How to Prove Your Carpal Tunnel is Work-Related
You Can Get Medical Coverage, Cash Benefits, and a Workers Comp Settlement for Carpal Tunnel Caused by Your Job
No matter your occupation or the industry you work in, you probably use your hands to complete job tasks. And the more often you use your hands to do your job, the higher the risk your work will cause carpal tunnel syndrome (CTS).
In some situations, you may qualify for workers compensation benefits and a settlement for carpal tunnel. But you will need to present medical evidence from your orthopedic surgeon that links your carpal tunnel problems to your employment. And proof that excludes activities outside of work as potential causes.
The purpose of this article is to discuss how to prove your carpal tunnel is work-related. I hope you use this information to win your workers compensation hearing if necessary and to negotiate a fair workers comp settlement amount for carpal tunnel syndrome.
If you have questions about how workers comp works in Virginia, how much it pays, and how you can protect your legal rights, call me for a free consultation: (804) 251-1620 or (757) 810-5614. See why past clients and my fellow attorneys have voted me one of the best workers compensation lawyers in the state year after year. And what results I can get for you and your family.
What is Carpal Tunnel Syndrome?
Three nerves run through your hand and forearm: the median nerve, the radial nerve, and the ulnar nerve.
The median nerve helps you move your thumb and flex your wrist and fingers. It also provides sensation to your thumb, ring, middle, and index fingers.
The radial nerve helps you extend your elbow, wrist, and fingers.
The ulnar nerve helps you move your fingers.
When the transverse carpal ligament becomes inflamed and swells, it can press, squeeze, or pinch the median nerve—this inflammation results in carpal tunnel syndrome.
What are the Common Symptoms of Carpal Tunnel Syndrome?
Symptoms of carpal tunnel syndrome often start gradually and worsen over time – both in frequency and severity. They include:
- Numbness
- Tingling
- Paresthesia
- Burning
- Loss of feeling (not being able to determine if something is hot or cold)
- Weakness
- Dropping objects
Many of my clients first experience carpal tunnel syndrome symptoms in their dominant hand during the night, with the symptoms getting better throughout the day. Over time, however, the symptoms persist longer and are triggered by more and more activities.
What are the Common Causes of Carpal Tunnel Syndrome?
Repetitive motion that increases pressure on your median nerve and the tendons in the carpal tunnel is the leading cause of carpal tunnel syndrome. For example, typing, using vibrating hand tools, and picking up items can cause carpal tunnel syndrome.
It is also possible for a specific event resulting in trauma to your hand or wrist to cause carpal tunnel syndrome. For example, a work-related motor vehicle crash, a fall from a height, or a slip and fall may result in a sprain or fracture and swelling that contributes to carpal tunnel syndrome.
Who is at the Greatest Risk of Developing Carpal Tunnel Syndrome at Work?
Carpal tunnel syndrome is the most common entrapment neuropathy.
Women are more likely than men to develop carpal tunnel syndrome—about three times more likely.
Those of you who work in jobs that require constant use of your hands are also at higher risk of developing carpal tunnel syndrome. Many of my clients with carpal tunnel syndrome have worked in the following industries:
- Sewing and textile work;
- Cleaning;
- Meatpacking for companies such as Tyson Foods, Perdue Foods, and Smithfield Foods;
- Construction workers such as carpenters, electricians, and plumbers; and,
- Administrative work involving typing and data entry.
Other common medical conditions, called comorbidities, increase the likelihood that you will develop carpal tunnel syndrome. Common conditions that increase your risk include diabetes, obesity, and thyroid disorder.
How is Carpal Tunnel Syndrome Diagnosed?
After taking your patient history, your workers comp doctor will conduct a physical examination and possibly refer you for diagnostic testing.
Medical Signs of Carpal Tunnel Syndrome
During the examination, your doctor will check for different signs of carpal tunnel syndrome. These include:
- Phalen’s Sign: Your doctor will put your wrist in 90 degrees of flexion to see if you have pain. Pain indicates you have carpal tunnel syndrome.
