Carpal Tunnel Syndrome

The workers’ compensation system considers an occupational injury a ‘work-related’ injury if it is a result of an event or exposure at your workplace. When it is determined the carpal tunnel syndrome is a result of your duties causing your condition or aggravating a pre-existing condition, you have the right to file a workers’ compensation claim for your suffering.

Some of the common injuries experienced as occupational injuries in the upper extremities include damage to your shoulder, elbow, and your hand or wrist, such as carpal tunnel. Common injuries to the lower extremities include damage to your heart, hernia, psychiatric, and gastrointestinal system.

Workers’ comp insurance will rate the percentage of loss of function or your level of impairment when you file a claim for carpal tunnel or any other occupational injury. Each part of your body functions differently, so the rating method is different for claims depending on the injury you are claiming.

In California, all injuries are rated according to the American Medical Association Guides to the Evaluation of Impairment, 5th Edition. This guide is used to determine if your injury has caused permanent disability.

• Permanent Disability

If you have developed carpal tunnel syndrome or any other form of injury at your workplace, and will not be able to recover fully, you are entitled to permanent disability benefits. This ‘lost earning capacity’ is a personal injury law.

California permanent disability entitles you to receive money as compensation for the loss of your future earnings. To qualify for this benefit, workers’ compensation insurance will check the medical evaluation of your injury. Once verified it is ‘work-related’ injury, the benefit is modified according to what form of work you perform, the benefits pay-out amount you receive is determined using a scale of 0 to 100%, and you will then be set up on a schedule for benefit payments.

If you have been diagnosed with carpal tunnel syndrome and it has disabled you from being able to perform future jobs, contact the Workers Compensation Attorney Law Firm to ensure you receive the benefits you deserve under California law.

CTS (carpal tunnel syndrome) is the most common California workers’ compensation claim caused by repetitive motion. Your symptoms from this injury will begin with frequent and gradual numbness, itching, burning, and tingling in your fingers and the palm of your hand. You will notice these symptoms especially in your thumb, middle fingers, and index finger.

Many patients who have been diagnosed with CTS and work on keyboards all day report they first notice a tingling in their thumb and index finger which then turns into numbness and pain in their hands. The pain is not as intense when they take a few days off from work, but upon return, it becomes more severe. The symptoms even intensify to the point they begin losing their grip. A medical evaluation will show they are suffering from carpal tunnel syndrome.

There is no scientific cause of how carpal tunnel develops. It is clear that those who suffer from this syndrome perform repeated motions in their employment. When your wrist is continuously moved in the same action for an extended amount of time, it causes the median nerve in your wrist to swell.

It is estimated twenty percent of the population who perform hand-intensive activities all week long for approximately five hours a day or more will develop carpal tunnel syndrome. Women are at the highest risk of developing this injury as on average they have a narrower carpal tunnel than men for the median nerve to travel through, so it more likely to become compressed.

Some of the employment positions that have been known to cause this syndrome to develop include continuously positioning your hands over a keyboard, using a mouse, continuous use of power tools which vibrate, and other movements of your wrists that are repeated. California workers’ comp has been diagnosed in some of these occupations as well:

• Carpenter
• Automotive worker
• Truck driver
• Office assistant
• Cashier
• Grocery clerk
• Firefighters
• Police officers

Carpal tunnel syndrome  can be diagnosed through several different tests:

• X-rays can detect arthritis
• A physical exam of your fingers and wrist to check for sensation, discoloration, swelling, and tenderness
• An ultrasound will show an abnormal size of your median nerve
• A nerve conduction study will measure the electrical activity of the muscles and nerves in your wrist and hands
• Lab tests will detect diabetes
• Manipulation of your wrist by a physician will detect tingling and numbness

Contact your doctor to have a diagnosis if you feel you are suffering from carpal tunnel syndrome. If your doctor verifies this condition, contact your employer and find out how to file a workers’ comp claim to receive the benefits you will need as a treatment for this syndrome.

California workers’ comp program follows a disorder guideline from the American College of Occupational and Environmental Medicine’s. The guideline focuses on hand, wrist, and forearm disorders. It gives advice on how to treat the injury of carpal tunnel syndrome. This guide treats the syndrome through:

• Prescriptions of corticosteroids
• OTC (over-the-counter) pain relief
• Avoidance of activities that will provoke your symptoms
• Splinting
• Yoga as an alternative therapy

Carpal tunnel syndrome often requires surgery to correct the median nerve and relieve its compression. The operation is called carpal tunnel release and involves severing a ligament around your median nerve to reduce the pressure. After you’ve undergone surgery, you will need three to eight weeks of physical therapy within a three to five week time period. You are looking at a three month recovery time.

