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Carpal Tunnel Syndrome and Social Security Disability

Carpal Tunnel Syndrome - Condition and Symptoms

Carpal Tunnel Syndrome (CTS) is a disability characterized by enlarged or inflamed ligaments or tendons in the carpal tunnel area of the wrist. The enlarged or inflamed tissue pinches the median nerve that is located in the tunnel of bones and ligaments running from the wrist to the fingers and the base of the thumb (the carpal tunnel). The median nerve controls feeling in the thumb and fingers and allows the fingers and thumb to move.

A physician diagnoses Carpal Tunnel Syndrome with a physical examination of the hands, arms, shoulders, and neck to determine whether an underlying condition exists such as diabetes, arthritis, or fracture. The wrist, each finger, and the muscles at the base of the hand are all examined.

There are also condition-specific tests for Carpal Tunnel Syndrome, including the Tinel test and the Phalen test, both of which are intended to produce symptoms of CTS by applying pressure to the median nerve. It may be necessary to confirm the diagnosis by use of electro-diagnostic tests, which measure nerve impulses or allow the physician to view electrical activity in the muscle. Ultrasound imaging can show impaired movement and magnetic resonance imaging can show the anatomy of the wrist.

Symptoms of Carpal Tunnel Syndrome include tingling, burning, or numbness in the fingers, loss of strength in the hands, loss of dexterity, locked joints, swelling, inflammation, and pain. A person with Carpal Tunnel Syndrome may feel the need to "shake out" the hand or wrist to improve flexibility. Some people have a difficult time telling the whether an object is hot or cold. If untreated, it is possible for the muscles at the base of the thumb to atrophy.

Wrist injury that causes swelling, an overactive pituitary gland, hypothyroidism, rheumatoid arthritis, joint problems, stress, use of vibrating hand tools, fluid retention, and cysts or tumors can all contribute to the development of CTS. In addition, it is believed that genetics play a part in the onset Carpal Tunnel Syndrome due to the incidence of naturally smaller carpal tunnels in some individuals. Despite the popular misconception, no definitive link has been established between repetitive motion and CTS, although repetitive motion can cause other disorders such as bursitis or tendonitis that cause pain in the same area.

Early diagnosis and treatment of CTS are important to avoid permanent damage to the median nerve. Treatment of CTS includes rest of the affected wrist for at least two weeks and avoiding all activities that aggravate the condition. The wrist is usually immobilized in a splint to avoid further damage. Cool packs are sometimes recommended to reduce swelling. A range of drugs, from nonprescription pain relievers to diuretics to cortisteroids, may be prescribed for pain and swelling. Vitamin B6 supplements have also been shown to ease the symptoms of Carpal Tunnel Syndrome in some people. Treatment also includes stretching and strengthening the affected arm, but usually only after the symptoms have disappeared. Acupuncture and chiropractic care have benefited some patients and yoga has been shown to reduce pain and improve grip strength.

In addition to treating Carpal Tunnel Syndrome, the physician will need to treat any underlying condition that may be contributing to symptoms.

Filing for Social Security Disability with a Carpal Tunnel Syndrome Diagnosis

The Social Security Administration (SSA) does not have a specific listing for Carpal Tunnel Syndrome in the impairment listing manual known as the “Blue Book.” However, you do not have to have one of the impairments listed in the Blue book to be awarded disability benefits if your condition is severe enough to prevent you from working enough to earn the SSA- designated minimum gross earned income per month. Because CTS is not listed, however, there are no specific guidelines regarding proving your disability claim under a diagnosis of Carpal Tunnel Syndrome.

In considering your disability claim, the SSA bases its assessment of the severity of your condition on your ability to move about, how your symptoms (including pain) limit you, and the extent and effectiveness of any treatment. For example, your documentation may show that because of Carpal Tunnel Syndrome you are incapable of reaching, pushing, pulling, grasping, and fingering, and therefore unable to carry out activities of daily living.

Pain or other symptoms may be an important factor contributing to functional loss. However, you must be able to produce medical signs or laboratory findings that show the existence of Carpal Tunnel Syndrome, and CTS must be shown to produce the pain or other symptoms.

Intensity and persistence of pain or other symptoms will be evaluated as well. You should also be able to show that the severe pain or other symptoms caused by Carpal Tunnel Syndrome have lasted a prolonged period of time (usually at least 12 months).

When filing a disability claim, it is important that you obtain medical records which include an exact diagnosis of your condition and evidence in support of the criteria discussed above.

Because there is no entry in the Blue Book for Carpal Tunnel Syndrome, it is extremely unlikely that the state-run Disability Determination Services (DDS) or SSA will find a claimant eligible for disability benefits solely on the basis of a CTS diagnosis. While a significant number of people who file for SSDI list CTS as one of their primary disabilities, a claimant will have a much stronger chance if their diagnosis is supported by documented medical evidence of other, individually disabling symptoms.

Your Carpal Tunnel Syndrome Disability Case

If you are disabled because of Carpal Tunnel Syndrome that is severe enough to prevent you from working, you may very well be entitled to Social Security Disability (SSDI) benefits. Although total disability based on Carpal Tunnel Syndrome can be difficult to prove because the SSA has no specific listing for the condition, working closely with medical professionals and a qualified Social Security disability attorney or advocate to collect and present the appropriate documentation to support your disability claim can help to ensure that your Carpal Tunnel Syndrome disability case will have the best possible chance of success.