Carpal Tunnel Syndrome and Disability Insurance Claim Assistance

Hello, I had Carpal tunnel surgery due to repetitive work. I have filed for Workmans Comp, in the meantime, I have submitted a Short-Term Disability claim with AFLAC and they have denied me saying that it was an on-the-job injury. On my Accident Policy, they denied me because it was NOT an Accident but rather an illness. I have been off work for more than six weeks and anticipate needing more recovery time. I am not sure what language is needed to resumit claim or appeal with AFLAC.

Veronica Mar 24, 2022  #51

Attorneys Dell & Schaefer only handles disability insurance matters. We do not handle Workers Compensation cases. Please contact a local Workers Compensation attorney.

Gregory Dell Jan 18, 2021  #50

I work on an oil rig and just go to the doctor and sent me to do an EMG and I have severe carpal tunnel syndrome in both hands but I have AFLAC disability which is they’ll pay $2300 for six months of a disability loss but my mom is telling me to file Workmen’s Compensation because they will help me out more with the surgery bills and medical bills and give me a compensation. I need some advice on what I should do since my job I work derricks and it refers to repetitive hand grabbing push and pull on hammering.

Michael W. Jan 17, 2021  #49

Daria, if you do have disability coverage with your employer and your doctor supports and recommends that you should be on disability then you would have grounds to make a claim. That is not to say the insurance company will approve the claim, but it will put you in a position to have a better opportunity to receive benefits. If you would like to discuss everything further please feel free to reach out to our office.

Stephen Jessup Jun 3, 2020  #48

I am 34 weeks pregnant and my hands are numb which keeps me from being able to do my job on the computer. I work for an architectural firm so I spend 8 hours a day drafting on the computer. It requires me to use both hands to type and draw with the mouse. Recently it has gotten so painful that I cannot do this without extreme pain. Is it possible to go on early disability because of this? My company does not have any other positions that don’t require work on the computer.

Daria K. Jun 3, 2020  #47

Shonice, you should be able to apply for both benefits, but your disability benefit will be offset by the amount you received from worker’s comp.

Rachel Alters Oct 14, 2019  #46

I have carpal tunnel syndrome in both wrists both of my elbows hurt shoulders and my neck hurts badly. I had a nerve test done it confirmed I had carpal tunnel. My doctor said it was work related. I reported to my employer it’s been six months and I’m still waiting to be seen by the company doctor. I do have a workman comp lawyer. Can I get short term disability and workman comp together?

Shonice Oct 13, 2019  #45

Lisa, yes, potentially you can start a claim whenever a disabling sickness or injury leaves you unable to perform the duties of your own occupation or any occupation, depending on how your policy defines disability. However, it is not guaranteed that a claim will be approved. But the more medical support you can provide and the more physician support you can provide as proof of your claim will increase the likelihood that your claim will get approved.

Alex Palamara May 15, 2019  #44

I have been diagnosed with carpal tunnel syndrome in right hand. I wear a brace and am scheduled for orthopedic consult in June. My job consists of repetitive motions for 8 hours, pain is horrible. I only take ibupropen. Can I start my short term disability before surgery? I am a packer and I have neuropathy too.

Lisa May 15, 2019  #43

Sue, if you have an employer provided or individual disability insurance policy you could certainly explore filing a claim for benefits under same. If you have a copy of your policy please feel free to contact our office to discuss how we can assist you in making a claim.

Stephen Jessup Dec 5, 2017  #42

I was diagnosed last week with carpal tunnel right hand. I use computer mouse 99 percent of time, with keyboard too. I have WC case open. I wondered if surgery doesn’t cure this, can I claim disability? I have done this kind of work for 28 years, but the past 5 years with a company that doesn’t allow more than one 15 min break and half hour lunch and production standards that do not allow time to rest my hand at all.

Sue J Dec 4, 2017  #41

Jessica, if your doctor is willing to continue to support the disability and you are unable to work then it can be extended. However, that is not a guarantee that your insurance carrier will approve the extension.

