Carpal Tunnel Syndrome

National
Council on
Compensation
Insurance, Inc.
RESEARCH BRIEF
VOLUME 3, ISSUE 3
JUNE 1996
Carpal Tunnel Syndrome

In Workers Compensation:
Frequency, Costs and Claim
Characteristics
by JENNIFER KISH and VALDY DOBRILA
Jennifer Kish
Research Economist
National Council
on Compensation
Insurance, Inc.
Valdy Dobrila
Economic Research
Assistant
National Council
on Compensation
Insurance, Inc.
I. INTRODUCTION
Carpal Tunnel Syndrome (CTS)
causes thousands of lost workdays
per year and costs industries millions
of dollars in workers compensation
claims. Indeed, the Bureau of Labor
Statistics (BLS) found that the median
number of days lost from work for
CTS claims was three times the national average of other injury types.1 In the
last few years, there has been a striking
increase in the number of CTS injuries
reported in the workplace. NCCIs
Call for Detailed Claim Information
(DCI) data show that the relative frequency of CTS claims (as a percentage
of lost-time workers compensation
claims) increased by 55% between
1991 and 1994. In addition, out of 10
nature of injury categories researched
by NCCI,2 CTS was the third most
costly in terms of average cost per
workers compensation claim. Yet, little research exists that has analyzed
the magnitude of the cost impact of

CTS, or that has explored the claim
characteristics of these injuries.
This brief will present the cost
impact of CTS for 40 states and the
District of Columbia and for five broadly defined industry categories for
claims occurring between 1991
and 1993. Milestone durations and
other claim characteristics of the disorder will be compared to other workers
compensation injuries. A brief background on this disorder in terms of its
causes, symptoms and treatment will
also be provided so that the findings
of this study may be better understood.
This research shows significant
cost and claim milestone disparities
between CTS and the average claim
filed under workers compensation. In
addition, important differences in the
characteristics of CTS claims are
also revealed. For example, CTS claims
are more costly than other types of
workers compensation claims and
claimants take a relatively longer peri-
1 Occupational Injuries and Illnesses: Counts, Rates, and Characteristics, 1992. U.S. Department of Labor, Bureau of Labor
Statistics, April 1995.
2 NCCI, Workers Compensation Claim Characteristics Series, July 1996.
1996 National Council on Compensation Insurance, Inc.

All rights reserved.
RESEARCH BRIEF
VOLUME 3, ISSUE 3
od of time to return to work.

Additionally, in contrast with the average workers compensation claimant,
most CTS claimants are women.
II. DATA SOURCE
The data source used in this study is
NCCIs DCI. Initiated in 1979, the DCI
is a stratified random sample of losttime claims from 40 states and the
District of Columbia. Private insurers
provide 85 data elements on each sampled claim to NCCI, beginning six
months after a claim was first reported
to the insurer. NCCI receives annual
updates on paid benefits, incurred
costs and other claim developments
until the claim closes or eight subsequent reports have been collected.
From 1991 to 1994, the DCI captured information on 126,404 workers
compensation claims. Of these claims,
3,279 were for CTS injuries. From this
abundant data source, comparisons
were made between the costs, frequencies, milestone durations, and
demographic characteristics of CTS
claims and the remaining 123,125
claims filed for other injury types.
These comparisons allow for a clearer
insight into the characteristics of CTS
claims.
Claims from 1991 through 1994 were
used in deriving CTS frequencies and
demographic characteristics (claims
filed before 1991 did not include a
nature of injury category for CTS).
However, more complete cost and claim
duration information, which arrives 18
months after a report is filed, was not yet
received for 1994 claims so only
19911993 claims were used in the cost
and duration portion of the analysis.3
JUNE 1996
III. PHYSICAL CAUSES,

