Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a condition that occurs when the tissues around the wrist become inflamed and press the median nerve that connects the wrist to the hand. Carpal tunnel itself is a narrow passageway of bones and ligaments, located at the base of your hand. It houses bundles of tendons and the median nerve which twists and bend the fingers. The median nerve plays vital roles including enhancing the sense of touch or pain at the palm region, thumb, middle, index, and the ring fingers. The nerve also controls muscles located beneath the thumb.

If tissues get inflamed, they tend to narrow the carpal tunnel resulting in the compression of the median nerve. Whenever the median nerve is compressed, the hands and the wrist become interfered resulting in pain when they are in use. The pain is continuous and progressive accompanied by tingling and numbness. The inflammation is known to be caused by abnormal bending, persistent striking and twisting, which occurs when hands and the wrist move constantly. The condition may affect both hands and wrists, but it is usually dominant in one hand. People with this condition often experience a lot of fatigue in the hands, especially when they attempt to hold or grab objects.

Although there is no known exact cause of carpal tunnel syndrome, it has been considered one of the occupational conditions. It is mostly associated with tasks that involve repetitive movements of the wrists. Such movements are known to cause swellings of the median nerves or tissues surrounding it, causing pain. Generally, Carpal tunnel syndrome occurs over a long period of time, thus, it can be associated with cumulative trauma. The most common occupations that are known to cause carpal tunnel syndrome include craftsmanship, typing/computer operations, assembling, music, and driving.

Alongside occupations, there are other factors that cause swelling of the tissues at the wrists and eventually cause carpal tunnel syndrome. They include aging, arthritis, diabetes, pregnancy, and thyroiditis. Recreational activities like tennis, crocheting, playing piano, sewing and the use of hand tools have also been associated with causing carpal tunnel syndrome.

If you suspect that you suffer from CTS, you should seek immediate medication. Ensure to go for a doctor approved by your employer. Let them know that your injuries or traumatic conditions are related to employment duties. Give your employer written notice that is approved by your doctor, which shows that you suffer from CTS. This will help you when filing claims. The notification should be given within 30 days after you realized the symptoms. Otherwise, you may not be compensated and you may even lose your job.

There are many medical conditions that have the same symptoms as Carpal Tunnel Syndrome. This may make it difficult for you to assume that you have an injury related to carpal tunnel syndrome when you experience the symptoms. To be certain, visit your doctor and explain to him or her when you first noticed the symptoms suspected to be for CTS. Also, tell your doctor what you were doing when you first developed the symptoms and how the symptoms affect your working ability. Your doctor will perform various tests that will help rule out injuries or diseases with similar symptoms. The most common methods used include:

• X rays- meant to find out if you have arthritis;

• Lab test;

• Ultrasounds, which are meant to detect if there is any abnormal growth of the median nerve;

• Physical examination of the wrist, hand, and fingers. This will check for any discoloration, swellings, and sensation;

• Nerve conduction test to find out if the nerve and the muscles are electrically active;

• Manipulation of the fingers and the wrist to find out cases of numbness and occurrences of tingling.

Carpal tunnel syndrome generally affects your working rate and should be treated as soon as possible. Among the treatment methods for the condition include:

• Drug therapies;

• Hand splits that help prevent the hand from twisting or bending;

• Prescription corticosteroids;

• The use of pain relievers such as over the counter (OTC) drugs;

• Refraining from work and activities that are likely to provoke the CTS symptoms;

• Taking alternative therapies like yoga.

In extreme cases, carpal tunnel treatment may require surgery. The procedure is commonly termed as “carpal tunnel release” and involves detaching a ligament on the median nerve. This will help reduce the pressure that was exerted on the nerve. You will be supposed to take between 3-5 visits to a physical therapist for approximately 3-5 weeks. Total healing is expected to take no more than three months. During this time, you should be off the job to allow for healing. The specific duration will depend on several factors including the requirement of your job, the seriousness of the injuries, and the type of treatment you require.

It may reach a point during the treatment process when your doctor demands to check if Maximum Medical Improvement (MMI) point has been reached. At this point, no treatment will improve your conditions.

If your doctor declares that you are “temporarily totally disabled” it implies that you will be able to work as usual after a given period of healing. Alternatively, your doctor may recommend that you are given a modified job that enables you to work with your conditions.

You may also be diagnosed with a permanent partial disability. This occurs when your doctor believes that the tunnel carpal syndrome you are suffering from has lasting effects on you which are not treatable. You will not be able to resume your initial job. The workers’ compensation insurance you are covered by should send you a lump sum for the settlement of the injury. In addition, you should receive therapy expenses.

