What the CTS report is for
Carpal tunnel syndrome is common outside work too, so WCB Nova Scotia needs more than a diagnosis to decide whether a claim is work related. This report gathers the onset, your examination, a symptom map and a structured list of other causes. A separate report covers the general injury visit. This one is specific to hand and wrist symptoms.
Who completes it
The worker’s family doctor completes, signs and dates it. There’s no worker section. WCB asks you to contact it with any questions about the form.
How to fill in the report
Symptoms and history (sections A to C)
Describe the symptoms the worker reports, when they first reported them, and when you began treating the worker. Give dates where you can, since WCB is assessing whether the symptoms are causally related to the workplace.
Clinical examination findings (section D)
Record left and right results for Phalen’s test, reversed Phalen’s, Tinel’s sign, carpal compression, muscle wasting and sensory testing, plus any other relevant finding. Fill in both sides, including normal results.
Symptom diagram and diagnosis (sections E and F)
Mark every area where the worker feels the described sensations, using the symbols the form provides. Then give your diagnosis or differential diagnosis.
Other conditions and activities (sections G to I)
Note other conditions or activities that could be contributing, such as hobbies or second jobs. Then answer yes or no for diabetes, thyroid disorders, inflammatory arthritis, renal disease, hormonal conditions including pregnancy and menopause, anatomic causes such as fracture or osteoarthritis, surgical history, acute limb trauma and cervical spine comorbidity. Add comments for each yes.
Medications, measurements and tests (sections J to M)
List all current medications, the worker’s height and weight, and the sed rate, glucose and TSH results. Attach copies of any EMG or nerve conduction studies.
Common reasons it’s delayed
- Only one side recorded in the examination table.
- The competing conditions table left blank or partly answered.
- No labs listed and no note that they’re pending.
- EMG or nerve conduction results mentioned but not attached.
- Missing signature, date or HS number.
Submitting and who pays
Fax the report to WCB Nova Scotia at 902-491-8001 or mail it to 200-137 Venture Run, Dartmouth, NS B3B 0L9, with the claim number on every page. If you have WCB Online access, upload it as a secure message attachment instead. Bill WCB through MSI with WCB as the payee.