Oh yes , unfortunately difficult to prove unless you have very good drs & wc atty on your side.
mainly because TOS does not clearly "show up" { aka the proof in wc view} on the standard & usual tests.
be prepared for possible denials, appeals and stall tactics.
If you have/find a good dr that understands accumulated injuries and will stand strong against the IME drs and the wc case workers you have a better chance.
The worst part is the delay and stall tactics- you could be getting some decent PT/therapy that can turn things around right at the start and sometimes they drag it out and try to keep you working - which increases the damage and the PT treatments cannot get ahead of the injury if you are still using/working. {my honest opinion}

You can use the forum search tool to find how other here deal with wc or any specifics, symptoms, etc
http://neurotalk.psychcentral.com/fo...to_forumsearch
Our workers compensation forum has good info in the stickys there-
http://neurotalk.psychcentral.com/forum30.html

questions wc and atty will ask about-
was he healthy and active until these sx came on ?
after how many yrs of that type of work?
did any specific event set it off at all?
any hobbies or activities that might cause these symptoms/injury?

I can totally agree about handling papers - they had me do that for modified duty- it was almost as bad for me as the doing my normal job.
{the pinch, grip, wrist rotations and carrying papers and notebooks, filing papers in a over full file cabinet}

Thanks to my father and the rest of you for your responses. After 3 years at my occupation, an Industrial Engineer (and 3 years out of school), I started having a cold feeling in my right hand which was soon followed by the left. I was diagnosed with TOS and/or a C6-7 disk bulge. An MRI showed a bulge to the right and xrays were negative for an extra rib. After about 3 months of PT and rearranging my workstation my symptoms went away.

A year later the symptoms came back, but the PT did not seem to help. I struggled at work for a year before going on disability. I have now been off work for more than 8 months with bilateral symptoms of cold hands, some elbow pain, and back discomfort between my shoulder blades.

I've had the following tests:
XRays: Negative for extra rib
MRI of Cervical Spine: 3 separate MRIs showed a bulge at c6-7 to the right
EMG/Nerve Conduction: 4 separate tests were all normal bilaterally
Cervical Epidural: Twice. Symptoms went away completely after a week for about 1-2 weeks
Evoke Potential: Normal bilaterally

I also had an ulnar nerve transposition on my left elbow with no noticable improvement.

A Plastic Surgeon/Hand Surgeon in St. Louis diagnosed me with Carpal Tunnel, Cubital Tunnel, and TOS. She is recommending surgery for Carpal and Cubital Tunnel and PT for TOS. She did say that this is work related.

I am going to a Vascular Surgeon from your list in Iowa City on 4/30 for a second opinion. I would consider cortisone injections in shoulder or wrist to help in the diagnosis.

I plan to fully exhaust PT before considering anymore surgeries. I think I'm getting better, but very slowly.

I am also expecting a decision from WC and will likely appeal with an attorney if denied-which I expect.
The WC doctor believes that I need neck surgery but the neurosurgeons have told me that neck surgery could possibly give some relief on the right side but would not relieve any symptoms on the left. They did not offer surgery as option.

My dx's were of various RSI and shoulder/neck strains for a few yrs before it all joined up to become TOS in 03.
I am one that does pretty well with good PT, regular chiro and self care but it will be a lifetime thing.
I had about 2.5 yrs that were pretty restrictive due to sx & pain- part of it was due to not knowing anything about TOS, but once I learned about it and triggerpoints, spasms, posture awareness and all that kind of stuff I took my healing into my own hands after wc denied and we were appealing.
I felt my treating dr at the time was not being assertive about searching for real help either. I'd get well with PT but as soon as I used arms much pain would reappear.
So I began to look for DC/PT on my own - since claim was denied anyway- but had to pay cash to not confuse things ins wise & wc wise.

This is getting long LOL
It might take a couple of years of consistent focus on health, healing, postures & self care. So don't be discouraged if it takes time.

Thanks for the advice and encouragement. This forum has helped me realize that my recovering will likely take longer than I would like but is possible if I am diligent.
Thanks again for your time.

