About Carpal Tunnel Syndrome

Carpal tunnel syndrome describes the condition in which a pinched nerve within the wrist causes numbness, tingling and weakness throughout the affected hand and arm. The carpal tunnel is the passageway in the palm that protects the main nerve of the hand. When the nerve becomes compressed, it can cause numbness and tingling that eventually can lead to weakness as well as pain.

There are many known causes of carpal tunnel syndrome such as repeated wrist movement (typically due to occupation), pregnancy, illness, obesity, arthritis, and physical injuries. In several cases, carpal tunnel syndrome stems from work-related causes such as repetitive hand movement, hand-arm vibration, and long periods of remaining in unusual positions. Certain occupations have a higher risk than others. Construction workers, musicians (non-vocal), office workers (from continuous keyboard typing) and assembly-line workers are all at a higher risk of developing carpal tunnel syndrome due to the nature of those occupations.

Symptoms of Carpal Tunnel Syndrome

Typically the symptoms only affect the hand and parts of the forearm but occasionally can move up the shoulder in more severe cases. All parts of the hand besides the little finger (pinky finger) tend to become affected. This is because the median nerve doesn’t affect the little finger.

Pain – varies significantly with each case and becomes more noticeable when attempting to utilize the hand (such as gripping or pulling)
Numbness – the hand may lose feeling and sensation. People shake out their hands to attempt to relieve this symptom, sometimes with little success.
Stiffness – Hand muscles feel tight and can’t move quickly without pain and discomfort
Tingling – sometimes referred to as “pins and needles” is the sensation of prickling, tickling or stinging. This sensation is similar to paresthesia (a limb “falling asleep”).
Weakness – the hands become weakened and unable to perform the same. People may drop objects and may not be able to grip or pick up certain objects like they used to.
Muscle atrophy – the degeneration of the muscles; carpal tunnel syndrome degenerates the muscles within the hand (especially for the thumb muscles).

Qualifying with Carpal Tunnel Syndrome

The Social Security Administration (SSA) has a disability manual that lists the qualifications necessary for a disabling impairment to become approved for Social Security Disability benefits. Although most common disabling conditions have listed within the Blue Book, carpal tunnel syndrome does not have a specific listing. This means an applicant applying with carpal tunnel syndrome must have limitations that meet an equivalent listing. For example, an applicant with carpal tunnel may qualify under listing 1.02 Major Dysfunction of Joint(s) if they can no longer engage in fine and gross movements with their hands characterized by gross deformity as well as joint pain and stiffness.

Meeting an Equivalent Listing

Here are the following listings that carpal tunnel syndrome is commonly evaluated under. The proper acceptable medical documentation must be provided to fulfill each requirement and validate the applicant’s claim.

1.02 Major dysfunction of joint(s)

Distinguished by gross anatomical deformity, joint pain and stiffness, and limited mobility or motion of affect joint(s). An applicant must also have one of the following as well.

A.) One or more major peripheral weight-bearing joint causing the inability to walk

OR

B.) One major peripheral joint in each upper extremity (such as the wrist, hand, elbow or shoulder) causing the inability to engage in fine and gross movements

14.09 Inflammatory Arthritis

An applicant may qualify with carpal tunnel syndrome if their symptoms fulfill requirement A of listing 14.09. There are 4 requirements under this listing but only requirement A can be relevant to carpal tunnel syndrome.

Requirement A

Persistent inflammation or persistent deformity of:

1.) One or more major peripheral weight-bearing joints resulting in the inability to walk/move around effectively

OR

2.) One or more major peripheral joints in each upper extremity (such as the wrist, hand, elbow or shoulder) resulting in the inability to perform fine and gross movements effectively

Medical Vocational Allowance

The Social Security Administration (SSA) evaluates all disabling conditions that don’t meet any of the listings within the Disability Evaluation Under Social Security (also known as the Blue Book) under the rules of the Medical Vocational Allowance. The medical vocational allowance awards disability benefits to an individual with a disabling condition if the symptoms significantly limit their functional capabilities.

The rules that govern qualification take into account an individual’s age, level of education, and previous work history. Once an individual reaches age 50 or older, the SSA understands that learning how to perform a new type of job is extremely difficult. Therefore if someone over the age of 49 can no longer do the same type of work they used to due to a disabling condition, they will qualify for disability benefits through the medical vocational allowance.

For example, a 52-year-old man who has been an industrial painter for most of his life is diagnosed with severe carpal tunnel. The pain and stiffness in his hands is now severe enough to prevent him from painting anymore. He can no longer effectively grip a paint roller or paintbrush as well as lift any objects that weigh 20 pounds or more such as a full 5-gallon paint bucket (weighs approximately 50 pounds). In this case, the 52-year-old man can no longer perform his previous occupation and is unable to transfer his skills to another job. The SSA doesn’t expect him to learn a new type of work due to his age and most likely will approve him for disability benefits.