Navigating NC Workers' Comp for Thoracic Outlet Syndrome

Learn the causes of thoracic outlet syndrome, who’s at risk, and how to seek workers’ comp in North Carolina if it resulted from your job

Thoracic outlet syndrome (TOS) is a painful condition that can develop when nerves, veins, or arteries in the narrow passageway between the neck and upper chest are compressed. While it can affect anyone, certain occupations put individuals at increased risk.

For North Carolina workers, understanding the causes, symptoms, and available workers’ compensation benefits is crucial for managing this debilitating condition. This article will explore the factors contributing to TOS in North Carolina workplaces and guide workers through the process of seeking compensation.

What is thoracic outlet syndrome?

Thoracic outlet syndrome (TOS) results from the compression of blood vessels or nerves in the space between your collarbone and your first rib, an area called the thoracic outlet.

The 3 main types of thoracic outlet syndrome include:

Neurogenic TOS. This is the most common form caused by compression of the brachial plexus, a network of nerves controlling muscle movement and sensation in the shoulder, arm, and hand. Symptoms include numbness, tingling, neck, shoulder, arm pain, and hand weakness.
Venous TOS. This occurs when veins in the collarbone area are compressed, leading to symptoms like arm or hand swelling, bluish discoloration, and arm pain, often linked to blood clot formation.
Arterial TOS. This least common form is caused by compression of the subclavian artery. Symptoms include coldness, numbness, arm and hand pain, and a weakened pulse. It can lead to an aneurysm (a bulge in the artery) or blood clots, both of which can lead to serious complications.

According to estimates from researchers at the Cleveland Clinic, neurogenic TOS affects 1 in 40,000 people annually, while venous TOS impacts about 1 in 125,000. However, the true prevalence is likely underreported due to diagnostic challenges.

It’s also important to note that the severity and combination of symptoms can vary significantly from person to person and may worsen with activities or positions that compress the thoracic outlet, such as lifting the arms overhead or carrying heavy objects.

Does thoracic outlet syndrome ever go away?

Thoracic outlet syndrome (TOS) does not usually go away on its own, but the outcome can vary depending on the type:

Neurogenic TOS, which affects the nerves, may improve with rest, physical therapy, and lifestyle changes, especially when caught early. However, without proper treatment, symptoms can persist or worsen, leading to chronic pain and functional limitations.
Venous or arterial TOS, which involves the blood vessels, requires more immediate and aggressive treatment, such as medication, surgical intervention, and other interventions. These types are less likely to improve without medical intervention and can lead to serious complications or death if left untreated.

Early diagnosis and appropriate management are essential for addressing TOS effectively, regardless of the type.

North Carolina Workers’ Compensation for Pre-Existing Conditions

Learn how a pre-existing condition could impact your ability to collect workers’ comp benefits in NC.

Who is most likely to get TOS?

Thoracic outlet syndrome can affect anyone, but certain factors make some individuals more susceptible to developing this condition. Symptoms most often arise between the ages of 20 and 50 years old.

Factors that will increase your vulnerability include:

Repetitive motion activities. Athletes and workers whose jobs require repetitive arm and shoulder movements, such as swimmers, baseball players, construction workers, health care workers, warehouse workers, painters, and mechanics, are most at risk.
Anatomical abnormalities. Individuals with anatomical defects, like an extra rib (cervical rib) or tight fibrous bands in the neck, are more susceptible to TOS.
Poor posture. Those who frequently slump forward or hunch their shoulders, particularly in desk jobs, are more likely to develop TOS due to nerve compression.

Physical trauma. People who have experienced traumatic injuries to the neck, shoulder, or chest from car accidents are at increased risk, although symptoms are often delayed. Workers most at risk include truck drivers, delivery drivers, first responders, and other workers whose jobs require them to drive on a regular basis.
Specific health conditions. Conditions like arthritis, vascular diseases that cause inflammation, pregnancy, or tumors pressing on nerves can elevate the risk of TOS.
Gender. TOS is also more common in women.

