Carpal tunnel and workman's compensation

Hello all,

This is my first post to the group. I have really enjoyed reading
posts on this and that over the past week or so, and I have a
question I’d love to get some feedback on.

I feel certain that I am developing carpal tunnel syndrome. I
started making jewelry in 1990 and have worked busy bench jobs since
1993. I also make jewelry at home during my free time, mostly forged
silver bracelets and earrings. I have a continuous throbbing pain on
the back of my left hand that radiates all the way up to my elbow,
worsened after marathon bench sessions. (Christmas sucks.)

I have not gone for medical attention due to the workman’s comp
issue. I’m lucky to have health insurance, but they will not pay for
anything considered to be work related, workman’s comp is supposed to
pay for it. Today I called the state (NC) office to learn more. If I
do seek medical attention and it is carpal tunnel, I must file a
claim with workman’s comp within 30 days. Apparently my previous
employers as well as my current one can be held responsible for my
medical bills. As I live in a small town where I have worked for
several people, I can see this potentially causing a problem. I am
also worried that filing a claim will affect the amount of goodwill
shown to me at my current job. I am also concerned about the fact
that I do make jewelry at home, as well as having plenty of
carpal-inducing hobbies (quilting, sewing, gardening, beading…).

Has anyone been through this process? I’d be just as interested in
hearing from employers as employees.

My main worries are that I will somehow become financially liable
for large medical bills, or be fired (or at least greatly resented),
or that I will become physically unable to make jewelry.

Thanks for your thoughts,
Julia Newton

In rainy (that’s OK the tomatoes need it) NC, USA

Julia - can’t address the workmen’s comp issue, but can address the
carpal tunnel one, as both my husband and myself have it. Several
suggestions - first, ultimately what matters is that you get proper
medical care - because without it, and sometimes even with it - you
will lose at least part, if not almost all, of the use of your hand
plus be in extreme pain.

My husband’s is NOT movement related - they don’t know why he
developed it. It came on very fast, and as I already had it I
diagnosed it. Being his usual stubborn self he refused for about 6
months to go to a doctor. By the time he went the damage was so bad
in both hands/wrists that he required surgery - which gave him back
about 50 - 75% of his prior usage. Did you catch all that?? SIX
months, with 50 - 75% usage left!!! Which amazed all the specialists
he went to after the surgery - they couldn’t believe the result was
that high! While he was horrified it was that low! Believe me -
with only 50 - 75% of normal, there are a LOT of things you can’t
do, or do with great difficulty and much time!

Mine IS movement related (if I had know digging the nutgrass from
the flower beds would do that to me it would have STAYED!). It got
so bad that I could not count on being able to hold a glass of water

  • sometimes I still can’t. I did research, saw several doctors, had
    steriod shots into the joints (which hurt incredibly but DO help),
    wore braces day and night, did therapy…and decided not to do
    surgery. The “success” - as in pleased patient - rate seemed to be
    about 50% by my totally unscientific survey. I don’t "do"
    non-life-threatening surgery for a 50% success rate!

Anyway, I’ve had it now for about 15 years, and have found that if I
space my hand-intensice work out, use lots of Celebrex and
Tylenol-arthritis(I have major arthritis in most of my joints also),
and lots of Biofreeze (a pain-relieving cream that even seems to help
the joints) I’m generally ok. Not great - won’t ever be there - but
ok. I have also made adjustments in tools, mice, positioning, etc.,
and take lots of little breaks to let my hands rest. It works.

I don’t know how you want to handle the insurance issue. It should
be able to go under your own health insurance, if you decide you want
to take that route, as you do repetitive motion things on your own
time also. I don’t quite see how it could be decided whether the
home or work or a combination caused the condition, or how they would
apportion the expense then. But then while I’m expert at personal
health insurance I know nothing about workmen’s comp, never having
really worked anywhere that qualified for it! The joys of

Best wishes to all.
Beth in steamy SC

Hi, Julia-

I have never filed a WC claim, or had one filed against me, but I
have been active in medical reimbursement for a couple of decades,
and am somewhat experienced with Workers Compensation issues,
although WC laws vary from state to state.