- Pin Prick Testing: Your doctor will see if you feel a pinprick. Or if you or can tell the difference between light and heavy touch on your hand’s median nerve distribution.
- Tinel’s Sign: Your doctor will tap your median nerve to see if you have numbness, tingling, or paresthesias. If you do, carpal tunnel syndrome is indicated.
If one or more of these tests are positive, your doctor will likely refer you for a nerve conduction study.
Electromyography (EMG)/Nerve Conduction Study for Carpal Tunnel Syndrome
Nerve conduction studies are the best diagnostic tests for carpal tunnel syndrome. When done correctly, they identify carpal tunnel syndrome with greater than 90 percent accuracy.
Your nerve conduction study will compare the sensory conduction of your median and radial nerves at the thumb. Then it will analyze the conduction velocity near and away from the carpal tunnel in the palm. A slow nerve conduction velocity in the specific nerve segment indicates you have carpal tunnel syndrome.
Some doctors will refuse to operate on your carpal tunnel without confirmation by motor conduction tests.
What is the Treatment for Carpal Tunnel Syndrome?
In the short term, conservative treatment is usually successful in easing the symptoms of carpal tunnel syndrome. Conventional treatment includes ergonomic changes (changing the position of your hands or using tools at home or work), bracing at night, splinting, over-the-counter and prescription medication, and corticosteroid injections.
In the long run, however, many of you will be referred for surgery. You may have already had surgery if you are reading this article. At least one study found that half of all patients will be referred for carpal tunnel syndrome about 18 months after first receiving treatment for the condition.
The typical delay in the need for surgery is one reason you should file a workers comp claim as soon as you are diagnosed. Even if the conservative treatment is working and you do not think you will miss work because of carpal tunnel syndrome. By the time you realize you may need surgery, it may be too late to file a claim. The statute of limitations for workers comp claims is two years from the date you are told the carpal tunnel syndrome is related to your employment.
What Can I Expect from Carpal Tunnel Release Surgery?
Carpal Tunnel Release
If conservative treatment does not work, your doctor may recommend you undergo a surgery called a carpal tunnel release.
During carpal tunnel release surgery, the orthopedic surgeon cuts your transverse carpal ligament. Doing this releases the pressure on your median nerve.
There are two types of carpal tunnel release surgeries: open and endoscopic. Open carpal tunnel release involves a two-inch cut from your wrist to your palm, which may result in scarring. Endoscopic carpal tunnel release involves a smaller incision. It allows you to heal faster, but one study has found an increased risk of nerve damage with this type of surgery. And there may be an inadequate release of the transverse carpal ligament.
Carpal tunnel syndrome release surgery helps many patients with moderately severe damage to their ligament.
What to Expect After Carpal Tunnel Release Surgery
Below are guidelines on the light-duty work restrictions you can expect to receive after a carpal tunnel release. I include how long it may take to get released to full duty. These guidelines are based on my conversations with orthopedic surgeons who perform carpal tunnel release surgery and what I have observed with my clients.
- Immediately After the Carpal Tunnel Release: No heavy lifting, repetitive use of the hand, or grasping and fingering with the hand for 6 to 12 weeks. If you are unable to perform your job one-handed or with limited use of the affected hand and wrist, you should file a claim for temporary total disability benefits.
- One to Three Weeks Post-Carpal Tunnel Release: You will have minimal use of the hand and occasionally lift less than 5 pounds.
- Three Weeks to Eight Weeks Post-Carpal Tunnel Release: You will be able to progress to lighter or medium-level use of the hand.
- Eight to 12 Weeks Post-Carpal Tunnel Release: You may be released to full duty.
Remember: These are projections. Your recovery may be shorter or longer. And you may have both permanent impairment and permanent restrictions because of your carpal tunnel syndrome and surgical complications.
