Getting Disability Benefits for Cubital Tunnel Syndrome and Ulnar Nerve Entrapment

Your ulnar nerve, which runs through a small tunnel through the bump on the inside of your elbow, provides the sensation to your pinky and half of your ring finger. The ulnar nerve also controls the movement of the small muscles in your hands and the movement of the larger muscles in your forearm that allow you to grip. If the ulnar nerve becomes irritated, inflamed, or entrapped in the tunnel (called the cubital tunnel), you may develop cubital tunnel syndrome or other ulnar nerve dysfunctions.

Some causes of cubital tunnel syndrome and ulnar nerve dysfunction include leaning on your elbow for long periods of time, using a computer keyboard and mouse (similar to carpal tunnel syndrome), fluid accumulating in your elbow, and a direct blow to the elbow. Symptoms vary depending on how much damage has occurred to the nerve and surrounding muscles, but may include:

• numbness and tingling in your ring and little finger
• difficulty with finger coordination and moving your fingers in and out
• pain in the elbows and fingers
• weakening grip, and
• muscle wasting of the hand.

Treatment depends on the severity of your condition, but may include steroid injections, bracing, physical therapy, and in some cases surgery. For most people, ulnar nerve conditions can be successfully treated, but in rare cases the damage is permanent.

Can I Get Disability for My Ulnar Nerve Condition?

To be eligible for disability because of your ulnar nerve condition, the Social Security Administration (SSA) must conclude that it is so severe that it prevents you from working at the substantial gainful activity (SGA) level for at least twelve months. For most people with cubital tunnel syndrome or ulnar nerve entrapment, it will be hard to meet this requirement because they can usually be treated successfully in less than one year. Successful treatment, however, may mean switching jobs. If, because of your age, education, or work history, switching jobs is not practical for you, Social Security may approve you for disability benefits.

How Does Social Security Decide If My Ulnar Nerve Condition is Disabling?

If the SSA concludes you have met the basic eligibility rules for disability, the agency will look at your ulnar nerve condition to see if it meets the requirements of one of the medical conditions outlined in its Listing of Impairments (referred to as listings). Someone who has a condition that is in the listings and the condition meets all of the listing's criteria will be approved automatically for benefits. Unfortunately, ulnar nerve conditions, including cubital tunnel syndrome, don't have listings. This means that the SSA will have to continue its analysis by assessing exactly how your medical condition limits your work abilities.

Your RFC

The SSA will determine your physical residual functional capacity (RFC), what you can do on a regular and sustained basis. To determine your RFC, the SSA will use the medical evidence in your file to prepare an RFC report. This report assesses how your condition impacts your ability to do certain strength-related activities like lifting, carrying, and walking and assigns you a level of sedentary, light, or medium work. An RFC for someone with only an ulnar nerve condition will probably always state that the person can do at least a sit-down job, but depending on your non-strength-related limitations, you may still be able to get an approval.

Your RFC will include information on your non-exertional (non-strength-related) limitations, such as an inability to type, write, or do repetitive work with your hands. Other examples of non-exertional impairments that may result from cubital tunnel syndrome include:

• difficulty using the affected hand to manipulate objects
• difficulty using your affected hand to feel objects
• difficulty reaching overhead
• the inability to concentrate and focus (due to pain), and
• the inability to follow and remember instructions (due to pain).

These types of limitations are important in a claim based on cubital tunnel syndrome and other ulnar nerve conditions because the more non-exertional limitations you experience, the fewer the number of jobs out there that you could do. Here are some examples of how a disability claim based on ulnar nerve conditions might be evaluated.

• The disability claimant was a 49-year-old woman who filed for disability due to cubital tunnel syndrome. The condition had resulted in significant muscle wasting in her dominant forearm and "clawing" of her ring and pinky finger in her dominant hand. The SSA concluded that because she couldn't use both of her hands effectively, she couldn't do her most recent job as a factory sorter. The SSA approved the claimant for benefits because her attorney was able to show that the claimant's inability to use her dominant hand to effectively grasp, turn, or manipulate large or small objects, eliminated any other jobs she could otherwise do.
• The claimant was a 40-year-old man with ulnar neuropathy in his non-dominant hand. His past job had been as a mechanic. The SSA concluded that the claimant still had the RFC to do at least light work (work that requires lifting 10 pounds frequently and 20 pounds occasionally). The SSA also concluded that because the claimant suffered permanent moderate weakness and numbness in the affected hand, he was no longer able to perform his job duties as a mechanic. However, because the claimant's limitations were moderate and confined to his non-dominant hand, the SSA decided that there were other jobs he could do, such as a security guard. Accordingly, he was denied disability benefits.

If you want to learn more, you can read our article about how non-exertional limitations affect the disability decision.

Combination of Impairments

If you have more than one medical condition, the SSA must consider their combined effect on your ability to work. For example, it is not uncommon for people with cubital tunnel syndrome to also suffer from type II diabetes. Here is how the SSA might decide a case for a claimant who suffers from both conditions.

• The claimant suffered from type II diabetes which caused pain, numbness, and tingling in both of her feet that made it difficult for her to walk. She also had cubital tunnel syndrome that had left her dominant forearm weakened, causing permanent numbness in her dominant pinky and ring finger, and pain in her elbow. Her past work was as a cashier, which the SSA concluded she could no longer do since the doctor restricted her from doing "repetitive digital manipulation." Even though the SSA gave her an RFC for sedentary work, the claimant's attorney was able to argue that because of the combined effect of her conditions, there were no jobs she could do.

You can learn more by reading our article about how you can win your claim using a combination of impairments.

Does It Help My Claim if I am Older?

It can be much easier for you to get approved based on cubital tunnel syndrome or other ulnar nerve conditions if you are 50 years of age or older. This is because, if the SSA finds you can't do your old job, the agency will use the "grid rules" to determine whether it's practical for you to switch to another type of work. The grids are a series of tables that include the claimant's age, education level, RFC, the skill level of the claimant's past work, and whether any of the claimant's job skills can be transferred to a new position. For each combination of factors, the table states whether the claimant can't switch to other work (is disabled) or can't switch to other work (not disabled).

Here is an example of how the grids might help an older claimant with cubital tunnel syndrome get approved.

• The claimant was a 58-year-old woman with cubital tunnel syndrome in her dominant hand. She had a high-school education. The condition had caused significant weakness in her grasp and permanent numbness and tingling in her pinky and ring finger. Because of her symptoms, the SSA concluded that the claimant could no longer do her past work as a seamstress; however, it also concluded that she still had the RFC for sedentary work. Although her seamstress work was skilled, she could not transfer the skills to a new position that didn't require heavy use of her hands. Under the grid rules used for her age, high school education, RFC, and lack of transferable skills, the claimant was awarded benefits.

To learn more, read our article on how to win your claim using the medical-vocational grid rules.

Contact an Attorney

If your ulnar nerve entrapment or cubital tunnel syndrome has caused you permanent damage or restricted you from a large number of jobs, you may be able to win your claim for disability. Even if you are denied benefits initially, you may be able to successfully appeal your claim depending on factors such as your age and whether you have other disabling conditions. In this situation, it may be helpful to talk to an experienced disability attorney about your case.