You need to file a claim with WC. Your employer’s good will is moot
if your condition progresses (which very well may, untreated) and
you find yourself unable to work. Additionally, any employer who
retaliates against you for filing a Workers Comp claim in good faith
is breaking the law, and you should report any such retaliation to
the WC Commission. If your employer has the brains God gave geese,
he/she will realize that you are only doing what the system requires
you to do in order to get medical treatment, and there is no basis
for bad feelings.

If your employers do not believe that your condition is work
related, they can dispute the claim, and you can appeal with the WC
Commission. If your condition is judged to be non-compensable
because it is non-work related, your health insurer should accept
the decision from the Workers Compensation Commission as sufficient
evidence that the condition is non-work related. All of the other
conditions, limitations and exclusions of your health policy will
still apply, though.

You would be well advised to request that your medical caregivers
seek any needed prior authorization or precertification from your
health insurer before rendering treatment, in order to protect
yourself in the event that WC does deny and you need to turn to your
health insurer for reimbursement.

[Disclaimer: I am not an attorney and this is not legal advice]

Lee Einer
Dos Manos Jewelry

 My main worries are that I will somehow become financially liable
for large medical bills 

julia -

you have an additional worry: picking the right surgeon to do
surgery should you decide that is the best solution, & there has
been no true permanent relief from any other course of treatment.
the damage to both wrists in my case was caused by the constant
grasping and manipulation of equipment, etc at the drafting table as
well as the actual equipment. so i went to the man who was supposed
to be the best carpal tunnel surgeon in orlando (no one told me he
had his own personal health problems) & had both wrists done at the
same time.

it was almost a year before i could count on getting across a room
still holding onto whatever i picked up with my right hand without
finding it on the floor part of the way over.

 If I do seek medical attention and it is carpal tunnel, I must
file a claim with   workman's comp within 30 days 

north carolina must have different workman’s comp than the
government (i was a gs11) because i was told there was a 2 year cap
filing time. perhaps you should check somewhere else such as online.

good luck -
life is short, make it worthwhile.

Some carpal tunnel syndrome problems may unfortunately be an act of
convenience, particularly in the workplace. There may be other
causes having nothing to do with the workplace. There may be a
terrible conspiracy at work. There may be therapies closer to you
than you think. First let=92s look at some statistics.

Repetitive strain injuries are diagnosed as conditions such as
Carpal Tunnel Syndrome, tendonitis and tennis elbow. Statistics U.S.
Bureau of Labor Statistics:

Year # of RSI cases % of all illnesses

1978 20,200 14%
1979 21,900 15%
1980 23,200 18%
1981 23,000 18%
1982 22,600 21%
1983 26,700 25%
1984 37,700 28%
1985 37,000 30%
1986 45,500 33%
1987 72,900 38%
1988 115,300 48%
1989 146,900 52%
1990 185,400 56%

(Source: Pinsky, Mark A., The Carpal Tunnel Syndrome Book, Warner
Books, 1993, pg. 144

Do the above statistics suggest a surging epidemic? The above Bureau
of Labor statistic is fourteen years old! Now we are reading about
CTS from holding cellphones that are a fraction of the weight of the
old style phone, the one with a cord attached.

Is it all happening in the workplace? Let=92s look at some recent


Studies Cast Doubt on Causes of Carpal Tunnel Risk & Insurance,
August, 2001 by Michael Capozzi

New research brings good news to employers concerned with costly
workers’ compensation claims, lost productivity, and potential
ergonomic regulations as a result of carpal tunnel syndrome (CTS),
one of the most common repetitive stress injuries. The research
attacks the causes and risk factors of CTS and pinpoints what types
of jobs are likely to cause the ailment.