SYMPTOMS & TREATMENTS
In the last decade there has been a
striking increase in the number of
repetitive stress injuries reported
in the workplace. Repetitive stress
injuries include such disorders
as tendinitis, tenosynovitis, de
Quervains syndrome and thoracic
outlet syndrome. However, the prevailing physical disorder associated
with repetitive motion is CTS.
CTS is caused by constant, repetitive flexing of the tendons located in
the wrists between the carpal bones.
The constant flexing builds up the
protective sheath surrounding the tendons, which in turn increases pressure
in the joint. The median nerve, which
runs through the wrist, becomes compressed. This compression is what
ultimately causes the onset of CTS.
The movements that cause the greatest irritation to the median nerve are
reaching with the fingers, outward
twisting of the wrists and grasping of
small objects.4
The pressure on the nerve causes
stiffness, tingling and pain in the
wrists, fingers and forearms. As the
disease progresses, soreness may
intensify and travel up the arm to the
shoulders and neck, and the hands
may become numb. Complete loss of
the ability to grasp objects may follow
if treatment is not begun.
Studies conducted by the Office
of Safety, Health and Working
Conditions5 have shown that the
actions which most often lead to CTS
are the use of small tools, repetitive
assembly work, prolonged exposure to
First report information (information from six months after the claim was reported) was used in analyzing frequency and
demographic information. Second report claim information (information from 18 months after a claim was first reported)
was used when analyzing CTS costs and milestone durations.
4 Carpal Tunnel Syndrome. The Centers for Disease Control and Prevention, March 9, 1995.
5 Ibid.
2
RESEARCH BRIEF
vibration, the manipulation of small
parts and the use of computer keyboards and mice. All of these actions
involve awkward and repetitive movement of the wrists and fingers.
Initial treatment of the disorder
may include the placement of splints
to the wrists and hands for several
weeks in order to restrict movement
and reduce swelling. Anti-inflammatory drugs, including cortisone and
steroids, are also administered. In
advanced cases, surgery is often
required. New treatments and surgical procedures are beginning to see
better results. These include an endoscopic surgical procedure6 and a nontraditional carpal tunnel release
operation, which is a 15-minute procedure requiring only a small incision
and an average two-week recovery
period.7 These forms of treatments are
only in their early stages of use and
their effect on the cost and duration of
CTS cases is, as yet, unknown.
VOLUME 3, ISSUE 3
JUNE 1996
translates to an annual growth rate of

15.8%. The largest annual increase
(40.2%) occurred between 1991 and
1992. These figures coincide with BLS
data which show that CTS cases
accounted for approximately 1.8% of
workplace injuries and illnesses in
1993.8
Figure 1
Frequency of Carpal Tunnel Syndrome Cases

19911994
55.2% Increase
from 1991
PERCENTAGE
2.0
1.5
1.78%
1.77%
1992
1993
1.97%
1.27%
1.0
0.5
IV. CLAIM FREQUENCIES

Since 1991, when NCCI began collecting data on CTS cases, the relative
frequency of claims for CTS injuries
has increased significantly. Although
the percentage of claims for this injury
remains relatively slight (less than
2.0% of total lost-time claims), the current growth rate implies a potentially
dramatic change in CTSs ranking in
terms of frequency within the next
decade. Figure 1 shows the aggregate
growth in the percentage of CTS
claims filed from 1991 through 1994.
During this period, CTS workers compensation cases increased 55.2%, from
1.27% to 1.97% of total claims. This
0.0
1991
1994
ACCIDENT YEAR
Source: NCCI DCI database
6 Endoscopic Release of Carpal Tunnel Syndrome. Roth, James H. , Journal of the American Medical Association,
Sept. 14, 1994.
7 CTS Prevention, Treatment. Pagnanelli, David M., Occupational Hazards, Volume 51, April 1989.
8 News: Workers Injuries and Illnesses by Selected Characteristics, 1993. USDL-95-142. Bureau of Labor Statistics, United States
Department of Labor, April 26, 1995.
3
RESEARCH BRIEF
VOLUME 3, ISSUE 3
JUNE 1996
Table 1
CTS Injuries by State

(1992 and 1993)
STATE
All DCI States

Alabama
Alaska
Arizona
Arkansas
Colorado
Connecticut
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maryland
Massachusetts
Michigan
Source: NCCI Workers
Compensation Claim
Characteristics Series,
July 1996
Not reported due to less
than 14 observations.
FREQUENCY (%)
1.7
0.4
0.2
1.6
1.3
1.4
1.8
0.4
0.3
0.7
0.2
3.1
1.4
2.3
2.4
2.7
2.1
0.2
1.0
1.2
1.8
AVERAGE
COST ($)
12,731
14,514
10,553
19,250
9,639
18,812
14,421
8,169
21,581
10,375
10,031
15,930
11,889
7,572
11,442
9,597
STATE
9 NCCI, Workers Compensation Claim Characteristics Series, July 1996.

