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Carpal Tunnel Syndrome and Disability Insurance Claim Assistance



Since carpal tunnel is a common syndrome, some disability carriers will tell disability claimants that they should undergo surgery to alleviate their pain and resulting disability. While the majority of courts have ruled that a claimant is not required to submit for a surgery, disability insurance companies continue to argue that a claimant is not complying with the appropriate care provision if they do not submit for a carpal tunnel surgery. Most disability companies will require objective evidence of carpal tunnel syndrome which can be obtained through an EMG test, nerve conduction study, or ultrasound (which is a newer method for detecting carpal tunnel). Many claimants are diagnosed with carpal tunnel, but it is important to rule out other conditions which could cause similar symptoms. A survey of 400 American hand surgeons reported that each surgeon performed an average of 65 operations for carpal tunnel syndrome per year.

Our disability insurance lawyers have helped hundreds of disability claimants seek the short and long term disability benefits since 1979. We have worked with the some of the world’s best doctors that are experts in dealing with carpal tunnel. Insurance providers will use any excuse they can to deny your claim and save a few bucks in the process. We know the tricks they use, and we can help you to prove that your valid medical concern deserves the benefits that you paid for.

Please contact our disability insurance attorneys today and we can schedule a free consultation. We serve claimants throughout the country.

What to Do After a Carpal Tunnel Syndrome Diagnosis

If your doctor recently diagnosed you with carpal tunnel syndrome, or you suspect that you may have it, it is very important to record everything about your condition. Symptoms, amount of pain, any work dates you missed and all medical appointments could have an effect on your claim’s outcome.

It is also very important to consult a lawyer in the beginning stages. You have to fill out the disability application correctly, or your provider could deny benefits and prolong the care and relief that you need to recover. We have seen many denials based on someone checking the wrong box on the disability insurance application form.

Our Resolved Cases Featuring Carpal Tunnel

Our disability insurance lawyers have first-hand experience helping victims of carpal tunnel seek disability benefits. For example:

Carpal Tunnel And Work Related Conditions

Carpal tunnel often results from repetitive or strained hand movements. Prolonged or repetitive pressure on certain parts of the hand, arm or wrist can result in numbness, pain and weakness. People who work with computers for long hours are at a high risk of developing carpal tunnel syndrome.

Other conditions can cause carpal tunnel syndrome, including rheumatoid arthritis, diabetes, thyroid disorders, menopause, fluid retention due to pregnancy, or deposits of amyloid, an abnormal protein produced by cells in your bone marrow. If you perform any of the following tasks, you could develop carpal tunnel syndrome:

  • Repetitive hand motions
  • Awkward hand positions
  • Strong gripping
  • Mechanical stress on the palm
  • Vibration

These symptoms can affect every aspect of daily life for a person suffering from carpal tunnel syndrome both physically and emotionally. Even simple tasks can be a painful and debilitating experience. Carpal tunnel pain can literally stop you from performing any task that requires use of your hands, including gripping or lifting objects, typing on a keyboard or any other manual activity. By seeking disability, you can earn the relief you need to rest and recover.

Resources

For more information about carpal tunnel, please consult the following sites:

Check this page for updated information about carpal tunnel syndrome disability insurance claims and new disability insurance regulations that could affect your benefits.

There are 42 opinions so far. Add your comment below.

A:

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.

Attorney Greg Dell:

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.

renee:

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?

Attorney Greg Dell:

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?

Gracelda Bernardo:

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?

Attorney Stephen Jessup:

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.

jin:

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

Attorney Stephen Jessup:

jin,

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

Khloe Lam:

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?

Attorney Stephen Jessup:

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.

Katie:

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?

Attorney Stephen Jessup:

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.

Sonia:

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?

Attorney Stephen Jessup:

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.

Bret:

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

Attorney Stephen Jessup:

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.

June:

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?

Attorney Stephen Jessup:

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.

Marylou:

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.

Attorney Stephen Jessup:

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.

KJM:

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.

Attorney Stephen Jessup:

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.

Aviva:

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?

Attorney Stephen Jessup:

Aviva,

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

Sonia:

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.

Attorney Stephen Jessup:

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.

Brian:

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.

Attorney Stephen Jessup:

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

Marion S.:

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?

Attorney Stephen Jessup:

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.

Melissa:

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?

Attorney Stephen Jessup:

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.

Paola S.:

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

Attorney Stephen Jessup:

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.

Ellie:

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

Attorney Stephen Jessup:

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.

Connie:

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?

Attorney Stephen Jessup:

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.

Jessica M.:

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?

Attorney Stephen Jessup:

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.

Sue J:

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.

Attorney Stephen Jessup:

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.

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