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Carpal Tunnel Syndrome not a Disability
An Anonymous Coward writes: "It turns out that the Supreme Court of the United States doesn't think Carpal Tunnel Syndrome is a real disability. See here for details." Read the summary or the whole opinion. In a nutshell: just because a woman was sufficiently disabled that she couldn't perform her job due to carpal-tunnel, doesn't mean she was sufficiently disabled to be considered disabled under the Americans with Disabilities Act. Everyone who has that nagging pain in your wrists should probably read this decision.
Anyone who has a nagging pain in their wrists should learn how to use a keyboard properly.
I'm a writer, a poet, a genius, I know it. I don't buy software, I grow it.
This is interesting. The court is basically saying that if you can do "everyday life tasks" (brushing your hair, cooking dinner, whatever), you're not disabled for the purposes of the ADA. But on my disability policy, it states that if I can't do my regular job, they consider me disabled. Since my job (like most of yours) involves lots of typing, losing both legs wouldn't make me disabled, but C-T would. So now the question is, how does this court decision affect my policy? Can I expect a call from my agent telling me they've changed their definition to line up with the court?
God invented whiskey so the Irish would not rule the world.
Nowhere did it state that Carpal Tunnel Syndrome was not a disability -- it stated that in the case of the woman named, they were not considering it a disability because she was not impaired sufficently to be unable to do her job.
http://quiz.ravenblack.net/blood.pl?3357354385
Guess we're going to be needing these after all.
It's a pain in the ass to do them, but your wrists will thank you in five years. Young coders might feel invincible now, but any sort of 40hr+ work week will make quick work of the nerves in your hands and arms no matter how young you are.
Also check out this informative (if cute) prevention handbook.
-Erik
This doesn't mean that carpel tunnel isn't a disablity you dolts, it's a very serious problem. This woman's case simply didn't prove that her affliction was serious enough for her to be considered under the ADA.
I posted to
Sit in your chair properly.
Take simple preventative measures such as stretching to reduce pain and stress due to repeated tasks.
This has all been commonly known for years now, and most businesses will provide rudimentary ergonomic audits for their employees.
Everyone who has that nagging pain in your wrists should probably read this decision.
Too... sore... to... move... mouse.
For all intensive purposes, "whom" is no longer a word. That begs the question, "who cares"?
In cases like Williams', "the central inquiry must be whether the claimant is unable to perform the variety of tasks central to most people's daily lives, not whether the claimant is unable to perform the tasks associated with her specific job," the court wrote.
Many people who are in the construction industry, for example, get a bad back over time or are otherwise affected physically over the years of that kind of labor. Many of those people move on to other types of jobs, possibly relating to construction management, sales, inspection, etc. Just because their body no longer allows them to perform one job does not mean they have become disabled.
On the other hand, if said construction worker cannot perform basic daily tasks, such as bathing or dressing, or cooking, they would be classified as disabled.
I Heart Sorting Networks
Woah there moderators! Finish reading before you fire at me:
I've HAD three or four different maladies related to finger-hand-wrist related movement over the last, (oh god, has it been that long?) 15 years.
In all cases, the ones that were _computer_ related were cured by altering the work environment.
The one situation that eventually required surgery, and that was initially thought to be work related, wasn't. It was a Sports related injury. The fact that myself, the office Clinician, and the Workers Comp specified specialist didn't catch it as that is irrelevant. When the _hand_ specialist reviewed it, he stated it was a totally different problem (Intersection Syndrome, not Dequarvains Tendonitis) and not caused by lumping along at a keyboard during the work week.
That's not to say a company isn't liable for providing a safe environment for its employees, It is. But I wouldn't characterise CT as a modern equivalent of lead poisoning.
"Draco dormiens nunquam titillandus."
Isn't OSHA supposed to step in somewhere? Do companies actually not realize that it's in their interest to attempt to ensure that their workers' jobs can be performed without injuring them?