AVERAGE
COST ($)
2.0
0.9
2.7
1.9
3.2
2.1
0.8
0.7
1.3
1.6
1.8
2.6
2.8
2.6
0.8
1.6
2.6
2.9
2.6
1.2
2.9
9,699
9,166
15,914
7,904
18,690
19,338
12,994
20,056
12,904
12,312
18,368
19,371
15,392
12,602
5,667
10,899
8,798
8,581
Minnesota
Mississippi
Missouri
Montana
Nebraska
New Hampshire
New Jersey
New Mexico
New York
North Carolina
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Utah
Vermont
Virginia
Wisconsin
The frequency of CTS cases for 40

states and the District of Columbia for
accidents occurring in 1992 or 1993 is
shown in Table 1.9 Nebraska had the
highest frequency of CTS claims
(3.2%) followed by Idaho (3.1%), and
Utah and Wisconsin (2.9%). The lowest frequency of claims occurred in
Alaska and Louisiana, with CTS comprising only 0.2% of the total number
of claims filed.
FREQUENCY (%)
V. COSTS
Carpal Tunnel Syndrome injuries
are among the most expensive types
of workers compensation claims. Out
of 10 injury categories studied by
NCCI, CTS injuries had the third
highest average incurred total cost
per claim of $12,730 (includes lost
wages and medical costs) as shown in
RESEARCH BRIEF
Table 2.10 Incurred costs include both
paid to date and anticipated future
payments to be made on a particular
claim.
However, average CTS claim costs
varied greatly by state as shown in
Table 1. Illinois had the highest average cost per claim ($21,581), while
Utah had the lowest ( $5,667). Idaho,
the state with the highest frequency of
CTS claims, had an average cost of
$8,169 per claim. Eight states lacked a
sufficient number of CTS claims for an
accurate average claim cost to be
determined.
When analyzed by accident year,
the average incurred cost per claim for
CTS cases was higher than the average
for other injuries for all accident
years studied (1991, 1992 and 1993).
However, this cost differential
appears to be decreasing. In 1991, the
average total incurred cost for CTS
claims was 34.2% higher than the
average for other injury types ($13,594
vs. $10,128). In 1992 this difference
dropped to 9.8% and by 1993 CTS
costs only exceeded the average by
4.7% (see Table 3a).
10
VOLUME 3, ISSUE 3
JUNE 1996
Table 2
Average Claim Costs

19911993
INJURY
AVERAGE
COST ($)
STANDARD
DEVIATION ($)
19,036
215,799
1,522
249,769
13,526
65,410
Contusion/Concussion
10,060
154,707
Fracture/Crushing/Dislocation
15,639
569,552
9,430
84,974
Laceration/Puncture
10,039
102,710
Occ. Disease/Cum. Injuries
13,105
143,486
Other Trauma
14,121
247,300
Sprain/Strain
11,537
558,660
Amputation
Burn
Infection/Inflammation
Source: NCCI, Workers Compensation Claim Characteristics Series, July 1996
Table 3a
Incurred Costs by Accident Year: CTS vs. Other

19911993
YEAR
MEAN CTS COSTS ($)

(Standard Deviation)
MEAN OTHER COSTS ($)

1991
13,594
(56,555)
10,128
(691,249)
1992
14,586
(78,680)
13,289
(404,191)
1993
12,284
(52,274)
11,729
(344,791)
Ibid.
5
RESEARCH BRIEF
VOLUME 3, ISSUE 3
Table 3b
Incurred Medical & Indemnity Costs:

CTS vs. Other
19911993
NATURE OF
INJURY
MEAN CTS COSTS ($) MEAN OTHER COSTS ($)

Indemnity Incurred
7,654
(43,163)
6,774
(440,367)
Medical Incurred
5,872
(37,209)
5,267
(84,423)
Figure 2
Average Incurred Claim Costs of Wrist Injuries

