How many people get disability for carpal tunnel syndrome the first time they file an application?

The majority of individuals who file for disability benefits through the Social Security Administration are denied. This is a fact that has been true for decades and it applies to claims involving carpal tunnel syndrome.

Typically, a person who applies for disability on the basis of practically any mental or physical medical impairment can expect that their claim will be denied initially.

The rate of denial at the disability application level has historically tended to be about 70 percent or higher. In recent years, it has climbed to 77 percent. Meaning that only about 23 percent of all initial claims are approved. Roughly one out of four. The rate of denial will differ by state, but not by much, and the national average (currently 77 percent) is fairly consistent.

Because the denial rate is this high, most individuals will need to file for their first appeal. In most states, this is known as a DDS request for reconsideration appeal. DDS, or disability determination services, is the agency where disability examiners make decisions on claims for Social Security (both SSDI and SSI cases).

Reconsideration level appeals are denied at an even higher rate, usually more than 80 percent. Currently, the reconsideration rate of denial is about 90 percent meaning that only 1 in 10 of these appeals are approved. This makes it necessary for most individuals to file a second appeal, which is for a disability hearing date.

The rate of approval before an ALJ, or administrative law judge, has been diminishing in recent years. However, between 40-50 percent of claims decided by judges at hearings will be approved. However, this is an aggregate of all claims and includes claims for disabled adult children and SSI applicants. Claims for disabled workers in the Social Security Disability program are approved at rate of 76 percent according to the Annual statistical report on the Social Security Disability Insurance program.

So, to answer the question, Will you get disability for carpal tunnel the first time you apply?, the answer is that statistically, the odds are against you, as it is for 77 percent of all claimants.

That said, however, most claims are not decided on the basis of just one condition. In fact, it is fairly rare for a disability examiner or a judge to see a case that has only one medical condition listed. Usually, by the time a person has taken the step to actually apply for disability benefits, they have multiple health issues.

Multiple health issues, of course, will often mean more limitations in a person's ability to engage in activities of daily living and in the number of, and extent of functional limitations that they possess.

Functional limitations and Carpal Tunnel

How do "functional limitations" affect a disability case? Functional limitations that are proven by medical evidence can prove that a person no longer has the ability to engage in certain types of physical or mental tasks. This can translate to a decreased ability or inability to perform certain types of work.

In the case of carpal tunnel syndrome, it may mean that a person has difficulty grasping, holding, or pinching objects. It may mean the outright inability to engage in certain tasks involving one or both hands, or a reduced ability to do so, or an increased rate of fatigue with regard to the activity that involves one or both hands.

If the individual's past work was predicated upon the necessity to use his or her hands in ways that are diminished by their medical condition (e.g. carpal tunnel syndrome), then it should be possible to show that a return to the claimant's past work is not possible.

When that occurs, however, the next point of evaluation for a disability examiner or judge will be to determine if the claimant will be able to perform some type of other work. Being unable to do one's past work will not automatically result in an approval for disability benefits.

This is step 5 (other work) of the SSA decision process. This step will take into consideration the person's age, skills, and education, but also the limitations that are caused by their condition, which in this case is carpal tunnel syndrome but would, likely, in most cases, include limitations caused by other conditions as well.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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