a worker’s condition stabilises but does not fully resolve, WorkCover (or the injured worker) can seek a permanent impairment assessment. 

An assessor with the necessary qualifications will consider:

• loss of movement and strength;
• pain levels and neurological symptoms;
• impact on functional capacity;
• limitations on daily activities.

The resulting Whole Person Impairment (WPI) percentage determines eligibility for a statutory lump sum.

IMPORTANT: Do not accept any offer of lump sum benefit without getting legal advice. If you accept an offer based on an assessment of WPI of less than 20%, then you will not be able to consider bringing a common law claim for damages (see below) for your work injuries.

CALL US FOR FREE ADVICE: 07 3310 8729

You can read more about permanent impairment claims in our earlier blog, “WorkCover lump sum compensation claims Queensland”.

Common law claims for CRPS 

In addition to statutory benefits, some workers may be eligible for a common law claim if employer negligence contributed to the original injury. A common law claim can compensate for long-term losses not covered under the statutory scheme.

Examples of negligence include:

• inadequate manual handling training;
• unsafe systems of work;
• insufficient staffing in physically demanding roles;
• faulty or poorly maintained equipment;
• lack of proper supervision;
• failure to respond to reported hazards.

CRPS can significantly impact work capacity, making common law claims more substantial than a typical physical injury claim.

Return to work options for workers with CRPS

Returning to work with CRPS can be particularly challenging and will usually require careful planning. WorkCover Queensland may support:

• graduated return to work programs;
• modified or reduced duties;
• flexible rostering to manage flare-ups;
• ergonomic assessments;
• aids or equipment to reduce strain;
• advice from rehabilitation providers.

A successful return to work requires careful collaboration between the worker, employer, treating doctors and WorkCover.

Psychological impacts and secondary psychological injury

CRPS often involves significant emotional and psychological distress. Queensland workers’ compensation law allows claims for secondary psychological injuries if they arise directly from a physical work injury.

Support may include:

• counselling or psychological treatment;
• medication management;
• pain coping strategies;
• support for anxiety or depression linked to chronic pain.

You can read more about psychological injury claims in our earlier blog, “Mental health and workers' compensation: claiming for psychological injury in Queensland”.

Frequently asked questions

Is CRPS usually accepted by WorkCover Queensland?

CRPS is often scrutinised closely because symptoms vary widely. Essential medical evidence is required.

Can CRPS develop even if the original work injury was minor?

Yes. CRPS can arise from seemingly minor injuries and can result from certain nerve involvement or abnormal pain responses. which can be due to a number of different reasons.

Can I change doctors during my claim?

In most cases, yes. Workers will have their own treating doctor, though WorkCover may also arrange independent assessments.

Can I claim if CRPS develops /worsens over time?

Yes. Workers can seek further treatment or reassessment if their condition deteriorates as a result of the work injury.

Get help from a workers’ compensation lawyer

CRPS can have a profound effect on a worker’s physical, emotional and financial well-being. In Queensland, workers’ compensation offers vital support, including treatment, income replacement and permanent impairment compensation. 

Because CRPS is medically complex and can be difficult to prove, early and thorough documentation is essential. Seeking legal advice can help ensure the condition is properly recognised and that injured workers receive the full support and maximum compensation available under the Queensland workers’ compensation scheme.