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What Do You Think: Did Cake Icing Cause Walmart Decorator’s Carpal Tunnel?

25 Sep, 2023 Chris Parker

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Triadelphia, WV ( – It may be clear in a worker’s mind where and why she developed carpal tunnel syndrome. But what if the worker has other conditions that, aside from her work activities, could have caused her CTS?

That was the question in a case involving a Walmart cake decorator. The decorator said she squeezed icing bags up to 1,000 times per day. She began experiencing tingling in her wrists and thumb, as well as pain. She began to drop things. She told her employer that she had developed bilateral CTS from all the squeezing.

The decorator had other conditions as well, which were unrelated to her job, but which can contribute to or cause CTS: obesity, hypothyroidism, and moderate carpometacarpal arthritis.

In July 2018, the decorator allegedly had to stop working due to CTS.

In June 2019, the employee tested positive for CTS for the first time, when she had an electromyography.
An independent medical examiner noted that the decorator had several conditions that were known to cause or contribute to the condition. In fact, the doctor stated, the employee was at high risk for CST due to her personal risk factors. It was probable, the doctor concluded, that the condition was the result of those risk factors rather than her work duties.

Without her Walmart job, and experiencing pain and presumably racking up medical bills, the decorator sought worker’s compensation benefits. The icing on the cake? – the claims administrator denied her claim.

The Office of Judge’s affirmed the administrator’s denial and the employee appealed.

West Virginia Code of State Rules § 85-20-41.5 states that:

  • Occupational groups at high risk for CTS have included grocery store workers, and workers engaging in high repetitive manual movement.
  • There is a high prevalence of concurrent medical conditions capable of causing CTS in persons with the syndrome, without regard to any particular occupation.
  • When evaluating CTS in the above work setting, a careful search for other contributing factors is essential.

Was the decorator’s claim compensable?
A. No. She had three conditions that could have caused her impairment.
B. Yes. Based on her frequent squeezing of icing onto cakes, it was clear where she developed CTS.

If you chose A, you sided with the court in Moore v. Walmart Associates, Inc., No. 21-0948 (W. Va. Ct. App. 09/14/23), which held that the decorator failed to show she developed CTS in the course of her employment.

For an injury to be compensable, the court explained, it must be a personal injury that was received in the course of employment, and it must have resulted from that employment.

The court pointed out that the decorator had conditions that could have caused or contributed to her CTs. Further, the decorator was not diagnosed with CTS until a year after she stopped working for Walmart. This was “strong evidence that the condition was not work-related,” the court wrote. The court also opined that the decorator’s duties were not the kind known to cause carpal tunnel syndrome.

The court affirmed the denial of the claim.

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