Complex Regional Pain Syndrome and Qualifying for Disability

4. What Happens If I Have Additional Conditions Along With CRPS?

Many people with CRPS also develop or have co-existing conditions, which can actually strengthen your disability claim. The SSA must consider the combined effect of all your impairments, not just look at each one in isolation.

Common co-occurring conditions include:

  Depression and anxiety (chronic pain takes a serious mental health toll)  Post-traumatic stress disorder  Fibromyalgia or other chronic pain conditions  Sleep disorders  Cardiovascular issues  Migraine headaches

When multiple conditions combine, they often create limitations greater than the sum of their parts. For example, CRPS might limit your physical abilities while depression affects your concentration and motivation—together making it impossible to maintain employment even if each condition alone might not be disabling.

5. What Are the Basic Financial Requirements for Qualifying?

Before the SSA even looks at your medical condition, you need to meet certain financial and work history requirements. There are two main programs to understand: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

For SSDI in 2026, you need to:

  Have worked recently enough and long enough to earn sufficient work credits (generally requiring $1,890 in earnings per credit (2026), with most people needing 40 credits total, 20 of which were earned in the last 10 years)  Not be earning more than $1,690 per month (2026) during the period of disability if you’re non-blind ($2,830 per month if you’re blind)—this is called Substantial Gainful Activity (SGA)

The work credit requirement varies based on your age when you became disabled. Younger workers need fewer credits because they’ve had less time to accumulate them.

6. What’s the Appeal Process If I’m Initially Denied?

Here’s something you should know upfront: most initial disability applications are denied. In fact, roughly two-thirds of first-time applicants receive a denial. This doesn’t mean you don’t deserve benefits—it often just means the system requires persistence.

The appeals process has several levels:

1. Reconsideration

  A different examiner reviews your case and any new evidence you submit

2. Administrative Law Judge (ALJ) hearing

  This is where many successful claims are won

3. Appeals Council review

  If the ALJ denies your claim, you can request review by the Appeals Council

4. Federal court

  The final level if all other appeals are unsuccessful

You have 60 days to file an appeal at each level, so don’t miss these deadlines. Each stage is an opportunity to strengthen your case with additional medical evidence, updated records, and more detailed documentation of your limitations.

7. What Happens at Your Appeal Hearing?

The ALJ hearing is your opportunity to present your case in person, and it’s your best chance of winning benefits if you’ve been denied initially. These hearings are typically less formal than court proceedings but still require serious preparation.

Who may be there:

  The Administrative Law Judge: An impartial decision-maker who will ask you questions about your condition and limitations   You (the claimant): You’ll testify about how CRPS affects your daily life and ability to work   Your attorney: If you have representation (which is strongly recommended)   A vocational expert (VE): This specialist testifies about what jobs exist in the economy and whether someone with your limitations could perform them   A medical expert (ME): Sometimes present to review your medical records and testify about whether your condition meets or equals a listing

Hearings can be held in person, by telephone or via video conference. The judge will ask about your work history, daily activities, medical treatment, and specific limitations. The vocational expert’s testimony is crucial—if they confirm that no jobs exist that you could perform given your restrictions (as determined by the ALJ), this significantly strengthens your case.

8. Do I Need to hire an Attorney to Qualify for Disability?

What can’t be stressed enough: having an experienced disability attorney represent you dramatically increases your chances of approval, especially at the hearing level.

Here’s why legal representation matters:

  A disability lawyer knows exactly what evidence the judge needs to see  Can identify gaps in your medical records  Helps obtain opinions from your doctors  Prepares you for testimony  Cross-examines the medical and vocational experts  Presents legal arguments about why you meet the disability criteria

How disability attorneys get paid:

  Most disability attorneys work on contingency, meaning you pay nothing upfront  Attorney fees are typically 25% of your past-due benefits, capped at $9,200 as of 2025  This fee comes out of your back pay only if you win—if you don’t get approved, you don’t owe attorney fees

This arrangement means your attorney is motivated to win your case and makes legal representation accessible even when you’re not working and money is tight.

9. Does Being Over 50 Make It Easier to Qualify?

Yes, absolutely. The SSA’s grid rules—officially called the Medical-Vocational Guidelines—become more favorable as you age.

Once you reach age 50, and especially at 55, the SSA recognizes that it’s harder to transition to new types of work.

If you’re 55 or older, have limited education, and only have experience in physical jobs that you can no longer perform, the grid rules may direct a finding of disability even if a younger person with identical limitations wouldn’t qualify.

This doesn’t mean approval is automatic, but it does mean the SSA gives greater weight to the reality that older workers face significant barriers to learning new skills or adapting to different work environments.

10. What If You Don’t Qualify for SSDI? Can You Get SSI?

If you haven’t worked enough to qualify for SSDI, or if you haven’t worked recently enough, you might still qualify for Supplemental Security Income (SSI).

Key differences:

SSI is a needs-based program, so it has strict income and asset limits.

You generally can’t have more than $2,000 in countable assets as an individual ($3,000 for couples). The maximum federal benefit in 2026 is $994 per month for individuals, though some states supplement this amount.

Unlike SSDI, SSI doesn’t require work credits—you just need to prove you’re disabled and meet the financial criteria. You may also qualify for Medicaid immediately when approved for SSI, which can be crucial for managing CRPS treatment costs.

11. What If You Have a Long-Term Disability Policy?

If you have a private long-term disability (LTD) policy through your employer or that you purchased independently, applying for Social Security disability benefits may actually be required by your policy.

Many LTD policies contain “offset” provisions, meaning they reduce your monthly benefit by the amount you receive from Social Security.

Your LTD carrier may even require you to apply for Social Security benefits and might assist with the application.

Be aware that if you receive LTD benefits and later win Social Security back pay, your LTD carrier may be entitled to reimbursement for benefits they paid during the period covered by your back pay.

Your disability attorney can help you navigate these coordination issues.

12. Conclusion

Qualifying for disability benefits with Complex Regional Pain Syndrome isn’t easy, but it’s absolutely possible with proper documentation, persistence, and the right help.

CRPS creates real, significant limitations that can make working impossible—and the Social Security system does recognize this, even if the path to approval feels frustratingly long.

Remember that most people are denied initially, so don’t give up if you receive that first rejection letter.

Gather strong medical evidence from specialists who understand CRPS, document how the condition limits your daily activities, and seriously consider working with a disability attorney who can guide you through the appeals process.

Your disability claim isn’t just paperwork—it’s your lifeline to financial stability when chronic pain has taken away your ability to earn a living. You deserve benefits that reflect the real impact CRPS has on your life.

13. Frequently Asked Questions

Citations:

SSA CRPS Listing Complex Regional Pain Syndrome Mayo ClinicSSA Age Grid RulesSSA Disability Financial rulesSSI Qualifications – The SSASSA – Residual Functional Capacity