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.

Cancer, Colon


Related Terms

  • Bowel Cancer
  • Cancer of the Colon
  • Cancer of the Large Intestine
  • Colorectal Cancer

Differential Diagnosis

Specialists

  • Colon and Rectal Surgeon
  • Gastroenterologist
  • General Surgeon
  • Oncologist
  • Radiology Oncologist

Comorbid Conditions

  • Crohn's disease
  • Disease of the pancreas
  • Disease of the spleen
  • Irritable bowel disease
  • Liver disease
  • Ulcerative colitis

Factors Influencing Duration

Factors that may influence the length of disability include the stage at which the cancer was detected, the length of colon that was removed during surgery, the presence of a temporary or permanent colostomy, the effectiveness of treatment (radiation, chemotherapy, or immunotherapy), and the individual's response to these treatments. Advanced age may also be a factor because older individuals often require longer recovery times. The presence of comorbid illness may also increase duration.

Medical Codes

ICD-9-CM:
153 - Neoplasm, Colon, Malignant
153.0 - Neoplasm, Hepatic Flexure of Colon, Malignant
153.1 - Neoplasm, Transverse Colon, Malignant
153.2 - Neoplasm, Descending Colon, Malignant; Left Colon
153.3 - Neoplasm, Sigmoid Colon, Malignant; Sigmoid Flexure
153.4 - Neoplasm, Cecum, Malignant
153.5 - Neoplasm, Appendix, Malignant
153.6 - Malignant Neoplasm, Ascending Colon, Right Colon
153.7 - Neoplasm, Splenic Flexure of Colon, Malignant
153.8 - Neoplasm, Other Specified Sites of Large Intestine, Malignant
153.9 - Neoplasm, Colon, Malignant, Unspecified Site; Large Intestine NOS
197.5 - Secondary Malignant Neoplasm of Respiratory and Digestive Systems; Large Intestine and Rectum
211.3 - Polyp of Colon
230.3 - Carcinoma in Situ of Colon, Appendix, Cecum, Ileocecal Valve, Large Intestine NOS
235.2 - Neoplasm of Uncertain Behavior of Stomach, Intestines and Rectum
239.0 - Neoplasms of Unspecified Nature of Digestive System

Diagnosis

History: Individuals are usually asymptomatic in the early stages of colon cancer, some for up to five years, and often will discover cancer through screening tests. Occasionally, the individual will report no symptoms at all until the tumor grows so large that it causes a bowel obstruction or rupture of the intestine.

However, individuals with colon cancer may report blood in the feces, changed bowel habits (diarrhea or constipation lasting more than a few days), cramping or abdominal pain that radiates toward the middle of the abdomen (umbilicus) or around the anus (perianal), loss of appetite (anorexia), weakness and fatigue, and nausea and/or vomiting. These symptoms tend to vary depending upon the location of the tumor. In general, if the tumor is located in the segment of colon closest to the small intestine (right or ascending colon), individuals often report abdominal pain, nausea, and vomiting. Tumors in the segment of colon that is farthest from the small intestine and closest to the rectum (left or descending colon) are more likely to cause passage of blood or mucus, an alteration in bowel habits, and a feeling that the bowel is not empty after defecation. Regardless of the tumor's location, weakness and fatigue may be reported due to chronic blood loss, and constipation may alternate with increased frequency and loose stools.

A complete history of personal and family illness is usually obtained as an aid in diagnosis.

Physical exam: Examination of the abdomen by touch (palpation) may reveal a colonic mass. Abdominal palpation may also reveal an enlarged liver (hepatomegaly), which suggests that the cancer has spread from the colon to other nearby organs (metastasized). Digital rectal examination may be done and a stool sample obtained for occult blood determination. Signs of general health status are observed.

Tests: The most important tests for detection of colon cancer are routine screening tests. Screening tests for average-risk individuals over 50 years of age may include a chemical test done annually on a stool sample (fecal occult blood test, or FOBT), flexible sigmoidoscopy every 5 years, double-contrast barium enema every 5 to 10 years, and colonoscopy every 10 years. Double-contrast barium enema is able to detect about 90% of colon tumors (Hassan).

FOBT can identify blood that may be hidden (occult blood) within the fecal material. Diagnostic tests for colon cancer may include an x-ray procedure to visualize the colon (barium enema) or visualization of the entire colon (full colonoscopy) using a flexible fiber-optic viewing instrument (endoscope) that is inserted through the rectum. Flexible sigmoidoscopy can help view the rectum and lower half of the colon, and colonoscopy, which uses a longer (60- to 180-cm) flexible colonoscope, allows visualization of the entire colon. Colonoscopy also allows a small sample of tissue (biopsy) to be taken from the tumor, which can then be examined microscopically to confirm that it is cancerous (histopathological confirmation).

A complete blood count (CBC) can be done to rule out anemia. Additional blood tests, including measurement of a molecule that is associated with cancer cells (carcinoembryonic antigen, or CEA test), a liver enzyme test, and a kidney function test, may indicate the extent of disease spreading (metastasis) from the colon to other organs. A chest x-ray may be used to look for evidence of metastasis into the lungs. The extent of cancer growth (staging) can be determined using harmless, low-energy radio waves (MRI) or computer analysis of x-ray data (CT); a special CT scan staging system includes stages T1 through T4, ranging from intraluminal polypoid mass with no thickening of the bowel wall to gradations of thickening, thickening with invasion outside the intestinal wall, and distant metastases. Positron emission tomography (PET scan) with fluorodeoxyglucose (FDG) is of value in detecting recurrent disease and to visualize colon cancer that may have metastasized. Angiography may be useful to evaluate the potential spread of cancer to the liver and to diagnose metastasis to the liver and other organs. Ultrasound from within the colon (endoluminal ultrasound) can provide important information about how far colorectal cancers have invaded into or through the bowel wall. Ultrasound may also be used to determine if colorectal cancer has metastasized to the liver and other organs.

Source: Medical Disability Advisor






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