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Case Study: A Successful CRPS Settlement



This case relates to a liability admitted accident at work in 2016. The Claimant was injured when his right hand became trapped between tread plates in the course of his employment working as a tyre building for a large tyre manufacturer. The nature of the task undertaken and the equipment the Claimant was provided with were inherently dangerous and therefore met the test that the Claimant’s injuries were reasonably foreseeable and therefore avoidable.


As a result of the crush injury to the Claimant’s dominant hand, he developed Complex Regional Pain Syndrome type II (Causalgia), suggestive of some nerve damage.


The Claimant was living with his wife and two children when the accident occurred.


Unfortunately, because of severe pain and symptoms of depression secondary to pain, the Claimant was unable to return to work.


The Claimant and his wife had planned for the future and were intending to purchase their forever home until the accident happened which changed everything.


The Claimant and his wife lived in a small three-bed mid-terraced house which was woefully inadequate to cater for the Claimant and his family’s needs, particularly post-injury where it was established the Claimant would need space to deal with his condition. Prior to the accident the Claimant helped around the home (and in the garden, cultivating vegetables) within the limits of his working hours, and he contributed to childcare and chores. The Claimant never used the fact that he worked as a reason just to put his feet up and let his wife do everything.


As a consequence of the accident, the Claimant and his wife lost their stable regular means of income, in the form of the Claimant’s salary and they suddenly found themselves in financial difficulty. The Claimant’s wife became the Claimant’s carer and took over all childcare duties which the Claimant could not manage.


Before the accident they had no debts, did not claim benefits and the Claimant’s salary paid for everything including a family holiday, whilst his wife was a stay-at-home mum and housemaker.


As a result of the injuries the Claimant and his wife ultimately separated due to the strain of living with the Claimant’s condition.

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Interim payment


Sadly, by the time we took over the Claimant’s case, the couple had got into debt whilst adjusting to life without the Claimant’s salary and whilst waiting for statement benefits to be processed. The original solicitors were a large national practice who did not know about the Claimant’s condition, had not sourced much-needed interim funds for the Claimant were hard to contact and were in large part non-communicative and ineffective.

The Claimant transferred his case to us about a year after the accident and we were able to secure an interim payment based on preliminary medical evidence which enabled him to offset some of his debts and to help bridge the gap between state benefits which by then he had secured and his previous income.

His injuries impacted on so many areas of the couple’s lives and ultimately it became untenable to remain a couple after so many years of trying to deal with the emotional and financial fallout of the accident, and ultimately, they were unable to save their marriage.

Liability and Causation

As is often the case, people assume that when primary liability is admitted, i.e., that some injury and financial losses are admitted as having arisen out of a negligent act, it is going to be a straightforward case of obtaining medical evidence to support the injuries, adding up the financial losses and putting in the claim. This really is far from reality in chronic pain cases and this case was a good example of how the main battleground is causation, rather than negligence.


An insurer can admit liability for an accident, without admitting the full extent of the pain and suffering and the financial consequences.


To explain, as stated above the Claimant had a crush injury in the accident, this was not disputed. Secondary to his crush injury he had a diagnosis of CRPS which he gained from a nationally recognised pain team within the NHS with specialist knowledge of the diagnosis and treatment of CRPS. He also developed depression and anxiety and both conditions were diagnosed using the latest diagnostic criteria.


As well as the reliable diagnosis on the NHS, we sought expert reports in the case from a leading pain consultant, a leading hand surgeon and a psychiatrist with expertise in chronic pain and psychological overlay. All this evidence strongly supported the diagnosis of CRPS attributed the onset of the condition to the accident and justified a claim for future lost income until retirement as a result of permanent symptoms.


The Defendants disputed the diagnosis of CRPS, claimed the Claimant had developed transient soft tissue injuries and that he was vulnerable to the development of chronic pain and had a psychological condition called Somatoform Symptom Disorder (SSD). This is treatable and in basic terms explains the pain as being of a psychological origin, rather than physiological. The fact SSD can be treated means it is far less valuable in terms of damages and would not impact future earnings and future care and assistance would fall away post-recovery.

Joint settlement


The matter was hard fought over four years and eventually was taken to a Joint Settlement Meeting (JSM).


The issues between the parties were straightforward to identify:

  1. Diagnosis/reliability of CRPS ‘v’ other possible diagnoses;

  2. Treatment and prognosis;

  3. Consequent quantum issues.


The Claimant’s case as presented at the JSM was that the Court would accept that the Claimant was a skilled, hard-working, truthful, family-orientated man, who suffered an injury from which he had not obtained any meaningful measure of recovery.


Applying the Budapest criteria


The experts for the defence looked to sidestep the Budapest Criteria when we evidentially could prove the criteria had indeed been met.


Failure to mention CRPS-NOS


Over time the objective signs of CRPS when met by the Budapest criteria had abated, and the criteria for CRPS-NOS are to be considered. The experts for the defence did not consider this.


Final Verdict


Given the detailed and forensic approach to the evidence undertaken by us, we were able to successfully recover a seven-figure settlement for the Claimant which has secured his future earnings, care and assistance needs and some luxuries as he continues through life with this debilitating and painful condition.

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