If you have been diagnosed with CTS, you should be evaluated by an upper extremity specialist that specializes in upper extremity and hand injuries.

Carpal tunnel syndrome is considered a cumulative trauma as this damage occurs over a period of performing the same repetitive motion with your hands at your workplace. To open a workers’ compensation claim for this injury to your hands or wrists will enable you to receive the necessary treatment for this condition. You will require medication, possible splinting, be required to avoid painful activities and you may have to undergo carpal tunnel release surgery.

• Cumulative Trauma

California workers’ compensation law defines cumulative trauma as an injury resulting from repetitive mentally or physically traumatic activities which you perform over an extended period of time. The combined effect of these activities causes a disability which requires medical treatments.

Because this injury does not occur from a single event, you may not know you have developed carpal tunnel syndrome until a doctor has diagnosed it. Not being aware of this injury means you could have quit your job long before you realize the damage is a result of a workplace. Under the law, you have one year from discovering the cumulative trauma work injury caused by a job you were performing to file a workers’ compensation claim.

There is a special procedure to follow and a separate judicial system in California for work injuries. Every employer in California is required to have workers’ compensation insurance, or they will face criminal and civil penalties. When filing a claim for carpal tunnel syndrome, you will have to work with the workers’ comp insurance carrier.

Carpal tunnel syndrome is one of the most common repetitive injury claims under workers’ comp and also one of the most frequently debated issues. The debate arises from whether or not the injury occurred due to a work-related activity, or a non-work related factor. The burden of proof for how your condition developed is up to you. The worker's comp insurance company will look at whether or not you have a second job that could impact the condition, or if you partake in an athletic activity such as tennis that may affect your symptoms.

There is also a debate surrounding carpal tunnel syndrome in determining if the injury should be considered an accident or an occupational disease. How it is classified is important as it affects how you have to go about proving your eligibility for workers’ compensation benefits. If your condition is classified as an occupational disease, you will have to prove with convincing and clear evidence the disease is a direct result of your employment duties.

California Labor Code 3208.1 defines the difference between two types of on-the-job injuries. One type is classified as a specific injury, and the other is cumulative trauma. This classification under workers comp allows for workers to receive benefits when suffering from repetitive trauma injuries such as carpal tunnel syndrome. The two classifications are defined as:

• Specific Injury

Specific injury occurs as a result of one incident or event which causes disability or the need for medical treatments.

• Cumulative Injury

A cumulative injury is a result of repetitive physically or mentally traumatic activities that are prolonged over a period of time and have a combined effect which causes disability or the need for medical treatments. The date to use for reporting this type of work-related injury is determined under Section 5412.

• California Labor Code 5412

Due to the confusion surrounding common work injuries such as carpal tunnel syndrome, it is often difficult to determine a specific date of injury and trying to pinpoint one is nearly impossible. As a result, California adopted the Labor Code 5412 that provides for cases such as those of cumulative or occupational injuries. The date of injury is the date which the employee first suffered disability from, or they became aware of their condition. This date will trigger or determine the date to be used in the statute of limitations.

• California Labor Code 5500.5

The California Labor code 5412 determines the date of the injury which will be used by the statute of limitations, and Labor Code 5500.5 gives you the formula to determine the date of your injury to be used with regards to which insurance carrier is liable for the workers’ comp benefits.

This code defines liability being assigned to those employers you were working for during a period of one year or immediately after the date of the injury which was determined in Labor Code 5412. It further states the last date on which you were employed by an employer in an occupation creating an environment hazardous of occupational disease or cumulative injury or whichever comes first will be used in the determination of which carrier is liable.

Worker comp claims can be stressful and confusing for you as an injured worker. When you have an understanding of how you can file for the benefits you are entitled to, it can make the process a little less distressing. Having the Workers Compensation Attorney Law Firm working with you will make it even less challenging.

If you have received a diagnosis for carpal tunnel syndrome, you will need the benefits from workers’ comp to cover your treatments. To begin the claim process start by reporting to your employer that you are suffering from a work-related injury. You then need to ask your employer for the workers' comp claim form that needs to be filled out and returned promptly. You will also need all the medical evidence you’ve received, but be prepared to be seen by one of the workers’ comp insurance company’s physician to verify your doctor’s findings.