Gator said:
<<I've had the following tests:

EMG/Nerve Conduction: 4 separate tests were all normal bilaterally. A Plastic Surgeon/Hand Surgeon in St. Louis diagnosed me with Carpal Tunnel, Cubital Tunnel, and TOS. She is recommending surgery for Carpal and Cubital Tunnel and PT for TOS. >>

I was told that if there was a problem with carpal tunnel or cubital tunnel, you would have positive results from the EMG.

And:
<<I also had an ulnar nerve transposition on my left elbow with no noticable improvement.>>

I had the ulnar nerver transposition also. I had improvement for about 18 months in the hand symptoms, but then they came back. Doc suspects scar tissue.

However, the shoulder problems were never fixed, and a redo of the ulnar nerve transposition would not fix that.

Also, from what I read about double crush syndromes (which is what TOS plus cubital tunnel syndrome would be) the top "crush" needs to be fixed first.
And:
<<A Plastic Surgeon/Hand Surgeon in St. Louis diagnosed me with Carpal Tunnel, Cubital Tunnel, and TOS. She is recommending surgery for Carpal and Cubital Tunnel and PT for TOS.>>

Who did you see? I've hear Dr. Thompson in St. Louis is good, although I've never seen him myself.

As for me, I was diagnosed with Pectoralis Minor Syndrome by Dr. Sanders in Denver. (I live in the Chicago area.) Amongst other things, he did an injection into the pec minor which took away ALL of my pain, from shoulder to fingertips. It only lasted 10 minutes, but what a glorious ten minutes that was! I'm having a Pec Minor Tenotomy on Monday. Dr. S said that I may also need a redo of the ulnar nerve transposition, but maybe not. I'm hoping Monday's surgery will make that redo unnecessary!

Pianoplayer said:
<<Who did you see? I've hear Dr. Thompson in St. Louis is good, although I've never seen him myself.

Dr. Susan Mackinnon at Washington University. She is in the Plastic Surgery department and is a peripheral nerve specialist.

I am not familiar with Pec Minor Tenotomy Surgery. I do not have shoulder pain, but pec stretches intensify the symptoms in my hands.

Best of luck with your surgery on Monday.

I've heard Dr. Mackinnon is good, too. I was referred to her but chose to go the Denver route.

There are only a few surgeons who do the pec minor surgery. If pec stretches instensify your symptoms, you may have nerve compression in that area. It would make sense to have that released first (IMO).

Check out this paper by Dr. Sanders

http://www.ecentral.com/members/rsanders/

Please look to my response below to Tracey where I list all of the testing and why it is important before going to surgery, although I am very pro surgery as it did help some of my symptoms and I wish I had not had to fight work comp insurance for 4 years.

Can you get to Denver? Dr. Annest, Brantigan and Sanders are so knowledgeable and do so many surgeries on a daily basis that I feel so comfortable with any on of them. And St. Luke's hospital is so used to us, that they know immediately to look for CRPS and fibromyalgia symptoms which can flare up after surgery and respond with immediate meds to help quell them.

Please yahoo CRPS, and look at my post about the different types of nerve damage. My EMGs show that I need carpal tunnel surgery, shoulder surgery on the right, and I do have right elbow symptoms...but I've only had the BP release on the right side. Reason? Two - first work comp is slow and I have to bring them to judges to get approvals. TAkes years. But also, I have the CRPS sometimes very bad, and it is FRIGHTENING when it takes off, takes hold, and your life becomes literally some kind of horror movie every moment of every day with bright red skin and severe mind boggling pain.

So read up, then GO WITH YOUR GUT. I wish I had my BP release right away when I got TOS. I think I would have benefited and not be a bedridden 48 year old now. I have a nurse. So no, I'm not afraid of surgeries, just how and where you get them.

God bless.

And for all of you, work comp, social security and take a look at these, don't scoff right off, and just because you have to get medical proof do not be scared off from doing the work.

I went to another so called TOS specialist last month and he wanted to do six surgeries!!( I think not!!)
Wanted to do neck, elbow and wrist releases bilaterally. He barely did an exam, I told him of my DX of TOS x 14 years..
That's nuts, I'm sorry, and this was a highly recommended TOS specialist from The Rothman Institute at Jefferson.
Be careful and mindfull when wrist and elbow releases are encouraged.