Carpal tunnel syndrome is a condition that can be prevented. Prevention methods involve redesigning of the job’s workstations and tools. Workers should also be trained on the proper use of various tools and equipment while at work. Designing workstation well will help avoid uncomfortable positioning of the wrist and, consequently, reduce stress caused by repetitive movements. While designing a workstation, employers should consider the body sizes of specific employees. This is achieved by installing tools like benches that are adjustable to fit specific employees. Job designing include:

• Rotating tasks among the workers;

• Giving employees a rest to relieve the muscles and joints from stress-related complications;

• Giving workers break to help relieve them from monotony and patterns created by repetitive motions.

Workers’ Compensation covers specific on-job injuries and cumulative trauma. CTS is a condition that occurs over time, which is also covered by the compensation program. In California, employers are required to provide their employees with workers’ compensation coverage. Thus, if you experienced symptoms for CTS and your doctor confirms it, you should file for the compensation claim.

If you suffer from CTS due to job-related activities, you are allowed to file for Workers’ Compensation claims, and possibly get compensated. Carpal tunnel syndrome is a bit different from other accidents and injuries related to work in that they are not instant. Instead, they progress gradually and may take you a long time before you realize its symptoms.

However, the process of filing for a compensation claim is similar to those for other injuries. It starts when you report the injury to your employer for the first time. When reporting the condition, you should give a concise approximation of the day when you first experienced the symptoms of CTS. Then, the employer should provide you with a claim form as well as instruction of how to fill it. A workers’ compensation representative can also help you through this step. After filling the claim form, you should file it. While filing the claim form, be cautious with the deadline as this may lead to your compensation claims being rejected.

You may feel that the medical attention and treatments you are provided by the Workers’ Compensation are not enough. In such a case, you are allowed to seek for your own doctor. You should first send a request in writing to your employer before taking any action.

The benefits you should receive from the Workers’ Compensation for CTS include:

• Medical care comprising of medicines, lab tests, doctor’s visits, visits to health centers, medical equipment among other medical requirements;

• Payments for temporary disabilities. You receive the payments for the wages and salaries you lost during the recovery period. It is normally up to two-thirds of wages you used to receive before the injury. Generally, the payment doesn’t go beyond 104 weeks;

• Payments for permanent disability, which is received if you cannot recover from the conditions completely. The permanent injuries could be caused by mental impairment, permanent physical impairment or any other significant measurable injury. For the case of CTS, the permanent disability could be caused by amputation of the affected wrists or fingers. The amount you receive and the duration for the benefits are often determined by the degree of your disability;

• Retraining expenses, which are received if you are not able to resume your initial job, especially if you are given a different or modified job after the injuries;

• Death benefits. The amount for this benefit is given to your dependents when you die due to injuries related to your employment.

The law demands that all employers who have at least one full time or part-time workers should acquire workers’ compensation coverage. There exist exemption and special considerations that the employers need to know. That is;

• The coverage should include all LLC members who participate in the business;

• Non-LLC members are not included in the coverage but they can choose to be incorporated;

• All the directors and executive officers are covered. If they fully own the business, they can choose to be exempt;

• Partners are part of the insurance coverage and they can never elect to be exempted from it;

• Finally, sole proprietors are not included but they can choose to be covered.

Other people excluded in the Workers’ Compensation include volunteers, maritime employees, private homes employees, independent contractors, companies or business owners, railroad employees. Note that as an employee in these occupations, you are not covered by the Workers' Compensation for the pain and sufferings that carpal tunnel syndrome and any other injuries may have caused. However, there may be other options, so be sure to contact us to see if you are able to receive compensation for any work related injury.

For you to get benefits for carpal tunnel syndrome, you need a written note from a physician that approves its existence. The report should also indicate that the condition is directly related to your work. In addition, you should meet the following requirements for you to receive the benefits:

• Should have been employed for a period not less than six months;

• The condition was not caused by other activities not related to job duties;

• You should have physical conditions or injuries that arose from your work duties.

In California, workers’ compensation is a no-fault system. If you are injured, you will not be required to prove the presence of negligence. Rather, you will only be expected to prove that the injury or the syndrome was related directly to the duties you execute while at the job.