The most controversial study comes out of Australia, where
occupational therapist Sonja Falkiner’s findings were presented by
hand surgeon Stuart Myles at the Royal Australasian College of
Surgeons conference in Canberra, Australia. Both Falkiner and Myles
work at Prince of Wales Hospital in Sydney.

Carpal tunnel syndrome is more likely to be caused by being
overweight or by an underlying disease than by a person’s job
duties, according to Myles. Falkiner’s study found that the most
likely CTS patient is a woman of menopausal age who is obese,
diabetic, and a smoker.

Thousands of workers’ compensation claims are being paid
unnecessarily, says Myles, giving an example of a 51-year-old
administrative assistant who was overweight, had diabetes, arthritis
in the base of her thumb, and a family history of CTS.

“This woman had all the factors for the development of carpal tunnel
syndrome, and yet she had an accepted workers’ compensation claim,”
Myles says. “In such cases, it was just as likely to be pruning the
garden, cleaning the house, or playing a sport that caused the

“It is offensive and ridiculous that unfit people are demanding
government payouts for injuries that are more than likely caused by
their general lifestyle, not work,” says Myles. “It’s only those
people who work in cold environments, and those who work in highly
forceful and repetitive jobs, such butchers and meat packers, that
there may be said to be a cause (relating to work),” he adds.

Another study, published in the June 12 issue of Neurology by J.
Clarke Stevens and other researchers at the Mayo Clinic in
Scottsdale, Ariz., seems to support this claim, at least partially.
The researchers studied 257 Mayo Clinic workers and found that only
10 percent had CTS symptoms. An electromyogram, a device that
measures the ability of the nerve to conduct electrical impulses,
later found that only 3.5 percent of the workers actually suffered
from CTS. Clearly, the researchers were surprised by their findings.

“We had expected to find a much higher incidence of carpal tunnel
syndrome in the heavy computer users in our study because it is a
commonly held belief that computer use causes carpal tunnel
syndrome,” says Stevens.

These two studies, however, are hardly the last word on the subject,
as numerous other studies and experts hold the opinion that
repetitive stress from computer use and other job functions does in
fact cause CTS.

For instance, a look at the Mayo Clinic Web site reveals this
statement, under the risk factors of CTS subheading: “Although it’s
not clear which activities can cause carpal tunnel syndrome, if your
work or hobbies are hand-intensive, involving a combination of
awkward, repetitive wrist or finger motion, forceful pinching or
gripping and working with vibrating tools, you may be at higher risk
for the condition.”

Despite the lack of clear answers, one thing is for certain: the
condition is costing U.S. businesses plenty, both in terms of
workers’ compensation costs and lost productivity. According to the
U.S. Bureau of Labor Statistics, 27,900 cases of carpal tunnel
syndrome were reported in 1999 (the most recent year for which data
is available), with 27 days being the median average for days away
from work, the highest among all disabling injuries and illnesses.

With this in mind, employers surely will hold their breath, waiting
for the next study to bring more clarity to the subject.

Perhaps the cause of the surging statistics is something sinister:

Clip - We know that complaints of arthritic symptoms are more common
than they were sixty years ago. Quite a number of troublesome health
conditions seem to be more prevalent today. In earlier times,
secretaries typed all day on manual typewriters without developing
carpal-tunnel syndrome. All of a sudden, body parts we used to take
for granted seem to be wearing out before their time.

Health problems caused by fluoride:

Osteoporosis and Arthritis: Scientists at EPA in Washington have
declared that there is every reason to believe that the increasing
numbers of people with carpal-tunnel syndrome and arthritis-like
pains are due to the mass fluoridation of drinking water. On July 9,
1998 the Manchester Guardian reported news of fluoride poisoned
water in Central India, from untested wells drilled in the 1980s,
causing severe arthritic damage to tens of millions of people – a
national disaster. Fluoride is the most bone seeking element known
to mankind. The US Public Health Service has stated that fluoride
makes the bones more brittle and dental enamel more porous.

On the lighter side, type -electronic gem therapy- in closed quotes
into Google and get 1850 astounding pages!

