It is not uncommon for patients with TOS to have developed symptoms as a result of an injury, which may have occurred as a consequence of work-related activities, a motor vehicle collision, a fall on the arm, or similar activities or accidents. The symptoms of TOS often prevent patients from working, require certain restrictions, or may even lead to prolonged disability.

Assessment of the potential relationship between previous injury and the development of TOS is an important part of the evaluation we undertake as part of our care for all patients with TOS.


As part of our treatment program, specialists at the Washington University Center for Thoracic Outlet Syndrome at Barnes-Jewish Hospital also play an active role in overseeing the rehabilitation of patients with TOS with a goal of  returning to work and other activities. As these efforts often involve navigating various hurdles with regard to insurance, work-related, and legal issues that may face our patients, Washington University TOS specialists have acquired considerable experience in this realm and are familiar with the requisite interactions with case managers, attorneys, and others who serve the needs of patients. The staff of the TOS Center remains committed to doing what is necessary to help TOS patients achieve the best outcomes possible for their condition.

TOS case evaluations

In some circumstances, specialists at the TOS Center are asked to evaluate patients or case records with regard to specific legal questions rather than to directly provide medical care. Although we are willing to provide this type of service with a level of expertise that may be difficult to find elsewhere, our  priority remains the direct care of patients.

Specialists at the TOS Center are only rarely able to provide “independent medical examination” (IME) services, medicolegal consultations, or other related activities. Attorneys may contact Dr. Thompson’s office (314-362-7410) to obtain additional information about TOS, to make specific inquiries about potential review of cases, and for applicable fee schedules.