Stephen Jessup Aug 31, 2017  #40

I am currently on maternity leave but my disability has been extended due to having carpal tunnel and just the other day I was diagnosed with de quervains. Can my disability be extended longer so I can continue to care for my infant while I heal since my job is all computer work?

Jessica M. Aug 31, 2017  #39

Connie, if the condition prevents you from performing your occupational duties you could be eligible for benefits. Please feel free to contact our office to discuss your potential claim.

Stephen Jessup May 9, 2017  #38

I have dupuytren’s contracture in my right palm and on the sole of both my feet. I have LTD insurance at my job. Would I qualify?

Connie May 4, 2017  #37

Ellie, we handle claims for short and long term disability insurance benefits under private or employer provided disability policies. We do not handle Worker’s Compensation or Social Security disability claims.

Stephen Jessup Mar 28, 2017  #36

Do you guys work in Indiana? I have had carpel tunnel for five years and difficult to live my daily life. I just recieved surgery on my right them left hand. I have been out off work over a month becoming of my hands. Can you guys help me? Do you guys help with disability or just workers comp?

Thanks
Ellie

Ellie Mar 27, 2017  #35

Paola, if your condition is work related you will need to consult with a worker’s compensation attorney. In the alternative you can explore filing a claim under your employer short/long term disability policy- if you have one.

Stephen Jessup Nov 23, 2016  #34

Hello, after 16 years of work as a customer service rep and now bookkeeping same company ( computer work x8hrs daily) I’ve been diagnosed with carpal tunnel syndrome dr. told me is work related. What should I do in this case if this is a work related issue ?? please advise

Paola S. Nov 21, 2016  #33

Melissa, I am assuming this is a pre-existing condition denial of benefits? Please contact our office to discuss further to see if there is something that can be done.

Stephen Jessup Aug 25, 2016  #32

I started my short term disability policy in March 2016, I went for an EMG in April 2016 and was diagnosed with Carpal tunnel in left hand, had surgery in June 2016. Because of a doctors visit in Sept 2015 with a PA for tingling in hands and feet with some cramping. My claim was denied. The PA had stated it was possible bilateral carpal tunnel or a pinched nerve in back. Can I fight the denied claim status since I was not officially diagnosed or treated until after my policy started?

Melissa Aug 23, 2016  #31

Marion, some policies do require that you be under the care and treatment of medical doctor. If your policy does contain such language then Sedgwick would have grounds to fight the claim. However, this does not mean that the chiropractic care/treatment is not appropriate, only that you would need a medical doctor to complete paperwork. You could discuss with your primary care physician completing disability forms and providing the chiropractic treatment notes (and even a statement from the chiro) as an attachment to the forms.

Stephen Jessup Jun 8, 2016  #30

I’ve been on disability since 2/10/2016 for carpal tunnel and neck and back issues related to it. All my treatment came from a chiropractor. Recently Sedgwick refused my doctor’s medical paperwork to keep me off work due to the condition getting worse. They said it’s not his scope of support. I was told it must come from a medical doctor or orthopedic surgeon to be certified to be off. Otherwise I’m on LOA without pay.
Does this sound valid?

Marion S. Jun 3, 2016  #29

Brian, as we only handle claims for disability insurance benefits you will need to contact a worker’s compensation attorney to best advise you.

Stephen Jessup May 18, 2016  #28

I have been diagnosed having carpal tunnel in the right wrist and trigger finger unspecified same hand. Both diagnosis came from my primary care doctor as well as the initial workmans comp doctor I was sent to . As I recently went to a follow-up visit I saw a different doctor at workmans comp who changed my diagnosis to Dupuytren’s Contracture Disease, and said this is not work related so he just released me back to my Primary Dr. Unable to work TTD. I am a customer service rep for 20 years with a major communication company and also have diabetes my apnmnt for representation is not for two weeks, I have not been paid a dime for the month I have been off work from the workmans comp initial claim and was taken off work by their Dr.

