These conditions are causes for compensability, however, they should be accepted when verified, buy factual investigation, and medical confirmation of a work relationship. Underlying health problems may also contribute to carpal tunnel flare-up by these cited conditions.
Since many claims have been linked to computer usage, there may be a tendency to accept claims without fully exploring a true causal relationship.
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Some Occupations Most Likely to see Carpal Tunnel Injuries:
- Typists
- Assembly line functions requiring a lot of hand motion
- Professional Vehicle Drivers
- Craftsman
- Musicians
- Restaurant Chefs
- Professional Sports
- Jack Hammer Operators
What is Carpal Tunnel Syndrome?
It is the compression of the median nerve and tendons that flex the fingers as it passes through the carpal tunnel. The carpal tunnel is located at the base of the hand centered in the wrist. It is narrow so even a small amount of nerve swelling can produce symptoms. Conversely, it can be a progressive condition occurring over weeks, months, and even years.
Symptoms are:
- Numbness, tingling, and pain in the thumb and first three fingers of the hand.
- Pain or burning sensation that travels up the arm.
- Nightly wrist pain that interferes with normal sleep.
- Weakness in hand muscles.
- Tendency for the hand to want to go into a claw position.
- Swelling or redness in the wrist-hand joint area.
Diagnosis Tools:
- Nerve conduction studies
- Physical examination
- Reviewing all the patients daily physical activities
- Prior medical history
- Review of current physical pathologies
Treatments:
- Splinting
- Structured Exercise
- Steroid Injection
- Avoidance of activities that place strain on wrist
- Medication to reduce inflammation
- Surgery that cuts the bad of tissue crossing the median nerve
Disability may range from a few weeks to months, and permanent loss of function is possible. Reoccurrence can occur if the person returns to the activity or lifestyle that generated the symptoms originally.
Some Other causes for Carpal Tunnel Injury:
- Diabetes
- Lupus
- Pregnancy
- Obesity
- Hyperthyroidism
- Fractured bones in hand or wrist
- Excessive bone growth from healing fractures
- Illnesses that cause joint swellings, pain, stiffness, and bone deterioration
- Illness that reduces blood flow to the arms and hands
- Bone spurs
- Rheumatoid Arthritis
- Gout
- Claimant having a second source of exposure such as a second job, sports, or doing some activity in unusual positions that have a vibration or repetitive motion.
Prepare To Defend At The Time Of Hire:
Preparing to properly defend a carpal tunnel claim starts by hiring the proper person for the job which includes exploring the potential employee’s social background, experience, and health.
- Learning facts is challenging. Many records are public and available for research. Criminal, Court, Credit, Driver, Property Tax, Fire Losses, and Civil litigation records have some information that can be used as investigative leads
- The internet has information on how to obtain background information. Much is free, while other sources charge fees. These sources are discreet and mindful of exposures and reputations.
After the applicant meets the employment need socially and by experience, obtain a pre-employment medical examination. Provide the examining medical physician with a complete job description, including a video of the job being done on actual location.
Perform a Thorough Investigation
Once a claim is presented, the claim technician must do a thorough investigation.
- Full statements from the employee, the supervisor, and possibly fellow employees are necessary.
- Statements must cover detail on job function, length of time on the job, and how symptoms manifested.
- Secure a history of health conditions, and off-duty activities.
- Research personnel records for health claims, and performance information for potential impact.
- Provide the Independent Medical Examination physician with all the investigative facts, medical background, and a detailed job description including a video of the job.
- Have defense counsel review the case. Legal counsel should be well versed in Carpal Tunnel injuries and have a high defense success ratio.
Summary:
Carpal Tunnel Syndrome may have other causes than job function. Strong investigation and medical background is needed to successfully defend against non-work-related losses.
Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: mstack@reduceyourworkerscomp.com.
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.
No doubt, the ratio of this Carpal Tunnel Syndrome injury is increasing and I think everyone should take serious note on it.