Carpal tunnel syndrome and workers' compensation among an occupational clinic population in New York State

Robin Herbert, Katherine Janeway, Clyde Schechter

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

Background: This study evaluated the experience in the New York State workers' compensation (WC) system of 135 patients with work-related carpal tunnel syndrome diagnosed at an academic occupational medicine clinic between 1991-1994. Methods: Worker's Compensation Board (WCB) records were reviewed to ascertain: (1) the proportion of WC claims that were not initially accepted (i.e., that were challenged) by the WC insurer, (2) the proportion of challenged claims ultimately decided in the claimant's favor, (3) the length of the period between case filing and claim adjudication, and (4) risk factors for claim challenge. Results: Seventy-nine percent of the claims were not initially accepted by the WC insurer (challenged/no response). Of the 81 challenged/no response cases adjudicated (ruled on) at the time of the study, 96.3% were accepted as work-related. Mean time from claim initiation to adjudication was 429 days (range 58-1,617). Mean time from physician request for any treatment and WCB authorization was 226 days (range 0-1,296). Mean time from physician request for surgery authorization and WCB authorization was 318 days (range 7-595). Claims filed by non-whites, low-wage workers, and union members were significantly more likely than others to be challenged. Conclusions: Patients with work-related carpal tunnel syndrome face frequent claim challenge by WC insurers in NY State, with attendant prolonged delays in adjudication and treatment authorization. Likelihood of claim rejection was strongly related to ethnicity and socio-economic status.

Original languageEnglish (US)
Pages (from-to)335-342
Number of pages8
JournalAmerican Journal of Industrial Medicine
Volume35
Issue number4
DOIs
StatePublished - Mar 19 1999
Externally publishedYes

Keywords

  • Carpal tunnel syndrome
  • Ethnicity
  • Health services accessibility
  • Occupational disease
  • Treatment outcome
  • Workers' compensation

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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