If you are injured at work, you are entitled to compensation as we have discussed above. But depending on the specific circumstance of your injuries, you could be blocked from receiving benefits. The main goal of the insurance company disputing the compensation claim for your carpal tunnel injury is to reduce the limits of your benefits or to deny you the claim altogether. You should prove that your injuries meet all the specifications required for compensation. The proving is technical and you may not be able to succeed alone. You will need an experienced attorney to help you.

Generally, the compensation insurance will attempt to use any of the following Workers’ Compensation defenses to bar you from the benefits.

The statute of limitations

California requires that you give an approximate date when you first developed the symptoms related to carpal tunnel syndrome or when you experienced the disabilities. You can also file the claim beginning from the day you knew that the injuries were related to the employment. If you fail to give such time approximations, it may prove difficult for the Workers’ Compensation to process your claims.

Failure to notify the employer

The Workers’ Compensation law demands that you notify your employer of your carpal tunnel injuries immediately or within 30 days from the day you notice its symptoms. You can report it in writing or verbally to your work supervisor personally or through your close relatives like spouse or family member. Your doctor can also report the incident. If you fail to report, the employer will not be aware of your injuries and will not be able to notify the insurance company or the Workers' Compensation Agency.

Lack of causal links between employment and the injury

Typically, the causes of work-related injuries must be closely related to employment for you to be compensated. You may not be compensated if it is established that your injuries are not related to employment.

Injuries that are self-inflicted

Injuries that are intentionally caused by the plaintiff cannot be compensated. If your carpal tunnel injuries were caused by your intentional acts so that you may fraudulently file for claims, the Workers’ Compensation will not compensate you. Other related instances are when you claim compensation yet the injuries were caused by deliberate fights.

Injuries that are not as severe as you claimed

You may have indicated in your claim form that the carpal tunnel injuries prevent you from performing your duties as usual. If it is determined that the claim is untrue, you may be denied the claims, or receive reduced benefits. Consequently, your employer may demand that you resume work immediately.

Failing to attend doctors’ appointments

One of the preliminary stages of filling compensation claims is seeing an independent doctor who will then determine the extent of your injuries and the amount to be compensated. If you fail to show up for the appointment, you may be denied compensation or if given, it may be greatly reduced.

Horseplay or willful negligence

Most workstations have safety rules and regulation which every employee is expected to observe. If your injuries or carpal tunnel related conditions were caused by your failure to observe such rules, your employer may challenge your compensation claim. Though negligence is not usually cited in workers compensation, your employer may refuse to compensate you if the injuries resulted from carelessness or goofing off.

Difficulty determining the cause of the injury

Before you are compensated, the cause of your injuries must be known. In addition, the cause has to be related to employment. Generally, companies or employers use independent medical examiners to determine the cause of the injury. Thus, if the cause is not determined or the factors do not relate to work, you risk receiving no compensation.

If your claims for CTS is rejected, the law allows you to present your case to the judge for a hearing. You will be expected to file a claim that you require adjudication. Ensure to submit all the required documents, and notify your employer about the step you have taken. Also, file a note declaring that you are ready to proceed with the case. Once you are done with the process, an arrangement will be made for a conference meant for a mandatory settlement. Your case may not be settled at this point. You will have to come up with documents that explain your complaint, and what you will be presenting during the trial. Additionally, you will have to provide the names of those who will testify for you. A qualified attorney will be of help to you throughout this process.

The no-fault rule allows you to receive compensation for CTS and any other injuries related to work despite the negligence of the other party. Thus, you cannot sue your employer. The only possible way to receive compensation will be filing for the Workers’ Compensation claims

Still, you may choose to sue your employer for work injuries including carpal tunnel syndrome, especially if the injuries were caused by the employer’s intentional acts. If you do so, you will not have a right to file for workers’ compensation. This is because workers’ compensation was brought to act as a tradeoff between you and your employer; by accepting the benefits you are agreeing to never sue your employer for the injuries. If you consider suing your employer and succeed in it, the court may award you for a variety of damages the injuries caused you. Such damages include pain and suffering, punitive damages, mental distress, and medical expenses.

No. the California state laws makes it illegal for employers to retaliate against employees who file for workers’ compensation claims. If your employer fires or threatened to fire you, you should report immediately to the Workers’ Compensation office in your region.

The procedures followed while filling for a workers’ compensation claim can be complicated. You may not be able to follow them to the letter, leading to no or minimum compensation. The Workers’ Compensation Attorney Group in Long Beach, CA, helps workers file claims for Carpal Tunnel Syndrome and other work-related injuries. Contact our Long Beach workers compensation attorney through 714-716-5933 if you need an experienced and dedicated team of attorneys to help you through this process.