Carpal Tunnel Syndrome (CTS) is a condition in which the median nerve becomes compressed in or around the wrist area. This nerve runs from the forearm to the middle of the hand, so CTS can affect the arm, forearm, wrist, and hand. Symptoms range from tingling, numbness, and pain in the wrist area to numbness, tingling, and swelling in the fingers and thumb. In advanced cases, additional symptoms include difficulty gripping objects, pain all the way to the elbow, and deterioration of the muscle under the thumb.
Will I Win My Disability Claim Based on My Carpal Tunnel Syndrome?
To determine whether you meet its definition of disability, the Social Security Administration (SSA) relies on a variety of factors, including the severity of your symptoms, the effectiveness of treatment options, the strength of your medical evidence, your age, your education level and the type of work you have done in the past.
To be approved, your doctors need to diagnose your CTS using x-rays, MRIs, and, most commonly, electromyography.
How Does the Social Security Administration Determine If My Carpal Tunnel Syndrome Is Disabling?
Social Security employs a 5-step sequential evaluation process to determine if you qualify for disability benefits under the SSDI and/or SSI programs. The following evaluation is employed by the adjudicator at each phase.
Step 1: Substantial Gainful Activity. The first thing SSA will look at is whether you are working above what Social Security calls a “Substantial Gainful Activity” (SGA) level. Essentially, you cannot be earning more than $1,260 (as of 2020) on a gross (pre-tax) monthly basis. No matter how severe and debilitating your carpal tunnel syndrome and other conditions may be, if you are earning more than this amount consistently per month (with certain exceptions), your claim will be technically denied.
Step 2: Severe Impairment. The question in Step 2 is simply, “Are your conditions severe?” To answer this question, we will need to evaluate all of your medical records and compile evidence. As your attorney, Nolan & Shafer, PLC will be heavily involved in this process. The SSA can also request that you complete Activities of Daily Living and Work History reports, which provide an opportunity for you to communicate how your symptoms have impacted your ability to function normally.
Further, the SSA may also schedule a Consultative Examination (CE) with a doctor who is contracted by the Michigan Department of Disability Determination Services to perform medical evaluations on its behalf. Once all evidence has been assembled, the Social Security Administration reviews all relevant information and decides whether or not your symptoms are severe. To be considered severe, your symptoms must limit your ability to perform basic work-like activities. Severity can take many forms, including physical limitations, such as limited ability to lift, push, carry things, etc. If your symptoms are determined to be non-severe, your claim will be denied at Step 3 and you will have the opportunity to appeal this denial. However, if the conditions are determined to be severe, your claim progresses to Step 3 for further analysis.
Step 3: Do you have a listing impairment? At Step 3, the question is whether your carpal tunnel syndrome meets or equals a medical “listing.” The SSA has broken down the human body and mind into 14 different Impairment categories, called the Listing of Impairments. Unfortunately, carpal tunnel syndrome claims are not evaluated under a specific medical listing. Nevertheless, carpal tunnel syndrome can be linked to other impairments that do have a listing, such as arthritis, rheumatoid arthritis, and lupus. If your carpal tunnel syndrome is related to one of these impairments, it can be evaluated under the respective listing. But, generally speaking, since there is not a listing for carpal tunnel syndrome, your claim will advance to Step 4 for further analysis.
Step 4: Can you perform your past relevant work? The objective of Step 4 is to determine whether you have the ability to perform work you have performed previously. To determine what you are capable of doing, the adjudicator develops your Residual Functional Capacity (RFC). Your RFC identifies what your body and mind can still do after considering all of your medical symptoms, including those that affect your mental and physical health. The adjudicator will estimate your ability to perform functions like lifting, carrying, pushing, pulling, reaching, handling, stooping, crouching, remembering, understanding, etc. Your RFC might contain some of the following limitations:
- inability to lift and carry more than 10 pounds,
- inability to climb ropes or ladders,
- inability to use your fingers for fine motor manipulation,
- and more.
