Repetitive strain injuries do not happen in a single moment. There is no fall, no impact, no date on the calendar where you can point and say “that is when I was injured.” The condition develops over weeks, months, or years of performing the same motions — gripping, lifting, reaching, bending, typing, hammering — until the cumulative damage to muscles, tendons, nerves, or joints becomes a medical condition that prevents you from working.
This gradual onset is what makes repetitive strain injuries harder to prove than traumatic injuries. The insurance carrier cannot see a broken bone on an X-ray from a specific date. Instead, the carrier sees a worker who developed symptoms over time and is now claiming the work caused them. Proving the connection between the work and the condition requires a specific type of medical evidence and a specific approach to the claim.
What qualifies as a repetitive strain injury under New York Workers’ Compensation
New York’s workers’ Compensation System covers repetitive strain injuries as occupational diseases. The law defines an occupational disease as a condition that is a natural incident of a particular occupation and results from exposure to the conditions of that occupation. For a repetitive strain injury, this means the condition must be caused by the specific physical demands of the work, not by activities unrelated to the job.
Common repetitive strain injuries that arise in workers’ compensation claims include carpal tunnel syndrome from sustained gripping, typing, or vibration exposure; tendonitis in the shoulder, elbow, or wrist from repetitive overhead work or forceful gripping; trigger finger from sustained hand tool use; de Quervain’s tenosynovitis from repetitive wrist movements; lateral epicondylitis from repeated forearm rotation; and chronic back and knee conditions from sustained lifting, bending, or kneeling.
Each of these conditions can be caused by work activities. Each can also be caused by non-work activities or by the natural aging process. That dual causation is the central challenge in proving a repetitive strain injury claim.
The two things you must prove
To establish a repetitive strain injury claim under New York workers’ compensation, you must prove two things. First, that the condition exists — that you have a diagnosed medical condition with objective clinical findings. Second, that the condition was caused by or significantly aggravated by the specific physical demands of your job.
The first element requires a diagnosis from your treating physician. The physician must identify the condition, document the clinical findings that support the diagnosis (examination results, diagnostic imaging if applicable, nerve conduction studies for carpal tunnel, and other objective tests), and state the diagnosis clearly in the medical record.
The second element — causation — is where most repetitive strain cases are won or lost. The physician must explain the connection between the specific work activities and the condition. A letter that says “the patient has carpal tunnel syndrome caused by work” is not enough. The physician must describe the specific work activities (sustained gripping of power tools for eight hours a day, five days a week, for twelve years), explain how those activities produce the mechanical stress that leads to the condition, and state that the condition is causally related to the employment.
The medical evidence that wins repetitive strain cases
The treating physician’s causation opinion must be specific, detailed, and based on the physician’s independent clinical findings. The Board looks for a clear narrative: the worker performed specific repetitive tasks as part of their job, over a specific duration, the physician examined the worker and found specific clinical abnormalities consistent with the claimed condition, and the physician’s medical opinion is that those work activities caused or significantly contributed to the condition.
Objective diagnostic evidence strengthens the case. Nerve conduction studies that confirm carpal tunnel syndrome. MRI findings that show tendon inflammation or degeneration. Electro-diagnostic testing that documents nerve impairment. These objective findings support the diagnosis and make it harder for the carrier’s IME physician to dismiss the condition as subjective.
The work history is part of the medical evidence. Your treating physician should document a detailed occupational history: what your job requires you to do physically, how often you perform the repetitive tasks, how long you have been doing the work, and what tools or equipment you use. This occupational history connects the clinical findings to the employment.
What the carrier will argue
The insurance carrier will challenge the causation. The carrier’s IME physician will look for alternative explanations: the condition is age-related degeneration, it is caused by hobbies or non-work activities, it is a pre-existing condition that was not caused by the employment, or the work activities are not the type that would produce the claimed condition.
These are legitimate medical questions, and the Workers’ Compensation Law Judge will weigh the evidence from both sides. The strength of your case depends on how thoroughly your treating physician has documented the work activities, the clinical findings, and the causal connection. A physician who has examined you regularly, who knows your job duties in detail, and who can explain why the work activities caused the condition is more persuasive than one who provides a conclusory opinion without supporting detail.
Pre-existing conditions do not automatically defeat a repetitive strain claim. If the work activities aggravated a pre-existing condition and made it symptomatic or worse, the aggravation is compensable. The treating physician must distinguish the work-related aggravation from the underlying condition, but the claim is not invalid simply because the body part had prior issues.
The filing deadline for repetitive strain injuries
The filing deadline for a repetitive strain injury claim is different from a traumatic injury. For occupational diseases, the claim must be filed within two years of the date the worker knew or should have known that the condition was related to the employment. This is not two years from the onset of symptoms. It is two years from the point at which a reasonable person would have connected the symptoms to the work.
In practice, this date is often the date a physician first tells you that your condition is work-related. If your doctor diagnoses carpal tunnel syndrome and tells you it is caused by your work, the two-year clock starts on that date. If you had symptoms for years but never connected them to the job, the clock may not start until the connection is made.
Do not wait to file. The two-year deadline is a maximum, not a target. Filing promptly preserves your claim and begins the process of obtaining benefits. Delay creates risk.
What you can do to protect your claim
Tell your treating physician exactly what your job requires you to do. Be specific about the repetitive tasks, the duration, the frequency, and the physical demands. The physician cannot connect the condition to the work if the physician does not know what the work involves.
Keep a record of your symptoms: when they started, how they progressed, what makes them better or worse, and how they affect your ability to work. This contemporaneous record supports the timeline of your condition.
Report the condition to your employer as soon as you believe it is work-related. The reporting requirement for occupational diseases is tied to the date of disablement or the date you know the condition is work-related, but early reporting strengthens your claim and prevents the carrier from arguing that you concealed the condition.
How Schwartzapfel Holbrook proves repetitive strain injury claims
At Schwartzapfel Holbrook, we build repetitive strain cases from the medical evidence up. That means working with the treating physician to ensure the causation opinion is specific and well-documented, gathering the occupational history that connects the job duties to the condition, obtaining objective diagnostic evidence where available, and preparing to challenge the carrier’s IME when it attributes the condition to age or non-work activities.
Repetitive strain injuries are harder to prove than traumatic injuries. The carrier knows that, and it will use the difficulty to challenge the claim. The response is not to hope the evidence is enough. The response is to build the evidence so that it is.
Schwartzapfel Holbrook / Fighting For You