Bilateral carpal tunnel syndrome (CTS) occurs when the median nerve is compressed in both wrists, causing pain, numbness, and functional limitations in both hands. Whether this condition qualifies as a disability depends on its severity and the specific legal criteria applied. For Social Security disability benefits, the diagnosis alone is insufficient. The condition must be so severe that it prevents a person from working. The determination hinges on whether the functional limitations from the syndrome meet the strict requirements established by the Social Security Administration (SSA).
The Legal Definition of Disability for Carpal Tunnel Syndrome
The Social Security Administration (SSA) defines disability as the inability to engage in any Substantial Gainful Activity (SGA) due to a medically determinable physical or mental impairment. This impairment must be expected to last for a continuous period of at least 12 months or result in death. The monthly earnings threshold for SGA means any work earning more than this amount generally disqualifies a person from receiving benefits.
Bilateral CTS does not automatically meet the SSA’s Listing of Impairments, sometimes called the “Blue Book.” These listings detail conditions presumed disabling, but CTS rarely meets the criteria for musculoskeletal listings. Instead, bilateral CTS claims are evaluated based on the overall functional impact on the claimant’s ability to perform work.
The applicant must prove the severity of the median nerve compression prevents them from performing their past work and any other work existing in the national economy. The 12-month duration requirement is mandatory. Since CTS can often be significantly improved with surgery, the SSA frequently denies initial claims unless symptoms persist or worsen after treatment.
Essential Medical Evidence for Your Claim
Objective medical evidence is necessary to substantiate a disability claim for bilateral carpal tunnel syndrome, as subjective reports of pain and numbness alone are insufficient. The strongest evidence comes from diagnostic tests that objectively measure nerve damage. Nerve Conduction Velocity (NCV) studies and Electromyography (EMG) tests provide measurable data on the function of the median nerve and the muscles it controls.
NCV studies measure the speed of electrical signals along the nerve, where slower transmission indicates compression. EMG measures muscle electrical activity, revealing muscle weakness or damage from chronic nerve issues. Medical records must also document a history of treatment attempts, such as splinting, physical therapy, and corticosteroid injections, demonstrating that the impairment remains severe despite prescribed medical care.
If surgery occurred, operative reports and post-operative notes are needed to show the procedure’s outcome and any remaining functional loss. A detailed statement from the treating physician outlining the diagnosis, prognosis, and specific limitations is also important. Without this objective proof, the SSA cannot determine the severity of the impairment.
Translating Limitations into Inability to Work
The SSA determines the inability to work through the Residual Functional Capacity (RFC) assessment. The RFC defines what a claimant can still physically and mentally do despite their impairments. This assessment translates medical evidence into specific work-related limitations and is central to most bilateral CTS claims. The RFC focuses heavily on manipulative limitations involving the use of hands and fingers.
Bilateral CTS restricts both fine and gross movements, which are key components of the RFC assessment.
Manipulative Limitations
- Fine movements include intricate tasks like picking, pinching, manipulating, and fingering, essential for jobs requiring dexterity.
- Gross movements involve larger actions like handling, gripping, grasping, and holding, necessary for lifting and carrying.
Since most sedentary, light, and medium-level jobs require good bilateral hand function, severe limitations in these areas can eliminate a significant portion of available work. If the RFC limits a claimant to only occasional fine motor manipulation or prohibits repetitive grasping, they may be unable to perform even a desk job. This functional assessment, combined with factors like age and education, determines if the claimant can transition to any other type of work.
Navigating the Disability Application Process
The disability application process starts with filing the initial claim with the SSA. This claim is then sent to the state agency, Disability Determination Services (DDS), for a medical decision. Many initial applications for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) are denied, making the appeals process a common and necessary step.
The SSA provides a multi-level appeals structure. The first level is Reconsideration, reviewed by a different DDS examiner, which typically has a low approval rate. If denied again, the applicant can request a hearing before an Administrative Law Judge (ALJ), where many applicants are successful. Each appeal level has a strict 60-day deadline from the date of the denial notice.
It is important to understand the distinction between the two main types of benefits: SSDI is based on the claimant’s work history and contributions to Social Security, while SSI is a needs-based program for individuals with limited income and resources. Maintaining open communication with doctors and submitting all new medical evidence is important throughout this process. Many applicants choose to seek professional assistance from an attorney or advocate to navigate the complex rules and improve their chances of approval.