Carpal Tunnel Syndrome (CTS) happens when the median nerve, which goes from the forearm into the palm of the hand, becomes compressed at the wrist. This particular nerve controls sensations to the palm, thumb and fingers, and controls impulses to some small muscles in the hand that allow the fingers and thumb to move. The nerve compression is caused by inflammation or thickening in the tendons.
Carpal Tunnel Syndrome can cause pain, weakness, or numbness in the hand and wrist, and this pain can run from the hand up the arm, affecting a large area. People who suffer from Carpal Tunnel Syndrome often have a loss in movement in the hand and arm. This pain and loss of movement causes difficulty for people who must use their hands for work, as well as problems in doing simple day-to-day activities such as taking showers, getting dressed, or cooking a meal.
In fact, it is hard to imagine any job that doesn't require some use of one’s hands, from pastry chefs who create intricate designs with their fingers, to surgeons who manipulate surgical instruments with their fingers, to paralegals and administrative assistants who must type quickly, to school bus drivers who must safely maneuver the steering wheel.
According to the National Institute of Neurological Disorders and Stroke (www.ninds.nih.gov), symptoms of Carpal Tunnel Syndrome usually start gradually and gets progressively more painful. People who suffer from CTS experience burning, tingling, or itching numbness in the palm of the hand and the fingers, especially in the thumb and the index and middle fingers, and some may feel unable to tell the difference between hot and cold. The symptoms often worsen in one or both hands at night since many people sleep with their wrists flexed. CTS sufferers may have trouble gripping things due to less strength in their hand and arm, and may find it difficult to form a fist or pick up small objects.
In evaluating your case for disability, the Social Security Administration (SSA) will look at your "residual functional capacity (RFC)," which is your remaining ability to do work-related physical and mental activities after the limitations of your condition are considered. First, SSA will examine your exertional capacity, which is your ability to sit, stand, walk, lift, carry, push, and pull (known as the seven strength demands), and then your nonexertional capacity, which consists of your postural abilities (stooping, bending, climbing) and manipulative abilities (handling, reaching, fine finger movements), as well as your mental abilities (ability to concentrate, finish tasks, follow directions).
After evaluating your strength limitations, the SSA will classify your ability to do sedentary, light, medium, or heavy work (called your exertional level). Carpal Tunnel Syndrome can often leave you feeling weak in the hands and wrists, which would make gripping and carrying items difficult, and these exertional limitations may warrant a light or sedentary RFC determination. An RFC for sedentary work involves lifting no more than 10 pounds at a time and occasionally lifting or carrying files or small tools; and an RFC for light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to 10 pounds. Having less than an RFC for medium work can have a big effect on whether the SSA decides whether you should return to your old job and whether you can be expected to do any less demanding work.
In terms of non-exertional limitations, people with Carpal Tunnel Syndrome often have difficulty with fine motor skills, such as typing and filing papers, operating a cash register, and picking up and moving objects. These non-exertional limitations can affect whether you can actually do any jobs within your exertional level. For instance, if you have an RFC for sedentary work, but you can't do anything with your fingers, there will be very few sit-down jobs you can actually do. For further discussion of how the SSA uses the exertional and non-exertional limitations to assess whether you are disabled, see our article on how your RFC can get you disability benefits.
The SSA has a list of serious impairments that automatically qualify for disability when the listed requirements are met, but there is no listing for Carpal Tunnel Syndrome. However, Carpal Tunnel Syndrome may fit into one of the other SSA listings of impairments as it relates to the hands and arms. For instance, SSA Listing 11.14, on Peripheral Neuropathy, may be useful for people who suffer from very severe Carpal Tunnel Syndrome. Like Carpal Tunnel Syndrome, peripheral neuropathy involves difficulty using the arms/wrists/hands or legs/ankles/feet. Other related listings include those for soft tissue injuries, lupus, and arthritis.
If you believe you are disabled due to Carpal Tunnel Syndrome, contact your local Social Security Administration office to set up an appointment to submit an application for disability benefits. You can call the SSA at (800) 772-1213.