Carpal Tunnel, How Does Va Rate?

[bh1981]

Hello fellow Vets,

I had a nerve conduction test done with my neurologist and asked if he felt my carpal tunnel was related to military service with which he replied, "yes, definitively and absolutely". I obviously requested him to fill out a DBQ and am currently standing by for it. However, I have read numerous citations for this and cannot come up with a conclusive answer. How in the world does the VA rate carpal tunnel!? I read a few citations that stated the VA does not use terminology such as mild, moderate, or severe to characterize carpal tunnel so how do they rate it? Also, my private neurologist stated that I have moderate to severe carpal tunnel in my right hand and moderate in my left hand. I have attached a PDF of the electric nerve scan and physician impressions for your view. If rated, does anyone have any idea what that rating might be? Also, I have read some stuff about bilateral factors. Would a bilateral factor be applicable with carpal tunnel?Thanks, as always.

EDIT: For some reason I could not upload the PDF. Here is what was written by my doc;

EMG & NCV Findings:

Evaluation of the Left Median Motor nerve showed prolonged distal onset latency (4.7ms) and reduced amplitude (5.8mV). The Right Median Motor nerve showed prolonged distal onset latency (4.9 ms), reduced amplitude (3.3 MV), and decreased conduction velocity (Elbow-Wrist, 30 m/s). The Left Median Anti Sensory nerve showed prolonged distal peak latency (4.0 ms), reduced amplitude (13.5 uV), and decreased conduction velocity (Wrist-2nd Digit, 39 m/s). The Right Median Anti Sensory nerve showed no response (Wrist). All remaining nerves (as indicated in the following tables) were within normal limits.

All examined muscles (as indicated in the following table) showed no evidence of electrical instability.

Impression:

Bilateral median neuropathies at or distal to the wrists, i.e. carpal tunnel syndrome which appear to be in moderate to severe in the right hand and moderate in the left hand.

Edited April 16, 2015 by bh1981

[glider222]

I am interested in this topic as well. My EMG showed carpal tunnel syndrome in both wrists worse on the right. She also said there is evidence of acute cervical ridiculous thy at c8-t1 on the right, and on the left at T1 with evidence of acute denervation in the muscles innervated at those levels.

I have been rated 20% for cervical ddd. How would I put in a claim, would it be secondary to cervical ddd?

[bh1981]

I am interested in this topic as well. My EMG showed carpal tunnel syndrome in both wrists worse on the right. She also said there is evidence of acute cervical ridiculous thy at c8-t1 on the right, and on the left at T1 with evidence of acute denervation in the muscles innervated at those levels.

I have been rated 20% for cervical ddd. How would I put in a claim, would it be secondary to cervical ddd?

I imagine it would be secondary to cervical DDD but I would have your neurologist state it in writing that your CTS is directly related and secondary. Good luck.

Edited April 19, 2015 by bh1981

[Retired77]

Good Afternoon,

I would like to add some finding from my Nerve Conduction test to this question in hopes that someone might be able to interpret them and give me a ball park on what I might receive from the VA on this..

COMMENT:

--Normal right median, ulnar, and radial sensory latencies.

--Normal right median motor latencies to the APB with normal conduction

velocity, but decreased amplitude.

--Normal right ulnar motor latencies to the ADM and FDI with normal conduction

velocities and amplitudes.

--Delayed left median sensory latencies to the thumb, ring finger and

transcarpal sensory latencies.

--Normal left radial sensory latency.

--Absent left ulnar sensory latency to the ring finger.

--Normal left ulnar sensory to the small finger and normal transcarpal latency.

--Normal left median (to APB) and ulnar (to ADM and FDI) motor latencies with

normal amplitudes and conduction velocities.

--There is significant delay in median sensory conductions in comparison

with ulnar and radial sensory conductions- this is evidenced by an abnormal

Combined Sensory Index (CSI) of 1.2 on the right and unable to calculate on the

left due to the absent ulnar response to the ring finger (normal <1.0). The CSI

is a composite sum score defined as the difference between median vs. ulnar and

median vs. radial sensory or mixed nerve latencies, where a normal score is

IMPRESSION:

Abnormal study.

1. There is electrodiagnostic evidence of a demyelinating right median sensory

mononeuropathy at the wrist (carpal tunnel syndrome). There is no evidence of

axonal loss on needle EMG.

2. There is electrodiagnostic evidence of a demyelinating left median

sensory mononeuropathy at the wrist (carpal tunnel syndrome).

3. There are electrodiagnostic findings which might suggest a possible left

sensory neuropathy either at the wrist or elbow.

4. There is no electrodiagnostic evidence of right ulnar neuropathy at the elbow

or wrist.

4. There is no electrodiagnostic evidence of right cervical motor radiculopathy.

Electrodiagnostic testing is insensitive for the detection of purely sensory

radiculopathy

Thanks in advance..

<1.0.