If you’re experiencing symptoms of thoracic outlet syndrome and you have any of these risk factors, you should seek a diagnosis and treatment as soon as possible.

Can TOS be work-related?

Yes, TOS can be work-related. Certain jobs, occupations, and tasks, especially those involving repetitive movements, sustained awkward postures, or heavy lifting, can contribute to the development of TOS.

Can I file workers’ comp for TOS?

Yes, you can file a claim for workers’ compensation benefits if you develop TOS due to your job.

In North Carolina, most businesses with 3 or more employees must carry workers’ compensation insurance, with some exceptions for certain farmworkers, sawmill workers, railroad workers, domestic workers, and independent contractors.

Workers’ compensation covers injuries or conditions linked to work-related activities, including TOS, if you can prove they’re directly caused by your job.

To file a successful claim, you’ll need to provide evidence that your TOS is work-related, usually through medical documentation and a detailed explanation of how your job contributed to the condition.

What benefits does workers’ comp offer?

If your workers’ comp claim for thoracic outlet syndrome is approved, you may be eligible to receive several key benefits:

Medical benefits. Workers’ comp will cover all necessary medical treatments related to your TOS, including doctor visits, hospital stays, surgeries, X-rays, scans, medications, and rehabilitation.
Wage replacement benefits. You’ll receive compensation for a portion of your lost wages (typically two-thirds of your average weekly wage) if TOS prevents you from working or limits your ability to work during your recovery.

Vocational rehabilitation. If your TOS symptoms are so bad that you ultimately can’t continue in your previous job, you may be eligible for benefits that assist with job retraining or education to help you transition to new employment.
Death benefits. If TOS leads to a workers’ death, their dependents are eligible for benefits that cover a portion of funeral expenses and lost income.

These benefits are designed to support you and your family as you recover from TOS and adjust to any long-term effects of the condition, helping you transition back to work or find new opportunities that suit your abilities.

How do I file for workers’ comp in NC?

To file for workers’ compensation in North Carolina for thoracic outlet syndrome or any other work-related injury, illness, or occupational disease, follow these steps:

Seek medical care. Start by getting medical treatment from an employer-approved physician. The doctor will diagnose your condition and provide a medical opinion linking your TOS to your job.
Inform your employer. Notify your employer of your injury in writing within 30 days of the diagnosis. It’s crucial to do this promptly, as failing to provide timely notice could result in your claim being denied.
Submit Form 18. Complete and submit Form 18 to the North Carolina Industrial Commission (NCIC) as soon as possible, but no later than 2 years after your injury. This will officially begin the claims process.
Await insurer’s decision. After submitting Form 18, the insurance company should notify you in writing whether they accept or deny your claim within 14 days of receiving the form.

Following these steps carefully can help ensure your workers’ compensation claim is processed smoothly in North Carolina. If your claim is denied and you need help filing an appeal or if you want help determining how much your claim is worth, reach out to a local Charlotte work injury attorney for guidance.

Get help from an experienced North Carolina workers’ compensation attorney

Filing a workers’ compensation claim for thoracic outlet syndrome can be a complex process, but getting the right support from the start can make all the difference. Working with an experienced attorney can help you navigate the intricacies of the system, ensuring that your claim is successful and you receive the compensation you need for a full recovery.

With more than 85 years of combined experience, the skilled Charlotte workers’ compensation attorneys at Wilder Pantazis Law Group are dedicated to helping workers in North and South Carolina secure maximum compensation for their injuries. We can help you obtain the evidence you need and negotiate with the insurer to get you the compensation you deserve.

References

Cleveland Clinic. (2023, May 3). Thoracic Outlet Syndrome (TOS). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17553-thoracic-outlet-syndrome-tos

North Carolina Workers’ Comp for Thoracic Outlet Syndrome