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Carpel tunnel syndrome and private disability insurance

The medical problem

No doubt you've heard of carpel tunnel syndrome, but what exactly is it? Carpal tunnel syndrome causes pressure on the nerve in the wrist supplying feeling to the hand, leading to tingling, numbness, weakness, or muscle damage. Carpal tunnel syndrome occurs mostly for people who are 30 to 60 years old. More women are affected than men.

What are the causes? Some people are born with a small carpal tunnel. For most people, however, the cause is believed to be the repetitive making of the same hand and wrist motion. The problem is, while using vibrating hand tools may very well lead to carpal tunnel, there are no authoritative studies proving that this condition is caused by computer typing, using a computer mouse or playing instruments or sports.

Other possible causes or factors include the following:

  • Alcohol abuse
  • Bone fractures and arthritis
  • Cysts, tumors or infections
  • Extra fluids in the body
  • Obesity

The legal problem

If you develop carpel tunnel symptoms, what are your options? If you have disability insurance, either through your workplace or through a policy you acquired privately, you can file a claim.

Most people obtain long term disability coverage at work, as part of their employee benefits. Most such benefits are regulated under the Employee Retirement Income Security Act, a federal statute that incorporates regulations that are supposed to enforced by the Department of Labor, but which, at least according to a number of lawyers, frequently aren't. As a result, insurance companies may employ "bad faith" and deny your claim, especially since the cause of carpal tunnel is disputed.

If your claim is denied, you may have to file a lawsuit against the insurance company. What are your chances of recovery? One illustrative case might prove helpful.

In 2011, a California superior court jury awarded $4.2 million dollars (which included compensatory and punitive damages) to a disability insurance policyholder whose insurance company terminated her benefits after she had paid premiums on the policy for 12 years. The plaintiff, a dental hygienist, bought the policy in 1988 and, in 1996, developed a series of disabling medical conditions, including carpal tunnel syndrome and cervical pain. In 1999, she was forced her to stop working. In 2008, the insurance company terminated her benefits, despite a recommendation from the physician who had been treating her. She sued the company.

As quoted by LifeHealthPro, a representative of the insurance company stated: "We are very disappointed with this verdict. We will ask the trial court to overturn the verdict because we don't think it was supported by the evidence. If necessary, we will appeal."

Conclusion

Because carpel tunnel syndrome, it symptoms and causes are so complicated, and because ERISA, the law that governs most disability claims, is also so complicated, you should contact an experienced disability attorney to investigate the facts and to get you the compensation you deserve.