Once the adjudicator has developed your RFC, they will then list your Past Relevant Work (PRW), which is any job you performed during the 15-year period immediately preceding the Alleged Onset Date (AOD) of your disability. In general, if there is a job that you performed within 15 years of your AOD in which you worked close to full-time for a period of at least a few months, that job will likely be considered Past Relevant Work.
After finalizing your list of Past Relevant Work, the adjudicator must classify it. The type of work you have done in the past will be classified by both exertional level and by skill level. For example, a Nurse works at the Medium exertional level and the position is considered Skilled, while a Security Guard works at the Light exertional level and the position is considered Semi-Skilled. Once all of your PRW has been classified, the adjudicator must determine whether you have the functional ability to perform any of your past work. If the adjudicator determines you can still perform the functions required in your past work, you will be denied. You may have the opportunity to appeal this denial. If you cannot perform your prior work, the analysis proceeds to Step 5.
Step 5: Can you perform other work? Step 5 considers whether you can perform any other type of work, even if you have not performed it in the past. The adjudicator utilizes the same Residual Functional Capacity (RFC) developed in Step 4, and also considers your Age, Education, and Work Experience.
To start, Social Security classifies your education level as follows:
• Illiterate (or unable to communicate in English)
• Marginal (generally 6th grade or less)
• Limited (generally 7th through 11th grades)
• High School (and above)
Your education level is important, as it affects the skill level of different jobs that you might be able to perform. For example, if you have a Marginal education, then you would be limited to performing Unskilled jobs, but if you have a High School education then you would be expected to be able to perform both Semi-Skilled and Skilled jobs.
The adjudicator will then consider your Work Experience, specifically any skills and abilities you acquired from your past work. The fact that you are now at Step 5 means the adjudicator determined at Step 4 that you can no longer perform your past work. Nevertheless, the adjudicator will consider whether any of the skills and abilities you learned from your past work would transfer to different jobs. A Nurse who performed her job at the Medium exertional level and who can no longer perform her past work due to her carpal tunnel syndrome, for instance, might have acquired skills that would transfer to a Medical Assistant position, which she could perform at the Light exertional level.
Finally, the adjudicator will consider the last factor, age. Social Security evaluates adults in several age categories:
• Younger (ages 18-49)
• Closely approaching advanced age (ages 50-54)
• Advanced age (ages 55-59)
• Closely approaching retirement age (ages 60+)
While younger individuals have the burden of proving they are unable to perform any type of work, the burden is lessened in the more advanced age categories. Social Security refers to this premise as the Medical-Vocational Guidelines, or the “Grid Rules,” because the key factors are laid out in a grid with the final column being a determination of either “Disabled” or “Not Disabled.” Essentially, the older and less educated you are, the more likely you are to be found Disabled. The number of transferable skills you acquired in your past work may also affect this designation.
For younger individuals, obtaining approval for Carpal Tunnel Syndrome claims is more difficult. Often, the adjudicator will conclude you are able to perform sit-down or sedentary jobs, such as telemarketing or assembly work. If your prior work was classified as heavy, however, and you are over 50, your claim has a good chance of being approved.
If the adjudicator determines you can perform some other type of work, based on your age, education, and prior work experience, you will be found Not Disabled and denied. You will still have the opportunity to appeal this denial. On the other hand, if the adjudicator determines you cannot perform any other type of work, you will be found Disabled and approved for disability benefits at Step 5.
Conclusion: Will My Disability Claim Be Approved?
Getting approval for Social Security Disability (SSD) claims based on Carpal Tunnel Syndrome is never easy, but your claim can be approved if developed properly.
If you would like to discuss the specifics of your case with a disability expert now, please contact us.
We will do everything possible to get your claim approved.
Denied Disability? Don’t Give Up!
Having your SSD claim denied can be discouraging, and you may be wondering what you can do now that your livelihood has been taken away.
First, we want to encourage you not to give up. You could still win benefits. In fact, you should know that most people receive SSD denials on their initial applications.
If you’ve been denied, you may have to testify before an administrative law judge, which can be a nerve-racking process. Still, with Nolan & Shafer, PLC on your side, you can feel confident and prepared with both the medical evidence in your case and the questions the judge is going to ask.