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Does workers’ compensation cover carpal tunnel syndrome (CTS) in SC?

It should if the carpal tunnel is related to your work duties. Carpal tunnel is a type of “repetitive trauma” that can result from typing on a keyboard for hours every day, operating a machine, or performing any repetitive task. If your job requires repetitive trauma to your hands and wrists, the resulting carpal tunnel syndrome is compensable as an accidental injury.

What is carpal tunnel syndrome, how is it caused, and how do you know when you have it?


Carpal tunnel syndrome is a condition that can be caused by repetitive hand movements. It can be very painful, and it can be frustrating for someone whose job requires repetitive hand motions that may continue to inflame the condition.

What are the Causes of Carpal Tunnel Syndrome?

According to the Mayo Clinic, carpal tunnel syndrome is caused by pressure on “the median nerve,” which is a nerve that runs through your wrists to your hands, and it can be caused by anything that squeezes or irritates the median nerve.

In the workplace, carpal tunnel syndrome can be caused by any repetitive motions of the hands or wrists that puts pressure on the median nerve, such as:

  • Working with vibrating tools;
  • Working on an assembly line; or
  • Typing on a keyboard or using a computer mouse.

Working in a cold environment can make the damage worse. Other factors that can increase the risk of carpal tunnel syndrome include:

  • Wrist fracture or dislocation;
  • Arthritis;
  • Gender – women are more likely to develop carpal tunnel;
  • Diabetes;
  • Inflammatory conditions like rheumatoid arthritis;
  • Certain types of medications;
  • Obesity; and
  • Other medical conditions like menopause, thyroid problems, or kidney failure.

What are the Symptoms of Carpal Tunnel Syndrome?

Carpal tunnel syndrome tends to progress gradually. Over time, a person may notice increasing tingling or numbness in the hand or fingers, that may travel up the arm from the wrist. Sometimes it may feel like an electric shock.

People with carpal tunnel syndrome may also have weakness in their hands and may sometimes drop things unexpectedly. The condition can be very painful, it can interfere with a person’s everyday activities and sleep patterns, and it can result in permanent muscle and nerve damage.


In Pee v. AVM, the SC Supreme Court held that repetitive trauma injuries, including carpal tunnel syndrome, are covered by workers’ compensation.

The claimant in AVM began to experience tingling and numbness in both of her hands after working for eight years at a job that required repetitive use of her hands. Even after corrective surgery, the condition worsened, and she was diagnosed with severe carpal tunnel syndrome.

She filed for workers’ compensation benefits and was awarded temporary total benefits to continue until she reached maximum medical improvement, but the insurance company fought to deny her benefits and appealed the decision to the SC Court of Appeals and then the SC Supreme Court (losing at every stage).

Unexpected Injury or Unexpected Event?

The insurance company tried to deny the claimant’s benefits by saying that the carpal tunnel syndrome was caused by an event that was not unexpected – use of her hands to perform her job duties. According to the insurance company, “repetitive trauma injury cannot be compensable as an injury by accident” because “the repetitive event which causes a repetitive trauma injury is not unexpected but is part of the worker’s normal work activity.”

The SC Supreme Court disagreed and found that it does not matter if the event causing the injury was unexpected – what matters is whether the injury was unexpected:

We noted that two lines of cases had evolved in other jurisdictions: some jurisdictions, including North Carolina upon which our Act is modeled, held there must be some unusual or unlooked-for mishap resulting in injury to constitute an accident; other jurisdictions held no mishap was required for an accident so long as there was an unexpected injury occurring while the employee was performing his usual duties in his customary manner. We chose the latter definition, focusing on the unexpected nature of the injury rather than requiring that the event causing the injury be unexpected.

The focus is not on the event. The focus is on the injury. If the injury is unexpected from the worker’s point of view, then it is compensable as an injury by accident.

Time of Occurrence

The insurance company also attempted to argue that carpal tunnel syndrome is not compensable because there is no “definite time of occurrence.” The SC Supreme Court disagreed and found that “definiteness of time” is not required to prove an injury by accident:

Definiteness of time, while relevant to proving causation, is not required to prove an injury qualifies as an injury by accident. For instance, in Sturkie v. Ballenger Corp., 268 S.C. 536, 235 S.E.2d 120 (1977), we found the claimant’s emphysema, which developed gradually, was caused by repeated exposure to high humidity and dust on the job and was therefore compensable as an injury by accident. Similarly, in Stokes, supra, we found a psychological disorder which developed over a period of months compensable as an injury by accident.

Further, under S.C. Code Ann. § 42-1-160 (Supp. 2001), a disease, which typically has a gradual onset, is compensable as an injury by accident “when it results naturally and unavoidably from the accident.” This provision indicates the legislature intended an accident to be compensable under the Act, even where the effects of the accident develop gradually.

Although the SC Supreme Court also held that carpal tunnel syndrome is not an occupational disease – it is instead compensable as an injury by accident, it is like occupational diseases in that it develops slowly over time.


If you have been diagnosed with carpal tunnel syndrome caused by repetitive trauma to your hands or wrists in your workplace, your injury may be covered by workers’ compensation.

Call now and schedule a free consultation with a Myrtle Beach worker’s compensation lawyer on the Axelrod team. Call us at 843-353-3449 or fill out our contact form today.

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