Economic Burden of Carpal Tunnel Syndrome

One way to establish priorities for prevention in public health is to document the "burden" that different types of illness or injury impose on society.

Earlier SHARP research showed that workers' compensation costs for Carpal Tunnel Syndrome (CTS) were among the highest of all injuries or illnesses.

However, the full economic loss that results from work-related injury also includes costs borne by employers and also by the employees themselves. One of the largest of these additional costs is the long-term loss of earnings, which can extend long beyond the period of payment of wage replacement benefits to claimants whose injuries temporarily prevent them from working.

Focus on CTS claimants' earnings versus those of other claimants

SHARP examined the loss of earnings of CTS sufferers with time-loss claims from 1993-94 over a period of six years following their claim. These claimants were compared to two other groups of claimants whose injuries also dated from 1993-94: workers who filed a time-loss claim for fracture of the lower arm or hand, and workers who filed a medical-only claim for dermatitis. This allowed us to compare how CTS sufferers fare compared to other workers, while accounting for non-injury-related factors, such as age, gender and industry.

Workers with CTS face significant loss of earnings over the long run

CTS claimants, on the average, endure more than three times the workers' compensation days of paid time-loss compared to claimants with upper extremity fractures (see tables below).

Time Loss Days Paid to Claimants by Injury Type
Injury Type Claims Median Days of Time Loss per Claim
CTS 4443 138 days
Fracture 2544 46 days

Time Loss Days Paid to Claimants by Claimant Characteristics
  Median Days of Time Loss per Claim
By Age Group CTS Fracture
16-25 years old 109 days 43 days
26-36 years old 144 days 42 days
37-49 years old 145 days 51 days
50-70 years old 127 days 64 days
By Sex CTS Fracture
Male 155 days 45 days
Female 122 days 46 days
By Industry Sector CTS Fracture
Construction and Transportation 188 days 55 days
All Other 123 days 42 days
By Employer Size CTS Fracture
200+ workers 107 days 42 days
50-199 workers 130 days 39 days
11-49 workers 165 days 51 days
1-10 workers 162 days 51 days

The typical CTS claimant loses about 30% more of their pre-injury level of earnings than do claimants with either dermatitis (DERM) or upper extremity fractures (FRAC) (see chart below).

Graph showing the median claimant earnings per quarter as percent of pre injury level

We also find:

  • Older workers endure longer time-loss, and their long-term earnings loss is much larger.
  • Workers employed by larger companies endure shorter time-loss and experience higher long-term earnings.
  • Males who develop CTS while working in non-fixed-site industries, such as construction or transportation, have greater time-loss and poorer long-term earnings prospects than do males working in fixed-site industries.
  • High pre-injury earnings are associated with shorter time-loss and higher long-term earnings, especially for claimants with CTS.
  • CTS claimants who have carpal tunnel release surgery recover to a higher fraction of pre-injury earnings than those who don't have surgery.

Finally, the cumulative excess loss of earnings of the 4,443 CTS claimants we studied amounted to between $232 million and $368 million over the seven years following their claim, a per claimant loss of between $52,000 and $83,000 (see table below).

Cumulative Earnings Loss for CTS Claimants
Period Elapsed Since Injury CTS Relative to Fractures CTS Relative to Dermatitis
Per Claimant Group Per Claimant Group
One Year $7,402 $32,887,480 $11,902 $52,878,962
Three Years $23,467 $104,262,220 $34,297 $152,383,448
Five Years $38,498 $171,045,776 $57,634 $256,066,493
Seven Years $52,326 $232,484,946 $82,776 $367,773,088
For example, a typical CTS claimant can expect to lose $7,402 in income more than the typical fractures claimant in the first year after filing a claim, excluding workers' compensation benefits. The entire group of CTS claimants lost almost $53 million more than the entire group of dermatitis claimants in the first year after their claims.

The results of this study show the devastating economic impact that CTS can impose on workers and their households. We hope that these results will underscore the importance of efforts by business, labor and government to prevent CTS, to attain early diagnosis and treatment of CTS cases, and to accommodate workers to an early and safe return to productive employment.

For a copy of the full report from which these results were taken, contact the SHARP program at 1-888-667-4277 or SHARP@Lni.wa.gov.

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