Facts about Carpal Tunnel Syndrome and Filing for Disability
Carpal tunnel syndrome is a valid medical condition to list on an aplication for Social Security Disability or SSI disability. The condition falls under the classification of musculoskeletal impairments. Were it listed in the SSA bluebook listings, it would fall adult listings section 1.00, Musculoskeletal System - Adult.
Musculoskeletal sytem impairments are defined by the Social Security Administration as being disorders of the musculoskeletal system that may result from hereditary or congenital (essentially meaning a condition present from birth) process. They may also include acquired pathologic processes. Musculoskeletal sytem impairments may result from infectious, inflammatory, or degenerative processes, traumatic or developmental events, or neoplastic, vascular, or toxic/metabolic diseases.
Because carpal tunnel syndrome does not have its own listing in the SSA listings (despite the fact that it is a commonly listed condition on SSD and SSI claims), a person filing for disability on the basis of carpal tunnel syndrome must prove that they can no longer work at a level that earns them what the Social Security Administration considers to be a substantial and gainful income.
This is done through A) the information contained in their medical records, and through B) the information revealed in their vocational work history; specifically, the types of work they have done, the functional requirements required of each job, as well as the skills they may possess that can enable a transition to some type of other work.
Many individuals are surprised to learn, of course, that simply being disagnosed with a certain condition is not a requirement that will qualify a person for disability. However, in actuality, Social Security Disability considers the ways and extent to which a person is functionally limited, because this will impact their ability to engage in work activity.
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1. Carpal tunnel syndrome occurs in the underside of the wrist when inflammation causes pressure on the nerve.
2. It is a misconception that large amounts of computer use are the primary cause of carpal tunnel syndrome. Repetitive motions of flexing and extending the wrists, like when typing, can be a cause of carpal tunnel syndrome. But there are several other causes.
3. Carpal tunnel syndrome is also caused by inflammatory conditions like rheumatoid arthritis, as well as hormonal conditions like diabetes, thyroid disorders and pregnancy or menopause. Wrist and arm injuries can lead to the condition as well. Physical characteristics of the wrist and genetic makeup are considered the primary risk factors for developing carpal tunnel syndrome.
4. Symptoms of carpal tunnel syndrome begin gradually and get progressively worse over time if the condition is not recognized and treated. Numbness, burning and tingling are the primary symptoms, whereas experiencing only pain in the wrist is a signifier of a different problem.
5. Symptoms of numbness and tingling occur in the hand, particularly the thumb and first two fingers, rather than the wrist. Symptoms tend to be worse after sleeping, and as a result those with carpal tunnel syndrome commonly experience disrupted sleep. Many feel as though their hands and wrists are weak and they have a tendency to drop things.
6. Due to the prevalence of office jobs and computer usage at work, carpal tunnel syndrome is sometimes considered worthy of providing time off and compensation to employees with the condition. This is controversial because it is unclear whether these repetitive tasks in the work environment cause the condition or simply exacerbate symptoms.
7. Since carpal tunnel syndrome includes inflammation, over the counter pain killers like aspirin can be effective at alleviating symptoms. Inflammation may also be treated with injections of cortisone. Splints are usually necessary while sleeping. Frequent rest breaks and ice can help with symptoms and swelling.
8. If carpal tunnel syndrome progresses to severe nerve problems where symptoms occur almost all the time, carpal tunnel release surgery may be needed. Results from surgery are usually positive.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
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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