Carpal Tunnel ART Treatment & Claims

If your hand goes numb at night, you have lost grip strength, or the tingling in your thumb, index and middle finger has become routine, this is not a personal problem to absorb. Carpal tunnel syndrome is on Argentina's official schedule of occupational diseases. If your job requires repeated wrist extension or gripping, the insurer cannot deny work causation: it can only argue about the degree.

1. Why carpal tunnel is a scheduled disease

The carpal tunnel is a narrow channel in the wrist through which the median nerve passes. When the flexor tendons inflame from repeated gripping, extension or prolonged pressure on the carpus, they compress that nerve. The result is numbness and tingling in the thumb, index and middle finger, pain that wakes you at night and, in advanced cases, loss of grip strength.

In Argentina that is not only a medical diagnosis. Section 6(2) of Law 24,557 directed the executive to draw up a Schedule of Occupational Diseases, and Decree 658/96 approved it. Under the agent "Forced postures and repetitive gestures at work I (Upper limb)", in the wrist, hands and fingers section, the schedule lists verbatim: tendinitis and tenosynovitis of the wrist and hand tendons; carpal tunnel syndrome; Guyon's canal syndrome.

It also describes the exposures: "work requiring repeated or sustained wrist extension or hand gripping, or prolonged support of the carpus, or sustained or repeated pressure on the heel of the hand".

That wording is broader than most people assume. It does not say typing: it says wrist extension, hand gripping and prolonged carpal support. It captures supermarket cashiers, industrial sewing machinists, assembly line operators, packers, hairdressers, butchers, anyone using hand or vibrating tools and, of course, anyone who spends the day at a keyboard.

Being a scheduled disease moves the argument. If your activity matches those described and you developed the clinical picture, the law presumes the link to work. The insurer cannot simply say "this has nothing to do with the job": to deny causation it has to displace a statutory presumption.

2. What medical evidence the Medical Board requires

The diagnosis is confirmed by nerve conduction studies and electromyography, which measure median nerve conduction velocity, together with the classic clinical signs: Tinel's sign, the tingling produced by tapping the wrist, and Phalen's manoeuvre, the numbness produced by holding the wrist flexed for a minute.

The study is not a formality: it is what turns your symptom into objective data. Without it the Medical Board has nothing on which to grade motor and sensory involvement, and the report tends to land at the bottom of the range.

The current schedule has two rules on studies worth knowing. First: Medical Boards do not order invasive or risky studies to assess sequelae; if you already have them, they must be filed as part of the record. Second: where a complementary study proves unreliable for insufficient quality, it is repeated; if the second is also inconclusive for reasons not attributable to the assessor or the equipment, no further study is requested and unreliable studies are excluded from the assessment, with a written note to that effect. In practical terms: a poorly performed nerve conduction study can cost you the rating. Choose carefully where you have it done.

3. How median nerve damage is rated

A new impairment schedule has applied since February 2026. Decree 549/2025 (Official Gazette, 6 August 2025) replaced Annex I of Decree 659/96 with a new Labour Impairment Assessment Table, which took effect 180 calendar days after publication and applies "to any assessment or determination of labour impairment not yet issued, regardless of the administrative or judicial stage it is at".

For peripheral nerve injuries the schedule assesses two components separately. Motor function is graded on the modified Medical Research Council scale; sensory function on the modified Higuet Zachary scale, based on two-point discrimination thresholds. The physical examination returns a letter and a number for each component — M for motor, S for sensory — and the calculation follows from there.

That makes clear why the study matters so much: each step on the motor and sensory scales moves the percentage, and those steps come from the physical examination backed by the nerve conduction study, not from a description of pain. The schedule is explicit: "pain, given its subjective and variable character, shall not be included in the labour impairment weighting tables".

The weighting factors of Section 8(3) of Law 24,557 — age, type of activity and redeployment prospects — are then applied to the table percentage. The schedule assesses activity type and redeployment together, by measuring how much difficulty the sequela creates for your usual duties, and adds an age factor with its own table. Those factor percentages are summed into a single value, and that value is the percentage by which the table impairment is increased, not points bolted on from outside.

4. If both wrists are affected

Bilateral carpal tunnel is common, and the way it is calculated is not intuitive. The schedule draws a distinction. Where sequelae are in the same limb and on the same side, they are added arithmetically. Where they are in a different topographic region or on the other side — exactly the case with two wrists — they are weighted by the residual capacity method: the second impairment is calculated on the capacity left after the first, not on 100%.

That is why the report must record both sides, each with its own study and its own motor and sensory grading. If the Medical Board only assesses one wrist because you only brought one nerve conduction study, the other simply does not exist for the file.

There is also a sector ceiling: the sum of osteoarticular and neurological sequelae of the hand and wrist on the same side cannot exceed 50%, the value assigned to amputation of that sector.

5. What you collect

The formula is statutory and not open to negotiation. Section 14(2)(a) of Law 24,557 — which governs impairments of 50% or less, the range of practically every carpal tunnel case — provides:

53 × monthly Base Income × impairment percentage × (65 ÷ your age at the date of first disabling manifestation)

Base Income is the monthly average of all wages accrued in the year before the first disabling manifestation, indexed month by month by the RIPTE wage index (Section 12(1)). From that date until payment is made available it accrues interest equal to the RIPTE variation (Section 12(2)). The full walkthrough, with a numerical example, is in how workers' compensation is calculated.

