title: Pre-surgery disability compensation predicts long-term disability among workers with carpal tunnel syndrome.
abstract: BACKGROUND
  We sought to identify early risk factors for work disability compensation prior to and after carpal tunnel syndrome (CTS) surgery, and to determine whether pre-surgery disability compensation is associated with long-term disability.
  
  
  METHODS
  Washington State workers' compensation administrative data and data from interviews with workers 18 days (median) after submitting new workers' compensation claims for CTS were examined. Baseline risk factors for pre-surgery disability compensation and for long-term disability (>365 days of work disability compensation prior to 2 years after claim filing) were evaluated for workers who underwent CTS surgery and had at least 1 day of disability compensation (N = 670).
  
  
  RESULTS
  After adjustment for baseline long-term disability risk factors, workers with pre-surgery disability compensation had over five times the odds of long-term disability. Baseline factors in multiple domains, including job, psychosocial, clinical, and worker pain and function, were associated with both pre-surgery disability compensation and long-term disability.
  
  
  CONCLUSIONS
  Risk factors for work disability prior to and after CTS surgery are similar, and early work disability is a risk factor for long-term CTS-related disability. An integrated approach to CTS-related disability prevention could include identifying and addressing combined risk factors soon after claim filing, more efficient use of conservative treatments and appropriate work modifications to minimize early work loss, and, when indicated, timely surgical intervention.
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98104, USA. spectj@u.washington.edu
authors.forename: June T
authors.initials: JT
authors.lastname: Spector
authors.forename: Judith A
authors.initials: JA
authors.lastname: Turner
authors.forename: Deborah
authors.initials: D
authors.lastname: Fulton-Kehoe
authors.forename: Gary
authors.initials: G
authors.lastname: Franklin
mesh_terms: D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000191:economics* / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000191:economics; D009784:Occupational Diseases / Q000191:economics* / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014861:Washington; D014942:Workers' Compensation / Q000706:statistics & numerical data*