Customer Service Worker’s Foot Injury Leads To Complex Regional Pain Syndrome

Case name: Ridley v. Wal-Mart, 12 ILWCLB 24 (Ill.Ind.Comm.2004).

Ruling: The Commission held that a causal relationship existed between a customer service representative’s complex regional pain syndrome and a foot injury at work when a heavy object was dropped on her foot.

What it means: Continuous pain following a traumatic injury to the foot, changes in coloration or temperature, and successful lumbar sympathetic block treatments to alleviate pain are indicative of complex regional pain syndrome.

Summary: The claimant, a customer service representative, dropped a 50-pound box on her left foot. She underwent treatment, but continued to suffer pain. The arbitrator found that the claimant sustained a contusion injury to her left foot but that she failed to prove she suffered a condition of reflex sympathetic dystrophy as a result of the accident. The Commission modified the decision, noting that two months after the accident, the treating doctor diagnosed possible complex regional pain syndrome and recommended a lumbar sympathetic block to improve pain and for diagnostic purposes.

Following two treatments, the doctor noted dramatic improvement in the left foot pain and affirmatively diagnosed complex regional pain syndrome. The doctor performed additional lumbar sympathetic blocks and, in a final report, found that the claimant’s syndrome appeared to be controlled by both the lumbar sympathetic blocks and pain medication.

The Commission found it reasonable for the claimant to follow the treatment recommended by her doctor, who was treating the claimant as a result of the employer’s referral, and that the treatment record showed the claimant obtained substantial benefit from the treating regimen. Accordingly, the Commission ordered the employer to pay medical expenses of the doctor for treatment reasonably required to cure or relieve the effect of the claimant’s accidental injuries.

The Commission noted that the defendant’s examining doctor opined that the claimant’s neurological examination was unremarkable. He diagnosed trauma to the claimant’s left foot dorsum at the base of her left big toe without evidence of more serious pathology and with no findings that the claimant suffered from complex regional pain syndrome. However the Commission did not find the opinion of the examining doctor be persuasive because he did not examine the claimant until two years afer her accidental injuries.