Also from the article:
So pursuing a livelihood doesn't meet the ADA criterion of "major life activity"?OK,
- B
http://www.bradheintz.com/
- updated
Yes, exactly. Note that unanimous Supreme Court decisions are very rare in any case where there's substantial controversy -- I strongly suspect that this individual really didn't have very strong case (or maybe she had a really lousy lawyer.) I would be very surprised if this case turned out to set any significant precedent.
The correlation between ignorance of statistics and using "correlation is not causation" as an argument is close to 1.
The Americans with Disabilities Act was designed to protect those people with disabilities that *severely* impair their ability to function day to day. To compare "pain and discomfort for several months" with, say, losing a leg, is more than insulting to those who are unfortunate enough to have a true disability and is a bastardization of the law's intended use.
Take Aikido.
Aikido focuses on joint locks, which include wrist locks. After taking Aikido you will quickly have wrists that can withstand the rigors of typing. Flexible wrists are the key to avoid carpal tunnel syndrome, IMO, and Aikido is the key to flexible wrists.
Or you could just wait for speach recognition.
Which of course she responded to by filing a lawsuit.
There are several excerises for the prevention ff the Carpel Tunnel Sindrome Here.
Anybody who spends lots of time in front the computer should check that link
In its brief on the merits, petitioner asks us to reinstate the District Court's grant of summary judgment to petitioner on the manual task issue. In its petition for certiorari, however, petitioner did not seek summary judgment; it argued only that the Court of Appeals' reasons for granting partial summary judgment to respondent were unsound. This Court's Rule 14(1)(a) provides: "Only the questions set out in the petition, or fairly included therein, will be considered by the Court." The question whether petitioner was entitled to summary judgment on the manual task issue is therefore not properly before us. See Irvine v. California, 347 U.S. 128, 129--130 (1954).
Accordingly, we reverse the Court of Appeals' judgment granting partial summary judgment to respondent and remand the case for further proceedings consistent with this opinion.
Maybe this confirms my thinking that the mouse is an ergonomic nightmare and one should stay away from GUI-centric editors and do it all on the keyboard.
The US Supreme Court did NOT rule that CTS is NOT a disability. They ruled that whatever disability you have has to preclude you from leading a normal life.
From the link to the decision, scroll down toward the bottom of the page:
" The District Court noted that at the time respondent sought an accommodation from petitioner,
she admitted that she was able to do the manual tasks required by her original two jobs in QCIO.
App. to Pet. for Cert. A--36. In addition, according to respondent's deposition testimony, even
after her condition worsened, she could still brush her teeth, wash her face, bathe, tend her flower
garden, fix breakfast, do laundry, and pick up around the house. App. 32--34. The record also
indicates that her medical conditions caused her to avoid sweeping, to quit dancing, to occasionally
seek help dressing, and to reduce how often she plays with her children, gardens, and drives long
distances. Id., at 32, 38--39. But these changes in her life did not amount to such severe
restrictions in the activities that are of central importance to most people's daily lives that they
establish a manual-task disability as a matter of law. On this record, it was therefore inappropriate
for the Court of Appeals to grant partial summary judgment to respondent on the issue whether
she was substantially limited in performing manual tasks, and its decision to do so must be
reversed."
Eve Fairbanks says I drive a hybrid!LOL
There's no reason to even let CTS become an issue to you; work out your hand while you're sitting there mulling over a piece of code and not only will it make your hands feel a lot more nimble, it'll sooth the inflammation that causes that numb feeling.
I have no personal investment in these things, this isn't a plug. Just something I started doing once my fingers got numb one day and the effect was nearly immediate, my hand felt better within a few hours.
For the link dependent, here is another person saying pretty much the same thing (with some other ideas, which I'm not exactly prepared to try out ;).
While I agree about computer usage, CT can be caused by other factors. For example: we just had our first kid. As we found out, CT can sometimes be brought on by hormone fluctuations post-partum. This is the case with my wife. I've never known anyone with severe CT, but now I know how excruciating it can be. She's often unable to lift our child and she certainly can't drive a car. It may be temporary (we certainly hope so), but in the meantime, it's pretty debilitating.
I read an article a while back that claimed that the cause of most carpal tunnel syndrome was the use of the mouse rather than the keyboard.