Brian May 17, 2016  #27

Sonia, I am sorry, but I do not follow. La Capitale operates out of Canada. If your claim originates in Canada you will need to speak with a Canadian attorney as we are not licensed to practice law in Canada.

Stephen Jessup May 16, 2016  #26

Have been declined claim for carpal tunnel for la capitale. Was told it is a gradual occurance so it is not considered an injury and is not covered under the policy I have. Even though it says it covers soft tissue injury. I thought cts was a soft tissue injury and you please brief me on that. Thank you.

Sonia May 11, 2016  #25

Aviva,

If you have disability coverage through your employer you may have options for filing benefits under same.

Stephen Jessup Jan 8, 2016  #24

I injured my median nerve in the military and have since then had an ACD, a carpal tunnel release, and a 4 level laminectomy, all in attempt to address severe hand, arm, neck, and shoulder pain related to the original injury. Each surgery helped for a while. Recently an EMG indicated moderate bilateral CTS, and I was given wrist splints. I am a UX designer and among other things the role requires very detailed mouse and keyboard work. I was fortune to be able to work from home for many years and have been able to manage my pain through medication and by changing my work position, reclining and standing, and breaking up my days with exercises, stretching, and setting boundaries as to how much keyboard time I put in per day, Company layoffs forced me to return to the brick and mortar workplace, and within three weeks of 10-12 hour days, 8-10 in a fixed desk in a cubicle. I was in so much pain I could not function. I asked my employer for a flexible workspace or a moderated schedule but was told it was not available. Remote work is not an option in this position.

I have had to stop working as this role requires long hours doing ONLY detailed mouse and keyboard work, and I simply can’t physically do it.

I have not yet gotten an new emg (it’s scheduled), but my physician has mentioned ‘Double Crunsh’ syndrome, where there may be an increase in severity of my Cabral tunnel due to my pre-existing neuropathy.

I had no idea returning to a cubicle would result in so much pain. Do I have any options?

Aviva Jan 8, 2016  #23

KJM,

Your carrier cannot force you to have surgery to “prove” your disability. That being said, the carrier can easily try to make the argument that although you do have the condition it does not raise to a level that would prevent you from working in any occupation (I presume part of the 2 year period you reference). Beyond the Tarsal Tunnel it is very important that you provide information to the carrier regarding the MS for review. Please note that the carrier will still try to find a way to artfully craft a reason why the condition would not prevent you from working. Please feel free to contact our office to discuss your claim in greater detail.

Stephen Jessup Aug 26, 2015  #22

I have been Diagnosed with Tarsal Tunnel with Radiculopathy in both feet. This has been documented by an EMG. It has taken over a year and a half and several MRI of my spine and x-ray’s and MRI’s of my feet and ankles to finally find the actual diagnosis. Tarsal Tunnel is not listed in my LTD Policy Handbook but Carpal Tunnel is. Basically My policy states it does not pay over a two year period for any of these illness’s but the limitation does not apply if any of these illness are caused or contributed by Radiculopathies documented by an EMG. My paperwork has been filled and filed by both my Neurologist and my podiatrist as well as my PCP that I have Tarsal Tunnel caused/contributed by S1 S2 Radiculopathies and I have attached the EMG readings as well. My two year period is fast approaching and I now have recently found that I not only have this to contend with but I have MS. I by no means am going to even attempt to have a surgery for the Tarsal Tunnel that only has a 50/50 relief odd any way, knowing that this will not only weaken my feet/ankles possibly more than already are or make them worse knowing that they will never be good again any way. Can my LTD insurance carrier force me into going a direction I don’t want to go because the Tarsal Tunnel is what made me loose my six figure income executive position to begin with.

KJM Aug 25, 2015  #21

Marylou,

Are you currently back to work at this point? Please feel free to contact our office with a copy of your denial letter so we can discuss your claim in greater detail.

