The Challenges of a Long Term Disability Claim for Carpal Tunnel Syndrome  

A hand surgeon knows how complex our hands are, but most of don’t think twice about our hands until they are injured in an accident or through repetitive stress or illness. Only then do we consider the many muscles, tendons, joints, and bones that go into the hand and how well designed these appendages are. 

When carpal tunnel syndrome strikes, our trusted hands suddenly become the source of great pain. The sharp, shooting nerve pain that runs from our wrist to our forearms can stop us from doing everything from performing delicate brain surgery to writing content. Anesthesiologists with carpal tunnel syndrome (CTS) can’t trust their hands to set instruments to precise levels, architects can’t create buildings by computer or on paper and computer programmers must wince through their use of a keyboard.

Anyone who depends upon having strength, dexterity, fine motor skills, and the ability to exert force from their hands suffers a great loss when their hands no longer work reliably.

Carpal Tunnel Syndrome is the name of a clinical disability occurring when the carpal tunnel, which is the pathway through which major nerves pass through our wrists to our hand, becomes narrowed to the point of restricting the nerves and creating pain.

For doctors, dentists, surgeons, and others who must use their hands in a controlled and precise basis, often for long or repetitive periods, CTS can spell the end of their career. Someone with CTS who tried to still work and needs to file for partial (residual) or cannot work and needs to file for total long term disability claims should prepare for a challenging claims process. While you and your doctor know that CTS has created a frustrating situation, especially when you are otherwise healthy and well, the only thing the disability insurance company knows is that you’re filing a claim that could be costly and could create an ongoing monthly obligation.

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What Can you Expect with a CTS Claim? 

The medical information you provide for a CTS disability insurance claim must be extremely detailed and the same goes for occupational information to support why you are functionally impaired . The medical studies need  to demonstrate how the median nerve is being squeezed at the wrist, where the “tunnel” in Carpal Tunnel is located. This narrow passageway contains both the median nerve and the tendons that control finger movement. When it narrows, either because of repetitive stress, inflammation or has simply never been big enough, you get CTS.   But even without positive testing, same may be disabled from this condition.

Here’s the challenge. Your doctor’s diagnosis of CTS based solely on observation of your hand, wrist, and forearm, including manipulation that may cause pain, and even decades of experience is often not enough for an LTD insurance claim to succeed. Objective evidence will likely be needed, some of which may be more invasive than others.

The National Institute of Health website explains the use of several different tests incorporating electric signals which augments your doctor’s observations.  A nerve conduction study can measure precisely how fast (or slow) electric signals are transmitted along the median nerve. This test will show if the signals slow down at the location of the carpal tunnel. 

An ”electromyography,” similar to that done to measure the strength of nerve signals in the back, can be done on the arm to measure any muscle damage that has occurred as a result of CTS. 

An ultrasound test may be done to measure the size of the median nerve, at the carpal tunnel location and possibly at other locations on the forearm.

A doctor might order laboratory tests and x-rays, to rule out any possible alternate sources for the pain, including arthritis, a fracture or nerve damage causes by diabetes, among other ailments. 

Other tests to identify CTS included:

Tinel’s Sign – Tinel’s sign is the tingling feeling that occurs when skin over an affected nerve is tapped. 

Phalen’s Maneuver – According to the Cleveland Clinic, this is a series of movements and positions that puts light pressure on the median nerve. 

Why Does the Disability Insurance Company Think I Can Do Other Kinds of Work?

Trying to get a neurosurgeon, dentist, or programmer to take on different work in an effort to preclude paying benefits is a common tactic from the LTD insurance company. However, if you purchased the policy on your own, that is, not a benefit you receive from your employer, you have more leverage to fight back. Chances are you have an “own occupation” policy, where you have insured your ability to perform the various tasks and duties of your own occupation. 

If your policy is through an employer, you will need to fight back within the constraints of a federal law known as ERISA that is used to control the process. Time limits, evidence to be considered and how the case progresses through an administrative process is governed by this law, which is extremely strict and limiting for claimants.

In both cases, the insurance company will attempt to have you admit that you can do another type of work for the simple reason that if you can work, you aren’t going to file a claim. We see this all the time and do battle with insurance companies over this position on a regular basis. A dentist who can’t use their hands should not have to become an office manager or sales person because of CTS. They should get the disability insurance benefits they have paid for with the own occupation coverage they were sold. 

The special challenge of CTS is that the possibility of working less may continue to exacerbate the injury. You may have success with filing for residual, or partial, benefits, but your CTS may remain the same or get worse as you are subjecting it to the same stress, just slightly less in duration.

If there is any possibility of improving the CTS, it is with treatment, not simply wearing a splint. Your disability insurance should cover this condition. That’s where Newfield Law Group comes in.

Can the Disability Insurance Company Force Me to Have Surgery?

Worry of undergoing surgery – or a bad result – for CTS surgery, keeps some people from having the surgery. But the decision of whether or not to undergo surgery should not be because of a threat to withhold benefits from a disability insurance company. Your treating physician, most likely an orthopedic surgeon who specializes in CTS, is the one who should present you with treatment options, not the insurance company.

We have handled numerous cases where the insurance company told the claimant they were good candidates for the surgery, even when their treating physician told them they were not and recommended they not undergo the surgery.   Policy provisions can have broad language, but should not be permitted to demand surgery as part of a claim.

What Should You Do to Protect Your Claim?

We advise our clients not to perform any tasks that could put their patients or projects at risk. Trying to perform a delicate operation or any task requiring delicate and precise movements with carpal tunnel syndrome could put another person at risk. If you are practicing medicine with CTS, we urge you to make the difficult decision.  Being pretty good is not enough for medical professionals  

We also advise clients to start keeping a log of their symptoms and how they affect your ability to perform day-to-day tasks. This will be helpful for your doctor as well. Disability attorney Jason Newfield knows how to use this and other information to frame your disability claim in the strongest possible way, and the more information he has, the better.

Be aware that anyone filing a disability claim should expect to come under surveillance at some point during the life of their claim. Your posts on social media may be examined to see what tasks you are able to do with your arms and wrists. Something as simple as retrieving mail from a mail box might be considered normal use of hands and used against your claim. Don’t be surprised if the disability insurance company (or the third-party administrator) requests follow up examinations with their own pay-for-hire doctors. 

As long as you are receiving benefits, the disability insurance company will keep their eye on you.  Unfortunately, proof of loss permits them to request materials and continue to investigate even when a claim has been accepted.

 A Trusted Advocate for You and Your CTS Disability Claim

Jason Newfield is known by his clients for his tenacious representation and compassion for their situation. Their heartfelt testimonials underscore his approach to practicing this very challenging area of the law. He understands he is often meeting people during one of the worst times of their lives and takes his responsibility very seriously. He will tell you what you can expect from the insurance company based on more than two decades of experience. 

If you are suffering from CTS and are unable to work, you are invited to call the Newfield Law Group and discuss your situation with Jason Newfield. He has seen your claim before.  Don’t delay, as there are strict time limits on disability claims.

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