There is a three-step process for filing a workers’ comp claim in California which includes reporting the injury to your employer, filing the actual claim with your employer, and filling out an application for adjudication of claim with your Workers’ Compensation Appeals Board. Each of these steps involves adhering to the deadlines for taking action which begins with the date of your injury, or in the case of carpal tunnel, according to the rules under California Labor Code 5412.

Step One

Within one working day after you’ve received your diagnosis, report your injury to your employer and request the workers’ compensation claim form DWC-1. Follow the instructions on the form and be sure to indicate the carpal tunnel syndrome as your injury.

As soon as you can, report your injury or illness to your employer. Not reporting within the correct time frame could cause you to lose your workers’ compensation benefits.

Step Two

The DWC-1 form will then need to be returned to your employer or sent by mail to your insurance company. You are required to fill out this form within one day of reporting your injury to your employer. Once this form has been submitted, the insurance carrier must authorize payment for any medical treatment you need as they investigate the claim. While they examine the workers’ comp claim, the insurance carrier is responsible for up to $10,000 of your medical costs. If they do not deny your claim within ninety days, under California Labor Codes 5402(b) and c (2018), your claim will be considered approved.

Step Three

Many times an employer’s insurance company will begin paying your medical and temporary disability benefits, but then you run into disagreements regarding your condition. If disputes arise from a workers’ comp claim, you have to open an Application for Adjudication of Claim. When your employer’s insurance company denies your workers’ comp claim, contact the Workers Compensation Attorney Law Firm to discuss your options and receive assistance with the application.

The Application for Adjudication of Claim has to be filed within one year of the date of your injury or the date discovered under Labor Code 5412, the last day your employer-provided medical benefits, or the day when your temporary disability benefits end.

The courts have discovered injured employees might have longer to file the application if their employer or the insurance carrier advanced payments to cover medical costs knowing the treatment was most likely a workers’ comp claim. If this situation is discovered, you have five years from the injury date, or the date according to Labor Code 5412, to file your application. You still have only one year to file after receiving notification your claim is being denied.

If you miss a workers’ comp claim deadline, you will need the experience of Workers Compensation Attorney Law Firm as this area of law is very complex. There are circumstances your attorney can find that may excuse your delay in filing, or they may be able to get your time period extended. Carpal tunnel is a painful condition, and you will want a knowledgeable attorney working with you to ensure you receive your full medical benefits to treat this injury.

There is no exact reason for carpal tunnel syndrome, so it will up to you to explain the work activities that you feel caused your injuries. It will also be up to you to choose a specialist in upper extremities to ensure you receive the right treatment.

Under the California workers’ compensation laws, you are entitled to collect temporary disability payments as a replacement for part of your lost income. This benefit is provided after your doctor has verified you are unable to return to work.

These benefits usually take place after three days of your disability. These three days are considered a ‘waiting period.’ There are exceptions to the three day waiting period:

• Exceptions to 3-day Rule

The temporary disability lasts for more than fourteen days

You require inpatient hospitalization

You are a qualifying state employee, and the disability is a result of a criminally violent act

The American Medical Association Guides to the Evaluation of Permanent Impairment, Fifth Edition is used by California’s workers’ compensation system. In Chapter 16 of this guide, carpal tunnel syndrome is evaluated to determine the loss of sensation which moves through the median nerve to the hand and fingers. The evaluation looks at the amount of damage in hand movement as well as the loss of strength. To determine these losses, a nerve conduction study is required.

• Nerve Conduction Study

A nerve conduction study measures how quickly impulses move through your nerve. This study is able to determine your nerve damage. The test stimulates your nerve with electrode patches attached to your skin over your nerve. One of the electrodes will stimulate your nerve with a mild electrical impulse. The second electrode records the results of the first electrode. The test is repeated for each nerve.

The speed is calculated by measuring the distance between electrodes and how long it takes for electrical impulses to travel between the two electrodes. This test is often done in conjunction with an EMG to determine the difference between a nerve disorder and a muscle disorder. The nerve conduction study will detect an issue with your nerve, while the EMG will detect a problem in your muscles and determine if they are working correctly in response to your nerve’s stimulus.

Depending on the result of these tests, workers’ comp will determine whether or not you are entitled to a disability benefit. If you feel they have not evaluated your condition properly, contact the Workers Compensation Attorney Law Firm to talk about your case and determine if you have a case for appeal on the insurance decision.

If you have carpal tunnel syndrome from performing your work duties, contact our Los Angeles Workers Compensation Lawyer at 310-956-4277. We have the experience you will need to help you through a workers’ compensation claim. These claims are complicated and confusing, and we want to help you understand the process and receive the benefits you deserve.