From personal experience being a programming who has used dvorak for 3 years, and using as many keyboard shortcuts as possible, I've never had a problem with carpal tunnel.
The courts are being used to finally stop the abuse of the ADA. It should interesting to see what happens when the "compulsive behaviour" abuses make it to the court.
Essentially they are stating, theres a big difference between being disabled and inconvienenced. The law was meant to help the truly disabled, not those who are lazy, or have good lawyers. (and I won't go into to alcholics)
* Winners compare their achievements to their goals, losers compare theirs to that of others.
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If memory serves, this woman had worked for Toyota in an assembly plant for a number of years. Over time, her carpal tunnel syndrome developed and resulted in significant absenteeism. After UAW-Management mediation, Toyota reassigned her to a job that was less physically demanding, e.g., inspecting the paint on new cars. While at that task, her attendance record improved dramatically. Unfortunately, after a time Toyota management again reassigned her to assembly work in circumstances that aggravated her carpal tunnel syndrome and again resulted in absenteeism due to chronic pain. I don't recall whether she quit or was fired prior to the filing of this lawsuit.
The Supremes have ruled that Toyota is not obligated to provide a job for this woman, nor to provide reasonable accommodation in any existing job, because the carpal tunnel syndrome she suffers from does not significantly limit "major life activities" -- meaning, she can still drive, care for her own hygiene, hold a less physically demanding job, etc.
In my view, Toyota is both a good guy and a bad guy here. After making a reasonable accommodation by transfering its employee to the paint shop, it then put her back in the circumstance that was a significant factor in the development of her carpal tunnel syndrome. Initially nice, then heartless. However, Toyota is in the right about asserting no responsibility to employ her because, as noted by the Supremes, its former employee is perfectly capable of choosing a less physically demanding career path, with equal if not better economic opportunities.
This is similar to a construction foreperson saying she will not hire me for the physically demanding job of digging trenches if I suffer from obesity, chronic back pain, and uncontrolled hypertension. I'm simply not suited to the job.
That being said, it sucks to be the plaintiff.
MacOS, Windows, BeOS, GNOME, KDE: they're all just Xerox copies
Moreover, Justice O' Connor pointed out that the test under the ADA is whether or not a person's disability affects his or her to perform normal daily tasks--not his or her ability to perform a specific job.
In fact, the ADA specifically states that this is the test. As Justice O'Connor wrote, "Repetitive work with hands and arms extended at or above shoulder levels for extended periods is not an important part of most people's daily lives," O'Connor wrote. "Household chores, bathing and brushing one's teeth, in contrast, are among the types of manual tasks of central importance to people's daily lives." In sharp contrast to the rather extreme and dire view suggested by the story posting <rant>(which, in my view, is either misleading and downright shameful or simply reflects a total lack of understanding of the decision and the governing laws)</rant>, the Justices did not rule on the validity of Carpal Tunnel Syndrome; they simply verified the intention of the ADA as written and asked the lower court to reconsider its decision.
In this case, the court held that the woman was not impaired in normal daily tasks, in spite of the fact that she was impaired in her job. There is a critical distinction here, and I firmly agree with the limitations placed on the ADA by the court here.
-db
As many others have already pointed out, this ruling is on what is considered a disability under the ADA, which is an American law that provides the minimum which everyone (employers, shopkeepers, public transportation, etc.) must do to accomodate disability. For example, I believe that it's the ADA which forces businesses that wouldn't normally allow pets on the premises to nevertheless accept seeing-eye dogs.
This ruling has no bearing on whether or not carpal tunnel could be considered a disability under, say, a worker's compensation law. It merely states that in order to invoke the power of the ADA ones disability must extend to basic life tasks; merely making ones job impossible is insufficient.
However, if your friend was forced to get a specially equipped car, then her disability was much more severe than the disability in this case, and in all likelihood meets the standard the court set in this case for invoking the ADA.
In fact, the article clearly states:
The ruling does not mean that anyone with carpal tunnel syndrome or similar partial disabilities is automatically excluded from protection by the ADA. But it probably will make such claims harder to prove, since the court makes clear that disability must affect a range of manual tasks or duties.