For those in the jewelry trade with CTS problems, the answer may
already be sitting in your hand=85.

Randolph Post


Workman’s Comp. varies so much from state to state that it is
impossible to give advice from out of state. That said, it is pretty
sure that if you go that route they will expect you to have the usual
standard medical treatments. (therapy, braces, shots, surgery, drugs,
etc.)They have a rather poor performance record.

I also have carpal tunnel syndrome (20 or so yrs.) However, I also
have a brilliant chiropractor. With some adjustments to my wrists and
elbows, and some acupressure, he was able to relieve 90% of my pain
and restore almost all of my function. He also showed me how to do
many of them myself. This is not an anomaly. He also helped my wife’s
just as much. (mine caused by hammering and all around abuse from 30
years as a carpenter, her’s is keyboard related)

To get workman’s comp to pay for alternative treatments can be like
pulling teeth sometimes, but it is worth it! Or, if you can find a
chiropractor who uses applied kinesiology, (lots do) ask if they can
treat carpal tunnel. Even if you have to pay for it yourself. It will
be less expensive and probably more successful than conventional
treatments. If all else fails, you can always go for the usual
treatments. It is very important to be treated ASAP as once the severe
damage is done even the chiropractic treatment can only reverse so
much. Please feel free to contact me off list for more info.(all are
welcome) Replies may be slow as I am moving my studio to a new place
cross town, but I will try to be timely. As they say down south, “I
am up to my butt in alligators” Later,


Mark Thomas Ruby
SunSpirit Designs
Loveland, CO
970 622-9500 studio
970 622-9510 fax

Hi-There are a number of things you can do to help prevent the
progress of Carpal Tunnel. However, it is important to have it
diagnosed. I just want to reassure you, that if it is Carpal
Tunnel, and it ever comes to the point of needing surgery-- I had
both hands done about 10 years ago, and retained 100% movement and

After spending about two years with numb hands and arms interrupting
my sleep every night, numb fingers during the day, and other
discomforts, wearing wrist braces, etc., the surgery was really
liberating and enabled me to continue to do my favorite things. I
would suggest your seeing a hand surgeon, if possible–someone who
has lots of experience with the subject.

As far as the WC goes, I can understand that it is a tricky
question. But you cannot ignore your health needs. Would it be of
any help to discuss it with your present employer before you make
the claim, letting him know how serious the outcome could be if you
don’t take care of it?

Good Luck, Sandra

Hi Gang,

I’ve been communicating with Julia (originator of this thread)
offline, but seeing all the responses on the topic, felt I should
respond publicly. Medical advice is like politics and religion, if
you know what I mean! Legal diclaimer, and such… I have never been
in the healthcare profession, and I have no personal stake in what I
am about to say.

Before rushing into surgery for carpal tunnel syndrome… STOP! In
my mind, surgery would be the last choice. It tends to be invasive
and irreversible. There is a method called Active Release Technique
practiced by a specialized group of chiropractors that has had
amazing results treating carpal tunnel and other soft tissue
maladies. Note that I said “soft tissue”, as conventional
chiropractic is focused on skeletal manipulation. The results are
fast, effective, and permanent, even with stubborn cases (okay, so
now I’m sounding like an ad).

Visit this Web site for more (official) testimonials
from real patients and doctors, and to find a doctor who can help:

Or, just do some checking on Google… I would if I were skeptical!

All the best,

Dave Sebaste
Sebaste Studio
Charlotte, NC (USA)

You’re first step is to see a doctor. It may or may not be carpal
tunnel, you’re symptoms are not typical. The doctor determines if
its work related. If it’s a result of outside activities, your
insurance will pay. I had carpal tunnel release done on both my
hands, 1 year apart. I worked in a hospital entering patient
and charges.

