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That sounds pretty dodgy - the Dr. should know better than to tell you the exact cause of your CTS was smoking. Go of your own accord to another doctor not connected to your employer insurance workers compensation to get another opinion - and ask the doctor to give you a written, signed and dated opinion. The insurance should be sending you to an unbiased 3rd party for evaluation. If it comes down to legal issues you'll be wanting a competing professional opinion anyways.

The problem with carpal tunnel is that in most cases its idiopathic - arising spontaneusly or from a cause that can't be readily established. While it has been found that very repetitive tasks are associated with higher cases of CTS, the issue is that it hasn't been established that they causes CTS (As far as I'm aware) - sort of like you know that people that eat mcdonalds are also likely to eat Burger King, but they don't eat at burger king as a consequence of eating mcdonalds. The biggest risk factors for CTS are genetics or biological actors (such as smoking), rather than environmental factors or activity. However, that doesn't mean its due to smoking. It may be due to smoking, or genetics, illness (ie. Arthritis) or tissue damage caused by 30 years of doing data entry.

If you're going after that it was due to the damage caused, ask the Dr. if it is due to a repetitive stress injury, if it may show up on a CT or Xray (or MRI?). They may refer you to get some, which might help support your argument.

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Q: What can you do if you have carpal tunnel and your employer insurance workers compensation sent you to a doctor that told you it comes from smoking not 30 years of doing data entry?
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