Personal Injury | September 30, 2026 by JOSHUA D. ANDERSON

Compensation for Complex Regional Pain Syndrome After an Accident

Occasionally, weeks or months after what looked like a routine injury, some accident victims find the pain hasn’t faded at all. In fact, it spreads, intensifies, and takes on symptoms that have nothing to do with the original injury for no clear reason. This is often the first sign of complex regional pain syndrome (CRPS), and it can turn what looked like a minor injury into one of the hardest claims to prove and settle. Because there’s no X-ray or MRI that can confirm the diagnosis the way one would for a fracture or torn ligament, adjusters often use the condition’s subjective nature as a reason to dispute the claim entirely.

Understanding what CRPS is, and what it takes to prove it in Washington, is the first step toward getting a fair outcome. Below, we cover what causes CRPS after an accident, what the symptoms look like and how the condition tends to develop over time, why insurance companies push back so hard on these diagnoses, and how Washington law allows you to document and value a CRPS claim.

What Is Complex Regional Pain Syndrome and What Causes It?

Complex regional pain syndrome, formerly referred to as Reflex Sympathetic Dystrophy (RSD), is a chronic pain condition that typically affects one arm or leg after an injury, surgery, or other trauma. What sets it apart from ordinary post-injury pain is the mismatch: the pain is far more severe and lasts far longer than the initial injury would explain. There are two recognized types:

• Type I develops after an injury without any confirmed nerve damage. This is the more common form, and the one most relevant to personal injury claims, since it can follow an ordinary trauma like a fracture, sprain, or crush injury.
• Type II follows a documented nerve injury. It’s sometimes still called causalgia and tends to arise from more direct trauma to a specific nerve.

Complex regional pain syndrome can follow almost any traumatic injury, and it doesn’t require a severe one. It can develop after fractures and crush injuries in car accidents, after falls that caused a wrist or ankle injury, and after workplace accidents involving a hand or foot. Even a period of immobilization, like a cast or a splint following a fracture, can be enough to set the condition in motion.

Researchers haven’t pinned down exactly why this happens. The leading theory points to a malfunction in how the nervous system processes signals after trauma, essentially getting stuck in a pain response long after the tissue itself has healed. It’s an uncommon condition, and not everyone who suffers a similar injury will go on to develop it, which is part of what makes it so hard for insurers and juries to accept at face value.

Why Insurance Companies Dispute CRPS Claims

Insurance adjusters are trained to favor injuries they can verify objectively: a broken bone visible on an X-ray, a torn ligament confirmed by MRI. Complex regional pain syndrome doesn’t offer that kind of proof. No single definitive test exists, so diagnosis relies heavily on a physician’s clinical evaluation of symptoms rather than imaging that clearly shows the damage.

As a result, it’s common for adjusters to argue that the pain is exaggerated, that it’s unrelated to the accident, or that a preexisting condition is really to blame. Because CRPS symptoms fluctuate in intensity over time, insurers sometimes point to those fluctuations as evidence the condition isn’t as serious as it’s being described.

None of this means a CRPS claim can’t be won. It means the claim has to be built differently than an injury case, with more emphasis on consistent medical documentation and a clear line connecting the diagnosis back to the accident.

How CRPS Is Proven and Valued in a Washington Injury Claim

Washington law does not cap the amount of economic or non-economic damages available in a personal injury claim, which matters a great deal in CRPS cases, since the bulk of the harm is often non-economic. Proving this kind of harm starts with the medical record, and the strength of that record often determines how seriously an insurance company treats the claim.

A diagnosis that follows the Budapest criteria, the clinical framework physicians use to formally identify CRPS, carries more weight than a general mention of chronic pain in a chart, since it shows the condition was evaluated against a recognized medical standard rather than assumed.

From there, consistency matters. Ongoing treatment with the same providers, rather than sporadic visits to different urgent cares, builds a documented history that’s harder to dispute. Referrals to pain management specialists or neurologists add another layer of credibility, since they show the treating physician took the diagnosis seriously enough to escalate care. Gaps in treatment, missed appointments, or long stretches without documentation give an insurance company room to argue the condition wasn’t as serious as claimed, or that something else explains the pain.

Beyond the medical chart, these cases benefit from a few additional pieces of evidence:

• A pain journal documenting day-to-day symptoms, flare-ups, and limitations
• Testimony from family members, friends, or coworkers who’ve observed the changes firsthand
• A functional capacity evaluation showing what the injured person can and can’t do
• Projections for future medical care, since CRPS is frequently a long-term or permanent condition
• Evidence of lost earning capacity if the condition prevents a return to previous work

Because CRPS damages are almost entirely subjective, the size of the settlement often comes down to how well the claim is documented and how credibly it’s presented, which is why we treat these cases with the same rigor we bring to any serious, long-term injury.

We Offer Free Case Evaluations For Those Suffering From CRPS

CRPS cases are harder to prove than most personal injury claims because the diagnosis relies on a physician’s clinical judgment and ongoing symptom documentation rather than an X-ray or MRI. Based in Bonney Lake, our firm helps injured clients throughout Western Washington, including Puyallup, Federal Way, and Eatonville, review medical records, coordinate with treating physicians, and document the functional and financial impact of a CRPS diagnosis to build a claim the insurance company can’t dismiss on documentation alone.

If you or a loved one developed complex regional pain syndrome after an accident, contact Anderson Law Injury Attorneys today for a free case evaluation. We don’t get paid unless you win.

The information contained on this website is intended for informational purposes only, and is not legal advice. Nothing in this website establishes an attorney-client relationship between us. Different facts can dramatically affect a legal opinion. You should consult an attorney for legal advice that pertains to your personal situation.