Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Arthritis, Rheumatoid


Related Terms

  • Chronic Inflammatory Arthritis
  • Proliferative Arthritis
  • RA
  • Systemic Arthritis

Differential Diagnosis

Specialists

  • Emergency Medicine Physician
  • Infectious Disease Internist
  • Internal Medicine Physician
  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist
  • Rheumatologist

Comorbid Conditions

Factors Influencing Duration

Although some individuals have mild symptoms that resolve, most people experience progressive disease over the course of their lifetime. The individual's age, the rate of disease progression, the severity of the disease, which joints and how many joints are involved, organ system involvement, the response to treatment, and the pattern of remissions and exacerbations all affect the length of disability.

New onset cases with today's disease modifying treatment will usually be able to stay at work, while cases with onsets greater than 10 years ago may have enough destructive arthritis to be permanently unable to do heavy work.

Medical Codes

ICD-9-CM:
710.2 - Diffuse Diseases of Connective Tissue, Sicca Syndrome; Sjögrens Disease; Keratoconjunctivitis Sicca (Sicca Syndrome)
714.0 - Rheumatoid Arthritis; Arthritis or Polyarthritis: Atrophic, Rheumatic (Chronic)
714.2 - Other Rheumatoid Arthritis with Visceral or Systemic Involvement; Rheumatoid Carditis

Diagnosis

History: The onset of RA is usually gradual. The most common symptom is symmetrical joint stiffness in the morning that lasts more than 1 hour. Individuals may also complain of fatigue, unexplained fever, malaise, weakness, loss of appetite (anorexia), weight loss, and dry, sensitive eyes. There may be a family history of rheumatoid arthritis or other autoimmune connective tissue disease (i.e., fibromyalgia, lupus erythematosis). Some individuals may report having had rheumatic fever during childhood.

Physical exam: The exam may reveal joint swelling with warm, reddened areas, tenderness to touch, and decreased range of motion. Walking and rising from a seated position may be difficult and grip strength may be markedly diminished. Joints may become deformed as the disease progresses. In more advanced stages, subcutaneous nodules develop in about 20% of cases. Other systemic manifestations may include spleen enlargement (splenomegaly) and carpal tunnel syndrome.

Tests: Laboratory tests, which are helpful in making the diagnosis, include serum rheumatoid factor (positive in about 70-90% of RA cases), erythrocyte sedimentation rate (ESR, a non-specific test for inflammation in the body which is elevated in 90% of RA cases), C-reactive protein (another indicator of inflammation), antinuclear antibodies (ANA, present in 20-30% of individuals with RA) and a positive anti-cyclic citrullinated peptide (CCP antibody). Synovial fluid analysis (aspirated from joint space with a needle and syringe) can reveal antibodies and certain types of immune system cells present in RA. The presence of crystal or bacteria in joint fluid suggests other diagnoses. Because RA is a progressive disease, the typical x-ray findings of joint space narrowing, bony erosion and deformities occur in more advanced stages. Serial x-rays can document changes over time and are helpful in monitoring disease progression and treatment efficacy. Bone densitometry (DEXA scan) is a useful diagnostic tool for osteoporosis, a major comorbidity with RA. MRI of affected joints is a sensitive technique for detection of erosions during the early stages of the disease.

Source: Medical Disability Advisor






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