Carpal Tunnel Syndrome and Workers Compensation – Part Two

Posted on Friday, October 30th, 2020 at 8:52 am    

Carpal tunnel syndrome is painful and is likely to cause workers to lose time from their job. If your median nerve isn’t working you’ll have a lot of complications such as:

  • Not being able to use your thumb effectively
  • Not having the right feeling in your fingers
  • Not being able to hold objects well
  • Not being able to distinguish between hot and cold – on touch

How does your doctor diagnose carpal tunnel syndrome? 

According to the Mayo Clinic, your physician will conduct a series of tests and questions to determine if you have carpal tunnel syndrome. These tests and questions include:

  • Asking you about your symptoms. The doctor will take an oral history of the problems you’re having such as asking when the pain occurs and under what conditions it occurs.
  • Physically examining you.  The doctor will examine how well you feel with your fingers and how strong your hand muscles are. He/she will bend the wrist, touch on the median nerve, and/or press on the nerve to see if these efforts trigger pain.
  • Taking X-rays. Generally, X-Rays can’t diagnose carpal tunnel syndrome. X-rays can rule out other problems such as fractures.
  • Giving you an electromyography. This test measures the tiny electrical discharges produced in muscles. During this test, your doctor inserts a thin-needle electrode into specific muscles to evaluate the electrical activity when muscles contract and rest. This test can identify damage to the muscles controlled by the median nerve, and also may rule out other conditions.”
  • Taking a nerve conduction study. Here, two electrodes are taped to your skin. Then a small shock is directed through the median nerve – “to see if electrical impulses are slowed in the carpal tunnel.” The test can help diagnose carpal tunnel syndrome and also helps rule out other medical conditions.
  • Giving you a Tinel test. This test is a physical test to see if you develop a tingling sensation or if you are numb in certain areas of the wrist and hand. 

Imaging tests may also eliminate other problems such as diabetes.

What are the initial treatments for carpal tunnel syndrome?

It’s best to start treatments of carpal tunnel syndrome as quickly as possible. Early self-help treatments include:

  • Taking more frequent rest breaks
  • Avoiding any actions that make your symptoms worse
  • Using cold packs to help reduce any swelling

In milder cases, where your condition is less than 10 months old, splinting may help. If, however, your hands feel numb, you should treat with a doctor as soon as possible. As a general rule, you should see a doctor, even if you have a mild case, so he/she can diagnose the condition and recommend initial therapy.

Splinting the wrist helps keep the wrist still while you sleep. Patients use the wrist splint at night though it can help with daytime aches and pains.

Some stretching exercises may help. Some patients seek chiropractic care and/or acupuncture

What nonsurgical treatments may help?

Some nonsurgical therapy treatments include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). These medications may help reduce carpal tunnel syndrome pain. NSAIDs include Advil, Motrin IB, and other medications. Generally, NSAIDs don’t improve your disorder. The aim of these drugs is to hopefully reduce the level of pain.
  • Corticosteroids. These are injections designed to help reduce pain. Sometimes your doctor uses an ultrasound to guide these injections.” “Corticosteroids decrease inflammation and swelling, which relieves pressure on the median nerve. Oral corticosteroids aren’t considered as effective as corticosteroid injections for treating carpal tunnel syndrome.”

What types of surgery are used for treating carpal tunnel syndrome?

The Mayo Clinic indicates that there are two types of carpal tunnel syndrome surgery:

  • Endoscopic surgery. “Your surgeon uses a telescope-like device with a tiny camera attached to it (endoscope) to see inside your carpal tunnel. Your surgeon cuts the ligament through one or two small incisions in your hand or wrist. Some surgeons may use ultrasound instead of a telescope to guide the tool that cuts the ligament.” This type of surgery, during the first few recovery weeks, may be less painful than open surgery.
  • Open surgery. “Your surgeon makes an incision in the palm of your hand over the carpal tunnel and cuts through the ligament to free the nerve.”

There are risks to surgery that your surgeon should explain to you before any operation. These risks include:

  • “Incomplete release of the ligament
  • Wound infections
  • Scar formation
  • Injuries to the nerves or blood vessels”

The healing process, after surgery usually takes a few months. During this time, “the ligament tissues gradually grow back together while allowing more room for the nerve.” Employees, who are entitled workers’ compensation, should receive temporary disability during the healing process. The employer’s insurance carrier should pay for the surgery.

In some cases, your symptoms may not completely disappear after surgery.

Are you entitled to workers’ compensation if you have carpal tunnel syndrome?

Often, employees can show that they developed carpal tunnel syndrome due to their work. Still, that doesn’t mean you’re automatically qualified for workers’ compensation in either North Carolina or Virginia. Generally, injuries must either be due to a workplace accident or an occupational illness or disease.

In Virginia, Carpal Tunnel Syndrome is specifically not recognized as a statutory occupational disease the same way as something like asbestosis; however, it is probably the most commonly claimed “ordinary disease of life” that injured workers claim is due to have occurred due to exposure to specific work conditions. 

It is definitely not a given that a claim for carpal tunnel will be found compensable. In Virginia, any “ordinary disease of life” much meet the higher standard of “clear and convincing” evidence. This means that there must be very clear proof that the unique work conditions are such that they have caused the CTS, and also that the CTS is not due to factors outside of work. It must be “characteristic of the employment and was caused by conditions peculiar to such employment.”

Employers will typically argue that your carpal tunnel syndrome is due to other conditions – such as a second job or activities you do at home. They’ll also argue that you had a pre-existing carpal tunnel condition caused by other activities or conditions that pre-dated your work history with the employer.

North Carolina is similar in its proof requirements. CTS would fall under the “catch all” occupational disease claim found at N.C.G.S. 97-53(13)  which does generally allow a carpal tunnel syndrome claim to be filed if it is due to a repetitive stress injury – if it can be shown that the CTS is proven “to be due to causes and conditions which are characteristic of and peculiar to a particular trade, occupation or employment, but excluding all ordinary diseases of life to which the general public is equally exposed outside of the employment.”

If you are able to prove your claim, while you’re out of work due to the CTS, you should be entitled to temporary disability benefits at 2/3rds of your average weekly wage and of course coverage for any and all treatment related to your CTS. If your hand doesn’t completely recover, and you end up with some kind of permanent impairment, you may be entitled to permanent partial disability (PPD) benefits.

North Carolina and Virginia workers’ compensation lawyer Joe Miller Esq has helped thousands of injured workers obtain just recoveries. He understands the unique coverage and treatment issues involved with carpal tunnel syndrome claims. To talk with a seasoned work injury lawyer, call North Carolina and Virginia attorney Joe Miller, Esq., at 888-667-8295. or use my online contact form or our new online case evaluation form to find out if you may have a claim.