19911993
DOLLARS ($)
20,000
15,000
14,586
13,594
13,742
12,284
10,000
9,238
12,215
9,324
8,069
7,816
5,000
1991
1992
ACCIDENT YEAR
11
Sprains/Strains
1993
Fractures
JUNE 1996
A breakdown of incurred costs into

their medical and indemnity components for CTS compared to other
injuries can be seen in Table 3b. The
average costs for CTS cases were higher for both the medical and the indemnity components. The average total
indemnity cost for CTS was 13.0%
greater than the average for other
injury types ($7,654 vs. $6,774), while
the medical cost was 11.5% greater
($5,872 vs. $5,267). The higher indemnity cost for CTS injuries is particularly noteworthy, since the average wage
for CTS claimants is significantly
below the average for other injury
types (wages discussed in section
VII). The proportion of medical costs
as a percentage of total costs was similar for CTS compared to other losttime injuries (43.4% and 43.7%,
respectively).11
CTS injury costs were also compared with two other common wrist
injuries: fractures and sprains/
strains. The average cost per claim for
CTS cases was found to be greater in
every year of the study period. Figure
2 shows the average cost per claim of
these three different types of wrist
injuries by accident year. In 1991, the
average incurred cost of a CTS injury
was $13,594, while the average
incurred costs for sprains/strains and
fractures were only $7,816 and $9,238,
respectively. However, throughout
this period, the cost of fractures
increased significantly and was only
0.6% lower than the cost of CTS by
1993. The difference in average costs
between CTS and sprains/strains
remained significant for all three years
(73.9% higher in 1991, 56.4% in 1992
and 52.2% in 1993).
Overall, when medical-only cases are considered, medical costs comprise roughly 52% of total costs.
6
RESEARCH BRIEF
VOLUME 3, ISSUE 3
Figure 3
VI. CLAIM DISTRIBUTIONS BY

INDUSTRY
Claim frequency distributions were
analyzed for five broadly defined
industry categories.12 DCI data
showed distribution patterns that
were similar to those compiled by
BLS13 and that are congruous with the
causes of CTS. Manufacturing had the
highest percentage of carpal tunnel
syndrome claims (49.7%). This finding
comes as little surprise since the repetitive motion of assembly work and the
manipulation of small tools and parts
that are prevalent in the manufacturing sector are synonymous with the
causes of CTS. Likewise, office/clerical industries experienced the second
highest percentage of CTS claims
(21.4%), probably due to the heavy use
of computer keyboards and mice.
Distribution and services followed
with 20.5% of claims.
The distribution pattern by industry for CTS claims was very different
from that of claims for other injury
types, as shown in Figure 3. Higher
percentages of CTS injuries occur in
manufacturing (49.7% vs. 26.1%) and
office/clerical (21.4% vs. 12.7%) industries compared to other injury types,
while lower percentages occur in construction and goods/services.
With the exception of construction,
all industry groups exhibited markedly higher total incurred costs for CTS
claims than for other injury types.
Figure 4 shows the average total
incurred cost by industry. The highest
average costs for CTS claims were in
construction and other sectors
($15,712 and $16,027, respectively).
12
13
JUNE 1996
Distribution of Injuries by Industry

19911994
Other
Carpal Tunnel
Syndrome
20.5%
35.4%
Goods/Services
Goods/Services
12.7%
Construction
4.8%
Construction
3.7%
Other
13.1%
Other
26.1%
49.7%
Manufacturing
21.4%
Manufacturing
Office/Clerical
12.7%
Office/Clerical
Figure 4
Total Incurred Claim Costs by Industry

19911993
DOLLARS IN THOUSANDS
20,000
16,784
16,027
15,712
15,000
13,861
11,758
13,240 13,021
14,047
11,436
9,767
10,000
5,000
CONSTRUCTION
GOODS/SERVICES MANUFACTURING OFFICE/CLERICAL
OTHER
INDUSTRY
Other
The five aggregate U.S. industries are Manufacturing, Construction, Office and Clerical, Distribution and Services, and
Other industries. Other industries includes mining, transportation and other professions.
Number of nonfatal occupational injuries and illnesses involving days away from work by industry and selected
natures of injury or illness, 1993. Bureau of Labor Statistics, United States Department of Labor.
7
RESEARCH BRIEF
VOLUME 3, ISSUE 3
Manufacturing, which had the highest

relative frequency of CTS claims, had
an average claim cost of $13,861.
VII. CLAIM CHARACTERISTICS
Many of the characteristics of CTS
claims are strikingly different compared to those found in other claims.
The frequency of surgery, the percentage of controverted cases, the level of
claimant attorney involvement, and
the demographic makeup of CTS
claimants were examined for claims
filed between 1991 and 1994.
Statistically significant 14 differences
were found for CTS claims compared
to other injuries for all of the characteristics studied (See Figure 5).
Figure 5
Carpal Tunnel Syndrome Claim Characteristics