How Do I Prove My Carpal Tunnel Syndrome is Related to My Job?
Code Section 65.2-400 discusses claims for occupational diseases under the Workers Compensation Act. It states that carpal tunnel syndrome is a common disease of life.
This classification is essential. It means you have a higher burden of proof to receive workers comp for carpal tunnel syndrome. You must prove that your carpal tunnel syndrome is related to your work by clear and convincing evidence, not a mere probability.
To meet this higher burden of proof, I recommend presenting testimony that your work is the primary cause of your carpal tunnel syndrome. You do not have to exclude all other possible causes of carpal tunnel syndrome to get workers comp benefits. Still, you need to show that your employment is the main reason for the condition. You do this by testifying about:
- The length of your work with this specific employer. You do this to show how long you had a job that required frequent or constant hand use.
- Every task you performed with your hands throughout your employment.
- How little your home activities or hobbies require the use of your hands.
You must ask your treating physician to write a report or answer a questionnaire stating that they are aware of your outside activities. But that it is your employment, not these other activities, that is the primary cause of your carpal tunnel syndrome. Even if your other activities are routine things like typing, weightlifting, yoga, bowling, sewing, or gardening, otherwise, you will lose.
What Workers Comp Benefits are Available for Carpal Tunnel Syndrome?
You may be eligible for the following benefits if you prove your carpal tunnel syndrome is work-related:
- Lifetime Medical Benefits for all treatment that is reasonable and necessary for your carpal tunnel.
- Temporary Total Disability benefits if your doctor disables you from all work or restricts you to modified duty work and your employer cannot accommodate your restrictions.
- Temporary Partial Disability benefits if your employer can accommodate your light duty restrictions.
- Vocational Rehabilitation if you are unable to return to your pre-injury job because of permanent restrictions related to carpal tunnel syndrome.
- Permanent Partial Disability benefits for loss of use of your hand and arm.
- A lump-sum settlement.
What is the Average Workers Comp Settlement Amount for Carpal Tunnel Claims?
In my experience, the average workers compensation settlement amount for carpal tunnel claims is between $30,000.00 and $65,000.00. But some settle for much more or much less. Your settlement for workers comp depends on whether you can return to your pre-injury job after surgery.
The amount of your carpal tunnel settlement will depend on:
- Your pre-injury average weekly wage.
- Whether you suffered additional injuries at the same time, you developed carpal tunnel syndrome, such as a back or neck injury.
- Whether you developed depression or anxiety because of your work-related carpal tunnel syndrome. If so, your psychiatric condition may be covered by workers comp as a compensable consequence.
- The strength of the medical evidence in your claim.
- The types of activities you do outside of work that require frequent or constant hand use.
- Whether you have reached Maximum Medical Improvement (MMI) for your carpal tunnel condition.
- Whether you have permanent restrictions that will prevent you from returning to your pre-injury employer. Usually, permanent restrictions are given after a Functional Capacity Evaluation (FCE) is ordered by your doctor. A 2000 study found that close to 40 percent of workers compensation claimants with carpal tunnel syndrome lose their job. And more than half of all workers comp claimants continue to have difficulty with home, work, and recreational activities one to five years after being diagnosed with carpal tunnel syndrome and an upper extremity cumulative trauma disorder. These facts should increase the value of your workers comp settlement for carpal tunnel.
- Whether you develop Complex Regional Pain Syndrome (CRPS) requiring chronic pain management.
Get Help with Your Carpal Tunnel Workers Comp Claim
Proper preparation and development of the evidence are crucial to winning your claim for carpal tunnel syndrome or negotiating a fair settlement.
My goal is to help you win your claim for carpal tunnel and get a settlement – without the need for litigation and trial. If possible, I want to help you avoid extensive discovery, depositions, interrogatories, and requests for production of documents.
No matter your occupation, I can help you win. Call now to resolve your carpal tunnel claim: (804) 251-1620 or (757) 810-5614.
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