They thought it was due to my jewelry activities. I didn’t disput it,
tho I thought they were wrong. I am left handed and the right hand
was the most affected, the hand I used the most typing in numeric
codes all day. It’s probably up to you to go after workman’s comp. I
am sure your medical insurance will cover it. If not, let the
insurance companies fight about it, Workman’s comp is an insurance
policy also. It is imperative that you see a doctor, as it may not be
what you think and you are in pain.

  However, it is important to have it diagnosed.  

This is such good advice – I started having symptoms in the spring,
and was told by my brother (a doctor) that it’s repetitive strain
injury, the precursor to the much more serious carpal tunnel, which
is scarring of the sheaths around the nerves (?ligaments? not an
anatomist) and requires surgery usually.

Mine came upon me when I was trying to learn how to do websites and
spending too much time mousing at the computer (is that a verb?).

I spent a lot of time analyzing different workbench heights,
keyboard positions, arm positions, wrist positions, etc., to see what
relieved it.

I talked with some alternative health folks, and people who have
suffered from this, to see what worked for them. I also don’t trust
doctors and surgery-happy ones even less.

I got an adjustable keyboard tray and variable-height mouse pad, an
adjustable chair (height), and really pay attention so that when I
get a little pain, I switch to a more neutral position or even go do
something else. I have found that alternating computer work with
bench work, and strengthening my arms/wrists (fencing lessons!)
worked wonders.

Anyone interested in more info I found this website to be helpful
for ideas but keep in mind that not every solution works for
everyone–it’s rather personal (it’s your body!):


Continue from:

Hi guys,

I finally went to the doctor and found that I have tendonitis, not
carpal tunnel. I have been advised to wear a wrist brace at all
times, which is QUITE annoying, especially while working. I am to
take large doses of ibuprofen each night and was also prescribed a
short course of Prednisone (a steroid) to help with the swelling. As
far as the workman’s comp issue is concerned, I explained to my
doctor (who is also a personal friend) that I just did not want to
get into it at this point, so we agreed to call it non-work-related.
He is of the opinion that with careful treatment in this current
non-excruciatingly painful stage, it may heal itself or at least
remain in a semi-healthy state. Another friend who is a physical
therapist has shown me stretches and exercises not only for my hands,
but basically everything above the solar plexus and below the chin.
(If you think me lucky to have such talented friends, take my advice:
join a local community theater group. A more useful and friendly
group of people never existed.)

So, as usual, most of my worrying was for naught. Isn’t that the way
it always is? You’d think I would learn. :>) Thanks to EVERYONE who
responded on and off list.

Julia Newton
Waiting for the next hurricane in Eastern North Carolina

You mention taking ibuprofen, and I have to put in a plug here for
Tylenol Arthritis! It has allowed me to get back in my garden, to
work for several hours without pain, etc., etc. Wonderful drug! It
works better than regular pain killers for me, as it is both an
anti-inflammatory and a timed-release, so its benefits get spread
over a longer time. I love it!

And no, I don’t own stock in whoever makes Tylenol - although maybe
I should!

Beth in SC who is being drenched by Tropical Storm Bonnie, with
Hurricane Charley on the way!

Having just gone through a period of about 6 months of dealing with
a bout of tendonitis I can tell you that my doctor said that the
ibuprofen is specifically recommended for its anti-inflammatory
effects on the affected areas as opposed to aspirin or acetaminophen
which work fine for other things. I also can recommend massage
therapy. I visited a massage therapist at my chiropractor once a
week for several months and it seemed to help a lot. Also icing the
affected area was of benefit.

Good luck with your recovery

Jim Binnion
James Binnion Metal Arts
Phone (360) 756-6550
Toll Free (877) 408 7287
Fax (360) 756-2160

Member of the Better Business Bureau

I can tell you that my doctor said that the ibuprofen is
specifically recommended for its anti-inflammatory effects on the
affected areas as opposed to aspirin or acetaminophen which work
fine for other things. 

Both aspirin and ibuprofen are NSAIDs (non-steroidal
anti-inflammatory drugs), but not all NSAIDs are equally effective
for all people or all purposes. Acetaminophen (Tylenol) is not an