In the November/December 1996 issue of The Guides Newsletter, Talmage wrote about the challenges faced by those evaluating carpal tunnel syndrome (CTS) impairment.1 A recent case highlights these challenges.
Ms Kirby presented for an independent medical evaluation (IME) to address two issues: first, the work-relatedness of her left CTS, and second, the percentage of anatomic impairment due to her surgically treated left CTS. Ms Kirby described the onset of regional left-hand pain and paresthesias without a recognized injury, illness, or precipitating event, although she associated these symptoms with the repetitive use of her hands while at work. Ms Kirby's relevant clinical records noted these nonspecific symptoms but documented no objective abnormalities of the peripheral neuromusculoskeletal system. When a course of conservative treatment failed to alleviate her symptoms, she was referred for electro-diagnostic evaluation. Left carpal tunnel...
