Carpal tunnel syndrome is a debilitating condition that can significantly restrict your range of motion in your wrist, cause pain, and sap your strength. If you have developed this condition on the job, you are likely entitled to workers’ compensation benefits. Since these are often unexpectedly challenging claims, you should consider hiring a workers’ compensation attorney before approaching the insurance company to claim benefits.
What is Carpal Tunnel Syndrome?
The carpal tunnel is a narrow passageway in your wrist on the palm side of your hand. The tunnel is formed by small wrist bones that are on each side. The top of the carpal tunnel is a ligament of connective tissue called the transverse carpal ligament. The entire tunnel is perhaps an inch wide.
Major nerves travel through this passageway and reach your hand. These nerves can transmit messages and sensations from your brain to your hands and vice versa. The main nerve that runs down your arm is called the median nerve.
The nerves running through this tunnel can become squeezed or compressed. Since there is bone on each side and a ligament at the top, the carpal tunnel cannot expand. The only movement is a possible compression that causes carpal tunnel syndrome.
When there is pressure on the median nerve, it can reduce the blood supply. Pressure on the nerve can then cause weakness in your hands, possibly keeping you from using them entirely. You may feel constant pain and discomfort when you have carpal tunnel syndrome.
Causes of Carpal Tunnel Syndrome
You can develop carpal tunnel syndrome regardless of whether you have a job that may be considered physical. Repetitive motion is the primary reason why people will experience carpal tunnel syndrome. If you type on a computer all day long, you are at a high risk of carpal tunnel syndrome, even if you are not doing any heavy lifting or labor for your job.
You can also suffer a carpal tunnel injury if you have been in an accident. For example, fracturing your wrist can lead to carpal tunnel syndrome.
However, there are also health reasons that cause carpal tunnel syndrome to occur over time. For example, rheumatoid arthritis or diabetes can cause you to develop carpal tunnel syndrome. Accordingly, the insurance company may have other reasons to point to when they argue that you have not suffered a job-related injury. You may need medical testimony from your doctor in a workers’ compensation appeal if the insurance company has denied your claim.
Diagnosing Carpal Tunnel Syndrome
You may be experiencing soreness and a dull pain in your wrist. The doctor can perform tests to diagnose carpal tunnel syndrome because you will need medical records that prove your injuries to qualify for workers’ compensation benefits. Your doctor may diagnose carpal tunnel syndrome in a variety of ways, including:
- X-Rays: An x-ray will not necessarily confirm that you have carpal tunnel syndrome, but it can rule out other possible causes of injury to your wrist.
- Ultrasound: This test can examine the tendons and muscles in your wrist, and it can detect whether there is any excess pressure on the nerves.
- Physical examination: Your doctor can tap on or squeeze your wrist to determine your reaction and test your strength. They will report what they find on your medical records.
- Electromyography: The doctor will insert an electrode into your wrist using a tiny needle to evaluate the electrical activity in your wrist when your muscles rest and contract. This test may indicate carpal tunnel syndrome and can rule out other conditions.
- Nerve conduction study: This test is similar to an electromyography, but the conduction occurs on top of the skin. Again, this test can rule out other reasons for injury to your wrist.
Your carpal tunnel syndrome is often a subjective one that the doctor makes based on their experience and what you report you are experiencing. Do not be surprised if the insurance company has their own doctor - who has never seen or treated you - reach their own conclusion at odds with your doctor's diagnosis. Then, you may need to fight the insurance company in a workers’ compensation appeal.
Treatment for Carpal Tunnel Syndrome
Carpal tunnel syndrome is a chronic condition that may be difficult to treat. In some cases, the condition may improve over time with rest. However, you may need to miss work while you are recovering from the injury. Your doctor may put your wrist in a splint and prescribe anti-inflammatory medications for your injury to heal, but it can impact your job.
You may need a combination of rehabilitation and changes to your ergonomic setup to experience some improvement. Your recovery will happen over time, and it may be a while before you can fully work. In the meantime, you may be limited at your job and unable to perform the work you once did.
In serious cases, you need surgery to repair the carpal tunnel syndrome. A surgeon can go in and relieve the compression on the nerve in your wrist. Even still, surgery for carpal tunnel syndrome is not guaranteed to repair the condition. You may incur significant medical expenses to treat carpal tunnel syndrome over time, which workers’ compensation insurance should cover if you qualify for benefits.
The exact treatment you receive depends on the severity of your condition and the judgment of your treating medical professional.
Workers’ Compensation Benefits for Carpal Tunnel Syndrome
You may be eligible for workers’ compensation benefits when you can prove your carpal tunnel syndrome is a job-related injury. First, you must file a workers’ compensation claim that the insurance company will review. They will decide whether to grant or deny your claim (which is subject to review if you receive an adverse decision).