19911994
Figure 5aSex
Figure 5bSurgery
31.1%
31.9%
68.1%
68.9%
OTHER
CARPAL TUNNEL
42.0%
14.8%
58.1%
85.2%
OTHER
CARPAL TUNNEL
Male Female
No Yes
Figure 5cControverted Claims
Figure 5dAttorney Involvement
8.3%
6.3%
91.7%
CARPAL TUNNEL
No Yes
14
15
93.7%
OTHER
18.8%
13.6%
81.2%
CARPAL TUNNEL
No Yes
86.4%
OTHER
JUNE 1996
The most prominent disparity

between CTS and other injuries was
the percentage of female claimants.
Almost 70.0% of CTS claimants were
female compared to only 32.0% of the
other injury claimants (Figure 5a). This
difference may be partly explained by
female labor force participation rates
in the industries (clothing manufacturing and office/clerical) and activities
(assembly work and keyboard use)
that were found to have a higher preponderance of CTS cases.15 An analysis
of claims by class code showed that the
greatest number of CTS claims were
from (1) office and clerical workers
(administrative support, female worker participation rate 78.8%); (2) clothing manufacturing workers (textile,
apparel & furnishings machine operators, 74.4% female; apparel & other
finished textile products manufacturing, 71.4% female); and (3) restaurant
workers (food preparation and service
occupations, 58.4% female).
Figure 5b shows the large disparity
that existed in terms of the percentage
of claims with surgery: 42.0% of CTS
cases as opposed to only 14.8% of
other injuries. The percentages of controverted claims and claims with
attorney involvement are shown in
Figures 5c and 5d. More CTS claims
were controverted by insurers
(8.3% vs. 6.3%), and a higher percentage showed claimant attorney
involvement (18.8% vs. 13.6%).
Age and wage differences were also
apparent as can be seen in Figures 6
and 7. CTS claimants were older than
the average workers compensation
claimant (40 vs. 37 years old) and their
average weekly wages were 5.2%
lower on average ($362 vs. $381).
Statistical tests (T-test, F-test, Chi-Squared and Duncans Multiple Range test) were performed on claim characteristics in
order to measure for statistically significant differences between carpal tunnel syndrome cases and all other types of
injuries.
According to research published in Workers Compensation Recipients with Carpal Tunnel Syndrome; the Validity of
Self-Reported Health Measures, Katz, Jeffrey N., et al., American Journal of Public Health, Volume 86 (1), January 1996,
females taking oral contraception were found to be particularly susceptible to CTS.
8
RESEARCH BRIEF
VOLUME 3, ISSUE 3
Figure 6
VIII. CLAIM MILESTONE

DURATIONS
The treatment procedures for CTS
have been described by the Centers for
Disease Control and Prevention as
long and arduous, with long-term
immobilization of the affected areas
and frequent visits with physicians.
The necessity of these types of treatment helps to explain the longer time
to claim milestones for CTS claims
compared to the average.
The claim resolution milestones are
designed to compare the elapsed time
from the date of injury to (1) the date
that the injury was first reported to the
employer; (2) the date of earliest return
to work; (3) the date of maximum medical improvement; and (4) final claim
resolution. Figure 8 shows the average
time to these claim milestones for CTS
compared to other injuries. CTS claims
take a significantly longer time to
achieve all milestones studied. The
most significant of these disparities
was the average time to return to work;
CTS claimants took an average of 143
days, while other claimants took an
average of only 58 days to return to
work, a difference of over 144%.
Average time to maximum medical
improvement and close of claim was
also 22.7% and 55.6% longer, respectively, for CTS claims. On average,
CTS claims took 325 days to close as
opposed to 209 days for other injury
claims.
The long treatment procedures and
the use of surgery in 42.0% of all CTS
cases may account for the lengthy
duration from the initial report of
injury to earliest return to work. The
JUNE 1996
Age Distribution of Injured Workers

19911994
PERCENT
35
33.0
31.6
28.1
30
26.4
25
21.8
20
17.4
15.2
15
10
8.6
7.4 7.7
1.0
1.7
0
UNDER 24
2534
3544
4554
5564
OVER 65
AGE
Other
Figure 7
Average Weekly Wages of Injured Workers