Well, for starters, the Court did not rule that carpal tunnel syndrom is not a disability. They ruled that the woman in question was not disabled from carpal tunnel syndrome.
The law already makes clear just what this snippet from the article says. I think that in many cases, employers and insurance companies are concerned with the political backlash that may come from a close interpretation (that is, applying the law as written) of the law.
Nonetheless, the law is clear that you aren't disabled if you can't perform your job...there is a much broader test to be satisfied to determine a disability.
Certainly there would be a big bonanza for the plaintiff if an ADA violation was proved, but I wonder if this would have been more appropriately handled as a Workman's Compensation case? After all, she claimed that her injury came from a work-related situation...that seems tailor-made for a Workman's Comp case.
Of course, the cynical side of my must point out there there is a lot more money to be had from an ADA lawsuit...
-h-
Disability is separate but related to the ADA. IF your CT is considered a job related injury, then it's more of an OSHA thing, with all the related hoo-ha. The ADA is a discrimination law, basically stating that hiring decisions can't be made on the basis of disability, unless the person's disability makes it impossible, without reasonable accomodation, to do a specific job. If this sounds vague, it is: Congress hasn't clearly written a law in years.
So, if you broke your hands when you were trying to change the water in the water cooler, workman's comp law says that you continue to get paid your full rate until you can work again. (of course, they can make you come into work and answer telephones with a hands free set, but that's a light duty assignment).
ADA says that, if an employer can make reasonable accomodations, they cannot hire or fire you simply because you have a disability. What's "reasonable accomodations"? No one knows, and Congress is letting the courts address it.
"As God is my witness, I thought turkeys could fly." A. Carlson
RTFA
Congress intended the existence of a disability to be determined in such a case-by-case manner.
...
An individualized assessment of the effect of an impairment is particularly necessary when the impairment is one such as carpal tunnel syndrome, in which symptoms vary widely from person to person.
It was not decided that the Americans with Disabilities Act didn't protect CTS. It was decided that in this woman's case, her specific form of CTS wasn't a disability under the ADA. In order for someone with CTS to be protected by the ADA, their form of CTS must "severely limit major life actives."
Rather, the central inquiry must be whether the claimant is unable to perform the variety of tasks central to most people's daily lives. Also without support is the Sixth Circuit's assertion that the question whether an impairment constitutes a disability is to be answered only by analyzing the impairment's effect in the workplace.
...
Moreover, because the manual tasks unique to any particular job are not necessarily important parts of most people's lives, occupation-specific tasks may have only limited relevance to the manual task inquiry
That speaks for itself. Just because your impairment won't let you perform your job, its not a disability, and your not protected by the ADA. So, we return to CTS. For many of us, it WOULD impair MAJOR life activity. IANAL, however I think that you would have a hard time of it in court.
--Cam
All jocks think about is sports. All nerds think about is sex.
- She wasn't moved to a desk job, but moved to an assembly floor position that didn't require as much manual labor. Specifically she was assigned to a quality control team which did four QC-related tasks, she initially was assigned to rotate between two of the four, two which didn't aggrevate her CTS. Management then got the bright idea to make everyone on the team to rotate through all four tasks, the other two which did aggrevate Williams' CTS.
- The district court (Eastern District of Kentucky) found for Toyota ("granted summary judgement for petitioner" in SCOUS terms means the person in front of the "v."). The Sixth Circut court overturned the district court, ignoring the fact that Williams didn't seem to have any problems keeping up with her hygine and household chores (which appears to be a requirement to qualify for ADA protection.)
-skYes, but what is considered to be a "major life activity"? What you might not see as a major loss would be to me. That inability to type would be as disabling as losing a leg -- it'd rob me of my ability to communicate in the best way I know how (and one of the relatively few options open to me.)
...
