Insurance companies tend to see carpal tunnel syndrome as a minor problem with a simple fix: a short surgery and a few weeks off. For some people that is true. For others, the numbness, weakness, and pain persist after surgery, affect both hands, or return. And for anyone whose work depends on fine hand control, such as a dentist, surgeon, hygienist, musician, or someone who types all day, even moderate carpal tunnel can make the job impossible.
Why insurers push back
- “Surgery fixes it.” After a carpal tunnel release, the insurer may assume you are back to normal, without checking.
- One hand. The insurer may argue you can work with the other hand.
- Sedentary work. The insurer may say a desk job requires no lifting, ignoring that it requires constant use of the hands.
- Subjective symptoms. Numbness and tingling are reported by the patient unless they are measured.
The evidence that matters
- Nerve conduction studies and EMG. These measure how badly the median nerve is compressed and are the key objective evidence. Repeat studies after surgery show whether the nerve recovered.
- Exam findings recorded over time: positive provocative tests, loss of sensation, weakness, and any wasting of the muscle at the base of the thumb.
- Measured grip and pinch strength, recorded at more than one visit, ideally with the dominant hand identified.
- Surgical records and follow-up notes describing what remains after surgery, or recurrence.
- Related conditions. Neck problems, arthritis, tendon conditions, diabetes, and other causes of nerve damage can add to hand symptoms. Each should be documented.
- A functional capacity evaluation can measure handling, fingering, and grip directly.
Limits to document
For carpal tunnel, the limits that matter are about the hands, not lifting. Ask your doctor to address, for each hand:
- Fine manipulation (fingering): typing, writing, using small tools or instruments, buttoning, and how long you can do it before numbness or pain sets in.
- Handling: gripping and grasping, and how often.
- Grip strength and dropping objects.
- Repetitive motion: how long you can do repetitive tasks before you must stop.
- Night symptoms that interrupt sleep and cause daytime fatigue.
- Use of splints or braces during work.
And make sure the record says which hand is dominant and whether both hands are affected.
Own occupation: where carpal tunnel claims are often won
For many professionals, the own-occupation period is the heart of a carpal tunnel claim. A dentist who cannot hold an instrument steadily, or a surgeon whose fingers go numb partway through a procedure, may be unable to do her own occupation even though she could do other work. Document the specific hand demands of your occupation: the instruments, the precision, the hours of continuous use. A statement from a colleague or a detailed job description helps.
Some individual policies sold to dentists, physicians, and other professionals define your occupation as your specialty. Read your policy carefully; it may be more favorable than a group plan. More: Own occupation vs. any occupation and ERISA plan or private policy?
Any occupation and desk jobs
After the switch to an any-occupation test, insurers often name office jobs. But most office jobs require frequent handling and fingering: keyboarding, filing, writing, using a phone. If you can type only 10 to 15 minutes at a time, or only occasionally use your hands for fine work, many sedentary jobs are ruled out. Check whether the insurer’s vocational report considered your hand limits. More: 5 reasons the vocational report may be wrong.
If it started at work
Carpal tunnel caused by repetitive work may also be a workers’ compensation claim. Coordinating the two matters, because LTD policies usually offset workers’ comp. More: LTD and workers’ compensation offsets.
What to do now
- Ask your doctor whether nerve testing should be repeated, especially after surgery.
- Ask that grip strength and sensation be measured and recorded.
- Keep a log of how long you can type, write, or grip before symptoms stop you, and of objects you drop.
- Document the hand demands of your occupation in detail.
- Read your policy’s definition of disability, especially if it is an individual professional policy.
Denied or cut off for carpal tunnel syndrome? Call 770-351-0801 or request a free case evaluation.
Related: Neck and shoulder pain · Why your doctor must describe limitations · Top 5 reasons LTD claims are denied