19911994
WAGE ($)
400
$387
390
380
$372
$374
$390
$370
370
$360
360
$355
$359
350
1991
1992
1993
1994
ACCIDENT YEAR
Other
9
RESEARCH BRIEF
VOLUME 3, ISSUE 3
Figure 8
Claim Milestone Durations: CTS vs. Other

19911993
NUMBER OF DAYS
350
325.3
300
243.9
250
142.8
150
100
50
209.1
198.8
200
67.3
58.4
24.4
0
REPORTED TO INSURER
RETURN TO WORK
CLOSE OF CLAIM
MAX MED IMPROVEMENT
Other
Figure 9
Average Number of Days to Return to Work:

CTS vs. Other
19921994
AVERAGE NUMBER DAYS TO RETURN TO WORK
(For Claims That Returned to Work by Second Report)
150
146
use of surgery is highly correlated to

longer time to return to work for both
CTS and other cases. For the claims
without surgery, time to return to
work for CTS cases was 168% greater
on average than for other injury types
(121 vs. 45 days). For the claims with
surgery, CTS claimants took 64%
longer to return to work (146 vs. 89
days). These significant differences
help to explain the higher incurred
indemnity costs for CTS claims (Table
3a) despite the comparatively low
average weekly wages of CTS
claimants. Indeed, average indemnity
costs were 13.0% higher for CTS cases
from 1991 to 1993, while average
wages were 5.2% lower.
When comparing the duration
milestones of CTS claims with other
types of wrist injuries, CTS claims
were still markedly longer in duration. Elapsed time to return to work
for CTS was 79.1% higher than for
wrist sprains/strains (143 vs. 80 days)
and 100.2% higher than for wrist fractures (143 vs. 71 days). Time to final
claim resolution was 325 days for CTS
and only 227 days for sprains/strains
and 238 days for fractures.
IX. CONCLUSION
121
120
89
90
60
45
30
0
YES
NO
SURGERY REQUIRED
16
JUNE 1996
Other
Repetitive motion disorders, and

more notably carpal tunnel syndrome,
have been among the fastest growing
types of occupational injuries. Over the
decade from 19821983 to 19921993,
the mix of injuries has changed from
those that were primarily caused by
exertion, to injuries associated with
repetitive motion.16 Between 1991,
when NCCI began collecting data on
carpal tunnel injuries, and 1994, the
Changing Composition of Workplace Injuries. Helvacian, Mike N., and Christopher K. Fred, NCCI Research Brief,
Volume 3, Issue 1, April 1995.
10
RESEARCH BRIEF
number of carpal tunnel cases as a
percentage of all lost-time claims
increased by more than 50%.
The high cost of carpal tunnel syndrome cases is an additional area of
concern. Out of 10 nature of injury
categories studied, CTS cases were
found to be the third most costly type
of injury. The average cost of CTS losttime claims is more than 12% higher
than the combined average of other
lost-time injuries. CTS injuries were
also found to be significantly more
expensive than other injuries of the
wrist.
The higher indemnity cost of CTS
claims appears to be a function of the
relatively long durations of these
injuries rather than claimants wages.
Indeed, the average weekly wages of
CTS claimants were significantly
below the combined average for other
injury types, while the time to return
to work was 144% longer.
Many of the characteristics of CTS
claims vary significantly when com-
VOLUME 3, ISSUE 3
JUNE 1996
pared to other injuries. An overwhelming majority of the claimants

are female, a higher percentage of the
claims are controverted, and a higher
percentage show claimant attorney
involvement. Also striking is the
extensive use of surgery in the treatment of this injury: surgery was
performed in more than 42% of CTS
cases compared to only 15% of other
injuries.
As the frequency of carpal tunnel
injuries increases, new medical treatment procedures are being developed.
A new endoscopic surgical procedure
and a nontraditional carpal tunnel
release operation show great promise
in reducing recovery time, and may in
time help to lower indemnity and
medical costs associated with CTS.
However, these forms of treatment are
in the early stages of use; their effect on
the cost and duration of CTS cases is,
as yet, unknown.
11
National
Council on
Compensation
Insurance, Inc.
750 Park of Commerce Drive, Boca Raton, FL 33487

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