If your workers’ compensation claim is successful, you may receive the following benefits:
- Two-thirds of the average weekly income you were earning, subject to a cap, which is usually the average prevailing weekly wage in your state (each state has its own law that determines how long you can receive workers’ compensation benefits and any aggregate cap on what you can be paid)
- Reasonable medical expenses to treat your injury that can include doctor’s fees, the cost of surgery and rehabilitation, and prescription drugs to help manage your condition
- Vocational training if you need to learn new skills because you cannot perform your job with your injuries
- Mileage reimbursements for driving to medical appointments
If your carpal tunnel syndrome is a permanent disability, you may negotiate a workers’ compensation settlement that can pay you benefits in one lump sum. Your workers’ compensation attorney can negotiate with the insurance company for you, and you should never accept a settlement without first discussing it with a lawyer.
Challenges in Filing a Workers’ Compensation Claim for Carpal Tunnel Syndrome
There are often challenges involved when filing a workers’ compensation claim for carpal tunnel syndrome. Since carpal tunnel syndrome is an overuse injury, you cannot point to one single accident as the cause of what happened. Insurance companies like to challenge overuse injuries on many grounds in an effort to save money.
One of the main issues that you may face is pinpointing the cause of your carpal tunnel syndrome injuries. The problem with your claim is that there may be multiple causes of this condition, and your job may just be one of them. The insurance company may claim that you have not presented sufficient evidence that shows that your carpal tunnel syndrome was job-related. You have the burden of proof to show that your injury was connected to your job, and the insurance company may argue that you failed to meet it.
Then, you need to prove that your injury keeps you from fully working to qualify for workers’ compensation benefits and the medical care you need. A diagnosis of carpal tunnel syndrome relies on what you have been reporting as your subjective symptoms. Even if there is an objective test to diagnose carpal tunnel syndrome, it often relies on your description of your own symptoms. The insurance company is not always inclined to take your word for anything, and they often deny claims that are not clearly documented. The insurance company may claim your condition should not keep you from working.
The insurance company might claim that your carpal tunnel syndrome was a pre-existing condition and was not a job-related injury. However, you may still qualify for workers’ compensation benefits when your job duties have exacerbated any condition that you already had.
You can also face difficulties even after you are already receiving workers’ compensation benefits for carpal tunnel syndrome. At some point, you might be directed to attend an independent medical examination because the insurance company wants to assess your condition to see if you can return to work. They do not like ongoing workers’ compensation claims. Ideally, the insurance company wants to see you return to work because it means they can stop paying the lost income portion of your claim (they may still need to pay medical expenses related to your injury even after you return to your job). Alternatively, they may want to reach a workers’ compensation settlement with you if it means that they can save money in the process.
The independent medical examination will report whether you have a permanent disability or if you can go back to work. Even if you are permanently disabled, the insurance company may underestimate the severity of your injuries. They will assign you a disability rating based on the results of the independent medical examination that may not capture the full severity of your injuries. Your workers’ compensation settlement will depend on the extent of your disability as determined by the medical examination.
You Can Appeal Incorrect Decisions to a Third Party
The insurance company does not get the last word in a workers’ compensation claim. They have their own financial interests that can color their decisions, so you can always file an appeal when they make any decision that negatively impacts your rights. You can certainly appeal an initial denial of your claim. In addition, you can also file an appeal when the insurance company has already granted your claim, but they either refuse to pay for necessary medical care or are prematurely trying to force you back to work. Finally, you can request a second opinion and file an appeal when you have been assigned a disability rating that does not accurately reflect your condition.
Each state will have an administrative office that handles workers’ compensation appeals for carpal tunnel claims. An administrative law judge will hold a hearing where your workers’ compensation lawyer can present evidence in your favor. Many initial claims denials are ultimately converted to benefits, whether because you won your appeal or you have agreed to a settlement. If you do not win your appeal in front of the administrative law judge, you can take your case to state court, where a judge will issue a decision based on the evidence in your case.
Why You Need a Workers’ Compensation Lawyer for a Carpal Tunnel Claim
You may need the help of an experienced workers’ compensation attorney any time that you have what may be viewed as a challenging claim. When you hire a workers’ compensation lawyer for your case, they can do the following:
- Review your medical records and help marshal the evidence you need to prove you have a work-related illness
- Prepare your workers’ compensation claim to submit
- Appeal any wrongful denial of your claim
- Negotiate a workers’ compensation settlement with the insurance company on your behalf
- Advocate for you when you experience any issues related to your claim, such as a refusal to pay your benefits or the insurance company tries to prematurely force you to go back to work
Workers’ compensation is a legal process where you have rights under the law. A workers’ compensation lawyer can fight for you and help protect those rights from an overreaching insurance company that wishes to save money at your expense.
