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Occupational Medicine Advance Access published online on August 20, 2008
Occupational Medicine, doi:10.1093/occmed/kqn099
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Impact of compensation on work outcome of carpal tunnel syndrome

Paul Sperka1, Nicola Cherry1, Robert Burnham2 and Jeremy Beach1

1 Community and Occupational Medicine Program, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
2 Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada

Background Work-related carpal tunnel syndrome (CTS) is a complex and costly condition. There is some evidence that the employment outcome may be worse in cases of CTS where the condition is being considered for compensation.

Aim To examine whether workers' compensation status is an important determinant of outcome of CTS.

Methods Cases, with a Workers' Compensation Board (WCB) claim, and referents, in work but without a WCB claim, were identified from the practice of a single specialist physician. Data on history prior to and at the time of diagnosis, and events since diagnosis, were collected from clinical records and by a telephone-administered questionnaire. Prior events, severity, treatment and outcome associated with a WCB claim were assessed by logistic regression.

Results Interviews were successfully completed for 46 cases and 50 referents. In the model adjusted only for age and gender, claimants had a worse outcome in terms of changing job or stopping work with time loss from work due to CTS [odds ratio (OR) 5.1, 95% confidence interval (CI) 1.9–13.3]. The OR was much influenced by the inclusion of treatment in the model (OR = 9.6, 95% CI 1.6–58.6) with WCB cases more likely to have surgical and physiotherapy treatments. Cases with a WCB claim cost more to treat and reported greater loss in income than those not seeking compensation.

Conclusions Although these data are limited, the results are suggestive of poorer outcome among WCB claimants despite greater use of treatment and comparable severity of disease.

Keywords      Carpal tunnel syndrome; lost income; outcome; workers' compensation board; work related

Correspondence to: Jeremy Beach, 13-103 Clinical Sciences Building, University of Alberta, Edmonton, Alberta, Canada T6G 2G3. Tel: +1 780 492 8175; fax: +1 780 492 9677; e-mail: jeremy.beach{at}ualberta.ca


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