A diagnosis of bilateral carpal tunnel syndrome (CTS) does not automatically qualify a person for disability benefits, but the severity of the condition can make a person eligible. The Social Security Administration (SSA) does not have a specific listing for CTS. Therefore, the claim must prove the condition is medically equivalent to a listed impairment or that it prevents the applicant from performing any substantial work. The focus of a successful claim is less on the diagnosis name and more on the objective, documented functional limitations caused by the condition.
Understanding Bilateral Carpal Tunnel Syndrome
Carpal Tunnel Syndrome results from the compression of the median nerve as it passes through the narrow carpal tunnel in the wrist. This entrapment neuropathy causes symptoms affecting the thumb, index, middle, and part of the ring finger. Symptoms include numbness, tingling, and a burning sensation, which are often most troublesome at night.
The condition is considered bilateral when both wrists are affected, which occurs in up to 70% of CTS patients. While one hand, often the dominant one, may exhibit more severe symptoms, the involvement of both hands presents significant functional challenges. Advanced cases can lead to muscle weakness, clumsiness, and the visible atrophy of the thenar muscles at the base of the thumb.
The bilateral impairment severely limits a person’s ability to perform fine motor movements, gripping, pushing, and pulling. These activities are fundamental to both daily life and most occupations. Simple tasks like buttoning a shirt, turning a key, or typing become increasingly difficult or impossible to perform consistently. This limitation on manipulative abilities is what makes the condition potentially disabling in the eyes of the SSA.
The Social Security Administration’s Criteria
The SSA uses a strict legal definition of disability, requiring more than a mere diagnosis. To qualify for benefits, an applicant’s condition must prevent them from engaging in Substantial Gainful Activity (SGA). The condition must also have lasted, or be expected to last, for a continuous period of at least 12 months. The SSA assesses a claim using a five-step sequential evaluation process to determine if this standard is met.
The initial steps confirm that the applicant is not working above the SGA level and that the medical condition is severe enough to significantly limit basic work-related activities. The third step checks if the condition meets or “medically equals” the criteria of an impairment listed in the SSA’s official Listing of Impairments. Since CTS is not specifically listed, it must be shown to be equivalent in severity and functional limitation to a condition like Peripheral Neuropathy (Listing 11.14) or certain severe Musculoskeletal Disorders.
Most claims for bilateral CTS are evaluated beyond the listings based on the applicant’s Residual Functional Capacity (RFC). The RFC is a rating of the most a person can still do despite their limitations. This assessment determines whether the applicant can still perform their past work or any other type of work that exists in the national economy. The legal standard requires proving a complete inability to work, making the RFC the primary tool for demonstrating disability when a listing is not met.
Documenting Inability to Work
A successful claim hinges entirely on providing objective medical evidence that documents the extent of functional limitations. Subjective reports of pain and numbness are insufficient; the SSA requires concrete proof of nerve damage and muscle weakness. This objective proof typically includes the results of electrodiagnostic tests, such as Electromyography (EMG) and Nerve Conduction Studies (NCS). These tests measure the electrical activity and signal transmission of the median nerve.
These tests confirm the diagnosis and provide measurable evidence of the severity of nerve compression in both wrists. Detailed treatment records are also necessary to show that the condition remains disabling despite treatment. This includes documentation of splinting, corticosteroid injections, and operative reports if surgery has been performed. The SSA is particularly interested in whether the condition is refractory, meaning it has not responded adequately to prescribed medical interventions.
The resulting RFC assessment focuses on the specific manipulative limitations imposed by the bilateral impairment. This includes the ability to perform tasks requiring fine motor control, such as:
- Grasping
- Handling
- Fingering
- Reaching
Proving a severe limitation in these areas, particularly the inability to perform even sedentary work, is typically the determinant factor in an approval. A supportive, detailed statement from the treating physician outlining these specific work restrictions is one of the most persuasive pieces of evidence.
Navigating the Disability Claim Process
The SSA disability claim process is a multi-stage system beginning with the initial application, which can be submitted online, by phone, or in person. Applicants must provide extensive details about their medical history, work history, and how the bilateral CTS affects their daily life. The initial review and decision process typically takes three to five months, though processing times may range up to a year.
Most applicants are denied at the initial stage, requiring them to file an appeal. The first level of appeal is a Request for Reconsideration, which involves a review by a different SSA examiner and generally takes three to five months. If the claim is denied again, the next step is to request a hearing before an Administrative Law Judge (ALJ).
The wait time for an ALJ hearing can range from 10 months up to two years, depending on the applicant’s location and the SSA’s backlog. This hearing stage is often where applicants have the highest chance of approval, especially when represented by a legal professional. If the ALJ denies the claim, the applicant can appeal to the Appeals Council and, finally, to the federal court system.