Stephen Jessup Jul 7, 2015  #20

CIGNA approved my STD in April of 2015, for bilateral Carpal Tunnel Surgery.
I had my right hand done on April 28, 2015 and my left on May 12, 2015. I’m a Licensed Nursing Assistant in Med-Surge and am the only one on night shift. My surgeon said I may be able to go back to work 6-8 weeks after my second hand is done. My scheduled date is for today, June 6, with no restrictions, as per my surgeon’s orders. My company ‘s policy is to see the doctor from Employee Health before returning to work, and he ordered me to return 6/30/15 with restrictions, to ensure my hands were well enough to handle going back to work. On July 2, I was told by my company that CIGNA had refused my claim as of June 1, 2015. After trying to talk to the people at CIGNA, all I got was I would have to appeal their decision. How do I get them to reverse their decision and who can I go to for help? I’ve been without pay and am behind on so many of my bills.

Marylou Jul 6, 2015  #19

June,

Potentially. If your policy does not allow you to work while on disability your claim can be terminated; or your work earnings would be deemed a source of other income which the carrier could reduce your benefit by, and/or may result in an overpayment being made on your claim.

Stephen Jessup Jul 4, 2015  #18

Good Evening,

I am on short term disability due to complications of pregnancy and developed carpel tunnel syndrome. My short term doesn’t cover all my monthly expenses and does not have a policy in RTW part time program for me to return to work slowly. My carpel tunnel has recovered 50 percent and I found a part time job working from home for billing and coding and it is a different title as the full time employment (which I’m on FMLA and short term disability). The part time job is minimal typing which is different from my full time job as extensive typing of 100 percent. Would I get in trouble with my short term disability insurance if I have this part time job?

June Jul 3, 2015  #17

Bret,

I have found the best way to secure a copy of your actual policy is to put your request in writing to your employer: I am requesting a complete of my group long term disability insurance policy with CARRIER, policy number (if you have it). This request is being made pursuant to Section 1332 of ERISA. Failure to provide same could result in civil penalties.

Stephen Jessup Jun 30, 2015  #16

As an addendum to Sonia’s comment (and many others’), how would someone obtain a copy of their entire disability policy?

Bret Jun 29, 2015  #15

Sonia,

Obtain a copy of your employer’s disability insurance policy and feel free to contact our office to discuss how we can assist you in applying for benefits under same.

Stephen Jessup Apr 26, 2015  #14

I had carpal surgery on January 16, 2015 and neck surgery the same time. I’m still having problems with my right hand. Just started therapy last Friday. I’m in a whole lot of pain, swelling, burning and numbness. I can’t pick up anything and today is April 25, 2015. Can I get help with benefits?

Sonia Apr 25, 2015  #13

Katie,

You cannot be forced into having surgery in order to keep your disability benefit. That is not to say the carrier wouldn’t find some other reason to try to deny you claim. I would also caution that many Employer provided disability policies write lengthy limitations for various conditions – if that applies to your policy you will want to be strategic in what information is being presented as disabling. Please feel free to contact our office to discuss your claim in greater detail.

Stephen Jessup Mar 20, 2015  #12

I have been out on LTD since June 2014. I did apply as well for SSDI and have been denied twice now. I have had Fibro since 1995. I had discectomy in 1991 in L4 and L5. I worked in retail positions all my life and my most recent position was in a high six figure management position in a 175,000 plus square foot store. I started with the company in 2004 and worked an average of 96 hours a week for the first four months of employment. These hours were then reduced to 50-70 hours a week from then on. I developed some foot issues in 2007 and had a neuroma removed and special inserts etc. in 2009. Then about two years after that I started experiencing extreme burning, tingling and numbness in my feet. The pain was so bad I cried at night and even in the morning. I have had eight different medications for pain and had allergic reactions to them all. I just recently had an EMG done on my legs and feet and I have Chronic Tarsal Tunnel and severe nerve and mussel damage. My concern is the surgery for this does not have a good result? Can I be forced to have this surgery to keep my LTD benefits? And no one has been addressing the lack of concentration, sleep, fatique and depression I still experience from the fibro.

