Carpal tunnel and repetitive strain

That requirement produces three scenarios, and nearly every California carpal tunnel rating falls into one of them:

Scenario two is the workhorse. A great many California carpal tunnel cases resolve at 3% whole person, and that is the correct application of the strict method — even after a release. Post-operative carpal tunnel is rated the same way as pre-operative. There is no additional value for having had the surgery.

Where the exam and the studies are both positive, impairment is computed from the grade of sensory deficit and the grade of motor deficit separately, then combined — with severe cases involving thenar atrophy and marked sensory loss reaching 12 to 18% whole person. One rule worth knowing: when more than one nerve in the same arm is entrapped, each is rated and the values are combined.

Because scenario three produces zero for a worker with real symptoms and clean studies, and scenario two caps at 3%, California evaluators sometimes reach for alternatives. There are recognized ones — rating by analogy to a comparable condition, the Guides’ own chronic-pain criteria for the upper extremity, or rating the measured loss of pre-injury capacity.

WE ARE GOING TO BE STRAIGHT ABOUT THESE

They are arguments, not entitlements. They are used, they are contested, and they sometimes win. Treat “carpal tunnel is worth more than 3%” as an argument, not settled law.

What is true is that the strict method has a known floor, the reasons for it are explainable, and where it plainly fails to capture what happened to someone, there is a recognized route to a more accurate rating that a physician has to build deliberately.

This is the defining fact of the repetitive strain category, and almost nobody explains it. These conditions are real, they are compensable, they entitle you to treatment and to temporary disabilityTD / TTD / TPD Temporary Disability, Total or Partial. Wage replacement while recovering. Two-thirds of average weekly earnings; 2026 maximum $1,764.11/week. — and if treatment works and your motion comes back, the permanent rating is zero. Knowing that in advance is better than discovering it at the end.

Carpal tunnel is coded as a nerve impairment, not a wrist impairment — 16.01.02.02. That is different from the codes used for wrist motion loss. And bilateral carpal tunnel should generate two strings, one per hand, each converted and then combined.

A worker with bilateral carpal tunnel who receives a single string has a checkable problem.

Expect: diabetes, obesity, thyroid disease, pregnancy, age, and non-work keyboard use. Several of those are genuine risk factors for carpal tunnel and there is no point pretending otherwise. But the same rules apply as everywhere else. The apportionmentApportionment Dividing permanent disability between industrial and non-industrial causes. It is to disability, not to findings on an image. is to disability, not to risk factors. A condition that raises the statistical likelihood of developing carpal tunnel is not the same as a condition that caused a measurable percentage of this worker’s permanent disabilityPD Permanent Disability. Compensation for lasting impairment. A different and much lower weekly rate — 2026 maximum $290/week.. And under EscobedoEscobedo The en banc decision requiring an apportionment opinion to explain how and why. A percentage without reasoning is not substantial evidence., the opinion has to explain how and why — a percentage without reasoning is not substantial evidenceSubstantial evidence The standard a medical opinion must meet to support a finding..

• Did the evaluator review pre-injury records? — No records reviewed means no factual basis for any number.
• Was there any prior hand complaint, treatment, or restriction? — If not, what is the pre-existing disability being apportioned to?
• Was the worker doing the full job without limitation before? — Full duty the day before is evidence.
• What is the medical basis for this percentage rather than another? — Why 40% and not 15%? The opinion has to say.

Repetitive strain claims cluster where the work involves high-repetition gripping, pinching, wrist deviation, forceful twisting, or vibration: sewing machine operators — thousands of pinch-grip cycles an hour; warehouse packers on tape guns and scanners; line cooks and prep cooks on knife work; baristas on tamping and portafilters — de Quervain’s is notably common; hotel housekeepers scrubbing and tucking; janitors on wringers and scrubbing; assembly and packing lines; cashiers and grocery scanners; dental hygienists; longshore workers on turnbuckles; landscapers and construction trades using vibrating tools.