The 20% single-payment supplement under Section 3 of Law 26,773 is added to the result, where the harm occurred at the workplace or while you were at the employer's disposal.

A statutory floor also applies, updated every six months by the SRT using RIPTE. For the period from 1 September 2026 to 28 February 2027, SRT Resolution 39/2026 set that the Section 14(2) award may not fall below ARS 114,354,110 multiplied by the permanent labour impairment percentage. That floor is why claiming is worthwhile even at low percentages. Current figures are in what workers' comp pays for carpal tunnel syndrome.

If the insurer fails to make payment available on time, Section 12(3) of Law 24,557 applies the Banco de la Nación Argentina 30-day general lending rate, capitalised every six months.

6. The procedure, step by step

Going through the Jurisdictional Medical Board is the mandatory administrative stage, exclusive of any other intervention (Section 1, Law 27,348). The only exception is unregistered workers of uninsured employers, who under the same section have the judicial route open. How the hearing runs is detailed in our note on the Jurisdictional Medical Board.

1. Notice of the disease. You report the condition to your employer and the insurer, which must open the file and cover consultations, nerve conduction studies, physiotherapy and, if needed, median nerve decompression surgery, as well as paying temporary disability benefits while treatment lasts.
2. Legal representation paid by the insurer. The final paragraph of Section 1 of Law 27,348 places legal representation fees and other expenses on the insurer, and Section 2 makes all evidence produced at any stage free for the worker. If you appoint your own medical expert for the hearing, however, whoever proposes that expert pays for them.
3. Impairment determination. Once temporary disability ends, the insurer or self-insured employer has twenty days to ask the Medical Board to fix your impairment. If they let that window pass, you can start the divergence procedure yourself, in person at the registry or by post (Section 3, SRT Resolution 298/17).
4. Sixty-day deadline. The Medical Board has 60 administrative working days from the first properly completed filing to issue its report (Section 3, Law 27,348), extendable once by up to 30 working days where evidence is still outstanding (Section 7, SRT Resolution 298/17). The deadlines are peremptory: once they lapse, the judicial route opens.
5. Report and review. It is served on the parties and the employer within ten days. From there you have three days to seek in writing the correction of clerical or formal errors, or revocation where the reasoning contradicts the conclusion or a submission went unanswered.
6. Approval and payment. Once those requests are decided, a hearing is scheduled before the Settlement Approval Service. Section 4 of Law 26,773 then requires formal notice to you, within fifteen days of service of the approval or the impairment determination, of the amounts due, itemised by head of claim and stated to be available for collection.
7. Appeal. Once the stage is exhausted, Section 2 of Law 27,348 allows review before the Central Medical Board or an appeal to the labour courts of the jurisdiction where the Medical Board sat, with an official medical expert from the forensic medical body.

Since March 2026 Section 4 bis of Law 27,348, inserted by Law 27,802, is also in force: it obliges adhering jurisdictions to apply the Impairment Assessment Table strictly at every stage, to establish or reinforce specialised forensic medical bodies, and to implement the digital environments the SRT provides to assist doctors and experts in calculating impairment.

7. If the insurer denies the claim or lowballs you

It is not unusual for the insurer to deny work causation from the outset, even where the activity is on the schedule. Against a rejection, the contingency-rejection procedure opens with three items (Section 1, SRT Resolution 298/17): proof of identity, the notice of the accident or disease, and the insurer's reasoned rejection. If the insurer also argues the disease is unscheduled, you must add a reasoned petition with factual, medical and legal support. The full circuit is in workers' comp claim rejections.

The other common move is the voluntary settlement: the insurer offers an amount outside the formal assessment, on a percentage lower than the real one. The Settlement Approval Service accepts those agreements, but nobody obliges you to sign before the full examination. If the offer does not match your symptoms or the nerve conduction results, ask for the formal assessment. And if the discharge came with a zero rating, the route is set out in what to do about a zero-impairment discharge.

8. Mistakes that cost you money

• Signing at the first hearing without arguing the percentage. The insurer arrives with its own report. Before approval you are entitled to ask for the formal assessment and, if needed, to appoint your own expert.
• Attending without a nerve conduction study. Without a study grading median nerve involvement, the Medical Board has nothing on which to apply the schedule's motor and sensory scales.
• Having the study done anywhere. If it comes back unreliable twice for reasons outside the assessor's control, the schedule allows it to be discarded with no replacement ordered. The quality of the study is your practical responsibility.
• Believing only keyboard workers qualify. The schedule speaks of wrist extension, hand gripping and prolonged carpal support. Cashiers, machinists, packers, butchers and line operators are equally covered.
• Claiming for one wrist when the condition is bilateral. Each side needs its own study and grading for the report to weight it by residual capacity.
• Not putting the onset of symptoms in writing. An email or telegram to your employer reporting the pain and asking for a change of duties fixes the date of first disabling manifestation, which determines which insurer answers and which age enters the formula.
• Letting the three days after the report lapse. It is the fastest route to correcting a clerical error or a contradiction before you have to appeal.

Frequently asked questions about carpal tunnel claims