I also wanted to mention that I am being tested for TSC Tuberolosis Sclerosis Complex. Have you ever dealt with any adults with this and the brain nerves with Social Security?

Katie Mar 19, 2015  #11

Khloe,

It is likely your insurance carrier would consider the carpal tunnel as an extension of your initial short term disability claim. I would advise them of the CTS as well as provide them with medical records regarding same.

Stephen Jessup Dec 30, 2014  #10

I developed carpel tunnel syndrome during my 8th month of pregnancy. After delivery of my first born, I continue to have carpel tunnel syndrome symptoms after 6 weeks. My job is mainly typing 95 percent of the time. I am currently on short term disability for vaginal delivery. Should I start another claim for carpel tunnel syndrome and should I include information from my pregnancy when I developed carpel tunnel syndrome? Which doctor should start this new claim? My OB/GYN MD or my Primary Care physician? What is the chance of receiving short term disability for this case?

Khloe Lam Dec 29, 2014  #9

jin,

Without knowledge of the language in your policy we would not be able to provide guidance.

Stephen Jessup Apr 16, 2014  #8

is pregnancy carpal tunnel covered by short term disability who covers only complications of pregnancy?

jin Apr 16, 2014  #7

Gracelda,

It is difficult to tell from the information you provided what the dates are of treatment for the initial carpal tunnel syndrome on the right hand, and what the date of the indication of possible CTS in the left would be. I would assume you have not been with your current employer for more than a year or Hartford would not be exploring a pre-existing condition analysis. If the dates of treatment for the condition do fall in the look back period for the pre-existing condition provisions in your policy, you may not be entitled to coverage.

Stephen Jessup Aug 20, 2013  #6

Good morning. I am a nurse in the state of NJ who had right hand carpal tunnel surgery two years ago. At that time I was diagnosed at risk of developing CTS on my left hand as well. My surgeon gave me some tips and exercises to prevent developing CTS on my left hand. Unfortunately last July 2013, I sought for my previous MD help and I was diagnosed this time for left hand CTS. I have been paying for my supplemental short and long term disability covered by Hartford. Hartford’s agent has implied possible denial of my claim using the “Pre-existing Condition” clause in the claim (which is defined as but not limited to within 6 mos condition w/ consultation from time of subscription). Additional investigation is now currently being conducted by Hartford – requesting my medical records from March 2013 to June 2013. My coverage is in effect January 2013, I was seen and diagnosed with left hand CTS July 19 2013. My left hand surgery was done July 31, 2013. To this time I haven’t received any approval on my supplemental/by opt. short term disability. In fact it was denied and as per Hartford’s agent, they will re open the claim once the added medical info are received from my surgeon.

What is my best move at this time?

Gracelda Bernardo Aug 19, 2013  #5

Renee,

Diagnosis does not equal disability. Does your condition prevent you from doing your job or any job? How does your policy define disability? These are factors that must be considered. Was the MEG testing positive for CTS? Are you going to have surgery?

Gregory Dell Apr 7, 2013  #4

Hello,

I have been diagnosed with sever CTS in both hands and nerve damage in right hand as well as muscle damage.

I took an EMG test and a nerve conduction study. Would I qualify for disability?

renee Apr 6, 2013  #3

A,

Your carpal tunnel would be covered your policy with Cigna. You need to make sure it is documented with your doctors. The next time you submit a Cigna claim form, then you should notify Cigna of the wrist problems.

Gregory Dell Nov 5, 2012  #2

I am currently on LTD through Cigna for lower back, hip, and leg pain and have had multiple spine surgeries trying to correct. Recovery from two of the spine surgeries required the use of a walker as I had to re-learn the use of my left leg. The use of the walker accelerated carpal tunnel problems in both hands and trigger fingers in both hands. I have had steroid injections to try and heal these issues but now require surgery. Would these secondary disabling conditions also be covered under my policy as they happened as a direct result of the spine problems?

Thank you for any insight you might provide.

A Nov 4, 2012  #1