CRPS cases are lost on documentation — not diagnosis

Your client has CRPS.
Can the chart prove it?

A board-certified interventional pain specialist reviews your client's complete medical record and delivers a physician-authored opinion on Budapest Criteria compliance, causation, permanency, and documentation gaps — before the defense IME exposes them.

The defense IME will argue:
×Budapest Criteria not formally documented
×No three-phase bone scan or thermographic testing
×Symptoms attributable to pre-existing neuropathy
×Treatment pattern inconsistent with CRPS diagnosis
×Insufficient objective findings to support permanency
Our review identifies every one of these vulnerabilities before the defense does.
Physician-Led
Clinical Underwriting
5–7 Days
Turnaround
48 hrs
Expedited Available
Nationwide
All 50 States

The Problem

CRPS is the most misunderstood diagnosis in personal injury litigation

01

The treating physician documents symptoms, not criteria

CRPS requires formal Budapest Criteria documentation — sensory, vasomotor, sudomotor/edema, and motor/trophic categories with specific signs and symptoms in each. Most treating physicians describe pain and swelling without mapping findings to the diagnostic standard. The defense IME does map them — and finds gaps.

02

Confirmatory testing is never ordered

Three-phase bone scan, thermographic assessment, and quantitative sudomotor axon reflex testing (QSART) provide objective evidence that corroborates the clinical diagnosis. Without them, the defense argues CRPS is a subjective diagnosis unsupported by objective data. The treating physician rarely knows to order these tests.

03

The causation narrative collapses under cross

CRPS develops after trauma — but the medical record must establish the causal chain with specificity. When did neuropathic symptoms first appear relative to the injury? Was there a documented inciting event at a specific nerve distribution? Without this, the defense expert attributes symptoms to pre-existing neuropathy or psychological overlay.

The Deliverable

What you receive

A comprehensive, physician-authored written opinion addressing every dimension of your client's CRPS case — designed to withstand defense IME attack and strengthen your position at mediation or trial.

Budapest Criteria Assessment

Systematic evaluation of your client's medical record against the internationally recognized Budapest Criteria. Each diagnostic category — sensory, vasomotor, sudomotor/edema, motor/trophic — is assessed with specific findings from the chart. Gaps in documentation are identified with recommendations for addressing them.

Diagnostic Gap Analysis

Identification of confirmatory tests not yet performed — three-phase bone scan, thermography, QSART, skin biopsy for small fiber neuropathy — with specific rationale for why each test would strengthen the diagnostic foundation. Prioritized by impact on case value.

Causation Opinion

A causation analysis connecting the inciting traumatic event to the development of CRPS, stated within reasonable medical certainty (or your state's applicable standard). Addresses temporal relationship, anatomic plausibility, and differential diagnosis. Pre-existing conditions are specifically addressed.

Permanency & Future Care

Assessment of permanency based on CRPS staging, disease duration, treatment response, and current functional status. Projected future medical care with estimated costs — spinal cord stimulation, intrathecal pump, ongoing pain management, physical therapy, psychological support.

Documentation Recommendations

A specific, actionable list of steps the treating physician can take to strengthen the medical record before the defense IME or deposition. This section alone can change the trajectory of your case.

How It Works
Standard Review
5–7 Business Days
Comprehensive written opinion with all five components
Expedited Review
48-Hour Turnaround
For cases with upcoming IME, deposition, or trial deadlines
Expert Testimony
Available Upon Request
Deposition and trial testimony based on review
Fees discussed after initial case review. No contingency arrangements. Report delivered as signed PDF.

Reviewing Physician

Not a hired gun.
A treating physician.

Your review is performed by a board-certified interventional pain management specialist who actively diagnoses and treats CRPS patients in clinical practice — not a retired physician reviewing files for supplemental income. The difference shows in the opinion.

A treating physician understands CRPS from the exam room. They know which physical findings map to which Budapest categories because they perform those exams daily. They know which confirmatory tests change case trajectory because they order them. They write causation language that holds under cross-examination because they've defended their clinical decisions before.

Credentials
Board Certified — Interventional Pain Management
Board Certified — Physical Medicine & Rehabilitation
Fellowship-Trained — Pain Medicine
Active clinical practice treating CRPS patients
Minimally invasive spine surgery credentialed
Spinal cord stimulation — implanter
Multi-state licensed
Experienced in deposition and trial testimony

National Coverage

Your client is in pain. The defense IME is scheduled. The treating physician's records aren't ready.

We accept cases from all 50 states. Records can be submitted electronically. No in-person examination required for record review and opinion. If your client is in New Jersey or New York and needs treatment, we can discuss clinical evaluation.

Common Questions

Frequently asked by counsel

What records do you need to perform the review?+
Is this a formal IME or a record review?+
Can the reviewing physician testify?+
What if the review reveals the CRPS diagnosis is not supportable?+
How is the report delivered?+
Do you accept cases on contingency or lien?+
What qualifies your physician to review CRPS cases specifically?+
Can you rebut a defense IME that denies the CRPS diagnosis?+
Do you review cases involving CRPS Type I and Type II?+
What if the treating physician has not documented the Budapest Criteria?+
How do you handle cases with pre-existing conditions?+
Can I speak with the reviewing physician before committing?+

Submit a Case

Start with a conversation or submit directly

Submit the form and we'll contact you within one business day to discuss the case and provide instructions for secure record transmission. Or call us directly — we're happy to discuss your case before you commit.

Direct Line
(833) 712-4800
crps@apexinjuryandspine.com
Process after submission:
01Case intake call within 1 business day
02Secure upload link for medical records
03Confirmation of scope and timeline
04Payment processed, review begins
05Signed opinion delivered via secure email
CRPS Record Review Inquiry
All fields are confidential. No records upload required at this stage.
Standard (5–7 days)
Expedited (48 hrs)

Confidential and secure. No medical records are required at this stage. We will provide HIPAA-compliant upload instructions after initial consultation.