I am hearing impaired, and I consider myself to be disabled. It isn't a disability that you can see, as the cause of it lies with destroyed nerves in my inner ears (my cochleas were damaged due to maternal illness before I was born). I do wear a hearing aid, which provides for some relief, but it's not complete; I still don't have normal hearing in my right ear, and my left is so far gone that an aid can't help. So I have no stereo hearing; I understand the principle of what stereo is, but I've never experienced it. It's sort of like trying to explain color to the blind. And until a few years ago, the sound of a bird chirping was foreign to me -- only recently have computerized hearing aids tailored to an individual profile been good enough to help. (I still can't hear all high-pitch sounds, though.)
Are there things I can't do? Certainly. I can't handle large crowds (face-to-face RPG gaming is a no-no unless the group is four people or less; I found this out the hard way, so I've reverted to MUCKs for most of my roleplaying). I can't talk to people easily while at a swimming pool (hearing aids aren't waterproof). I can't be in the military or hold many different jobs where good hearing is a necessity. I can't understand the lyrics of songs without reading a transcript first. I must have closed captioning on all television shows I watch. I cannot tell where a siren is coming from while I'm driving and have to look around for the flashing lights.
There are upsides (roomsful of screaming kids can be instantly silenced with the press of an 'off' button on a hearing aid, for instance) but the downsides are there, too. Under the ADA, I sometimes made use of a note-taker in high school and college because keeping up with lectures was difficult. (That sort of thing is what the ADA was designed for -- equal access where vital to those of us who otherwise would have to go without.) I think equal access to education is classifiable under "major life activity" -- but I don't go around claiming that the ADA means I have to be given a disabled parking placard or anything.
There are limitations to what I feel I can ask for under the law. I've adjusted my activities to use the senses I do have. Some people might think I don't have a life, for instance, because I chat with people on the Internet rather than going out and going to parties -- no, I say; my life is enriched by that. I'm just as social as the next person might be; I just interact in a way that utilizes what I'm left with.
As for the original topic, it does seem to me that the woman in this case did go a bit far in her efforts to get a "more acceptable" job
i am a soviet space shuttle
I assume the author intended this to be humorous, and to fish out lots of eager moderators who've clearly never trained aikido...
It's true that with good training, aikido (and other martial arts that involve wristlocks) will increase your wrist flexibility and strength. I've been training these things for years, and also play the piano as well as typing lots, and I've never encountered serious wrist problems. After a while, I even developed a reputation for having exceptionally bendy wrists amongst my peers, so I got to be the first guy anyone new tried them on -- if they worked on me, they worked on everyone.
Everything was great, until one day an overenthusiastic training partner slammed a wristlock on a bit too hard. My wrist still worked afterwards, but was obviously badly weakened, probably due to a connective tissue injury. I've been forced to give up training stuff I love for well over a year, while I let the wrist recover. After all, if it goes, I can't drive to work or type when I get there, and that's not a risk I'm prepared to take.
Sorry to go all serious, but while the parent post was amusing, I think it's important to avoid misleading people, just in case anyone goes out and starts doing this stuff after reading it.
If you disagree, post your argument. (-1, Overrated) isn't your personal censorship tool for views you don't like.
And your above statement shows you have had no direct experience with CTS or RSI.
In the US, surgery for CTS costs no less than $3000 per hand. Only one hand will be done at a time: your other hand, if it also needs surgery, wont be operated on until you have about 80% of use back in the first hand. Recovery to 80% is about 6 weeks, so if you need both hands done, you're out of work for three months.
Can you afford surgery for one hand? Do you have insurance? Can you go three months without a paycheck? Didn't think so. Will there even be a job for you when you get back? Probably not, so how much will it cost all taxpayers to have another guy on unemployment?
Luckily, I'm in Germany (and was when CTS became my little nightmare[1]. Thanks to the health laws and insurance, I paid ZERO for the operations, had my job when I recovered, and had 80% (five weeks), then 60% (remainder of the time) of my paycheck.
woof.
[1] Speaking of nightmares, if you have CTS, you ain't getting much sleep thanks to the secondary pain it causes in your upper arms. It disappears the night after surgery because the nerves are no longer pressed. This upper arm pain indicative of later stage CTS and until the surgery has been done, you won't be sleeping much. Instead, you wake up with incredible pain that only slowly subsides when you shift yourself in a certain position on your back with your head and shoulders elevated, your arms at your sides with the elbows and wrists held at a certain, fairly relaxed angle. You will not be able to hold this position for long once you fall asleep again and you'll be back awake within an hour.
As soon as I started weight training, it all evaporated. I make sure to do some stretching (it's become something I just kinda do while I'm thinking), and I get out to the gym three nights a week. (Soon to be joined by weekly hocky games.)
There are a bunch of us here at work that type for a living. I've noticed that the guys who are in good shape (we've got a few ex-motocross riders) don't suffer from RSI. I have a friend who's a physical trainer, and she's helped a lot of people with wrist/CT problems just by getting them to do a little strength training on their wrists. My pet theory: RSI & CT seem to be caused by overuse of underpowered muscles. Typing isn't stressful enough to make your arms stronger, but it is stressful enough to cause strain and eventual damage to over-worked muscles. Beef up, and you might avoid the problem.
There are several excercises that you can do to strengthen your wrists. My favorite is:
- Tie a weight (5 lbs or so) to the end of a string, and tie the string to the middle of a 2-foot pole. (I use a cut-off hockey stick, and a small milk jug for the weight.)
- Hold the pole in front of you with both hands, palms down, with the string hanging between them.
- Now, reel in the weight. Turn the pole away from you until the weight comes all the way up. Then turn the pole toward you untill the weight goes all the way down and back again. Repeat.
You can do this with your arms resting on your knees, or train your shoulders and posture by doing it standing.I'm fully aware that strength isn't the only factor in RSI and CT. But anything that trains strength and flexibility seems to help. Good luck, all!
(Yes, there's an intentional typo in the name.)
The xwrits tool occasionally pops up reminders to stop typing and do your writs exercises. And if you ignore it, it makes rude gestures at you. Debian users can just apt-get the xwrits package, and there's source and RPMs and stuff on the project page.
It definitely helped me. My wrists rarely hurt anymore (but I should keep doing the exercises anyway).
You cannot apply a technological solution to a sociological problem. (Edwards' Law)
So companies can require people to perform jobs that are injurous to them? I know the Libertarian readers will probably just respond by saying, "Get a job that's not on an assembly line", but then they probably have sufficient education and wealth that they can actually get other kinds of work.
Isn't OSHA supposed to step in somewhere? Do companies actually not realize that it's in their interest to attempt to ensure that their workers' jobs can be performed without injuring them?
This is NOT the Court saying Toyota can require her to do something injurous to herself. It is the Court saying Toyota does not have to redesign a job that has not be found unsafe by OSHA so that it is not painful or aggrevating for her. That is a big difference.
You ask where OSHA is? Trust me, this is the auto injury and OSHA is there, probably with an inspector on the shop floor. OSHA has probility had this job redesigned several times to be safe for the average person. The average person does not have CTS so OSHA safety requirements don't apply.
She argued that her CTS was bad enough that it qualified as a disability under the ADA. If she had won than Toyota could have been required to make reasonable (as defined by the court) accomodations, but even then it would not be absolute (otherwise a blind person could sue if not hired as a paint color match tester for example and the employer would have to find a way to make it work).
The CTS defines a disability as interfering with major life activities of the average person. While making a living qualifies, making a living as a paint inspector does not. Why? Because while the average person does have a job, they do not have a job as a paint inspector.
Herb
Again, feel free to sentence me to death if my questions annoy you. I'll come back in 5 minutes anyway. -Sythi
What works depends on the cause. CTS is a syndrome. That means that it's a collection of symptoms. They don't always have the same cause. Sometimes exercises make things worse instead of making things better. If it a chronic inflamation, then frequently exercises will help if you get the inflamation under control first. If it is not only chronic, but also mild, then it may be possible to use ibuprofen to get the inflamation under control. It is usually a bad idea to exercise while the inflamation is present (at least without being under close observation by a specialist in the field).
P.S.: IANA MD. This is only a warning, not a diagnosis or prescription for treatment.
I think we've pushed this "anyone can grow up to be president" thing too far.