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.

Carpal Tunnel Release


Related Terms

  • CTR

Specialists

Comorbid Conditions

Factors Influencing Duration

Factors that alter the duration of disability include the severity of the individual’s case and the duration of symptoms before CTR was performed. The longer and more severely the median nerve was compressed, the longer it may take for the nerve to improve. Recovery times are variable. Any postoperative complications will increase length of disability. The length of disability relates to tolerance and hand activity (repetitive motion, awkward posture, grip force used) and may not directly relate to the amount of weight lifted.

Older individuals, those with severe preoperative symptoms, and individuals involved in heavy manual labor, especially those working with vibrating tools, may have longer, slower recovery times from the procedure. For additional information on factors influencing recovery times, refer to "Work Ability and Return to Work," page 198, table 12-9.

For individuals who seem to be unimproved or worse after surgery, postoperative nerve conduction studies can be obtained and compared to pre-operative nerve conduction studies. This comparison can be helpful to educate the patient and to determine if entrapment still is present. The most common complication of surgery is incomplete release (Bland, Assmus). If the entire ligament was not cut, then pressure on the nerve may not have been released, and typically there will have been no improvement in the nerve conduction studies.

If carpal tunnel syndrome is present and sufficiently symptomatic bilaterally, then typically both sides are treated with surgery, but the second wrist is operated on 2 to 6 weeks after the first surgery. The timing of the disability duration in these cases should start on the date of the second surgery. Most individuals can return to modified work activities between the two surgeries. (See the conclusion in "Work Ability and Return to Work," page 200, as well as table 12-10. The length of disability outlined in the duration table demonstrates the challenges physician face regarding return to work. Although shorter durations of disability are possible, this requires increased effort by the treating physician.)

For additional discussions of the physician's challenge, please refer to "Work Ability and Return to Work," pages 1, 9, 23.

Medical Codes

ICD-9-CM:
04.43 - Lysis of Adhesions and Decompression of Cranial and Peripheral Nerves; Carpal Tunnel Release

References

Cited

"AAOS Guideline on treatment of carpal tunnel syndrome." AAOS. 9 2011. American Academy of Orthopaedic Surgeons. 25 Nov. 2012 <www.aaos.org>.

Adams, M. L. , et al. "Outcome of carpal tunnel surgery in Washington state workers' compensation." American Journal of Industrial Medicine 25 (1994): 527-536.

Adams, M. L. , et al. "Outcome of carpal tunnel surgery in Washington state workers' compensation." American Journal of Industrial Medicine 25 (1994): 527-536.

Assmus, H. "Correction and reintervention in carpal tunnel syndrome. Report of 185 reoperations." Nervenarzt 67 (1996): 998.

Assmus, H. "Correction and reintervention in carpal tunnel syndrome. Report of 185 reoperations." Nervenarzt 67 (1996): 998.

Bickel, Kyle D. "Carpal Tunnel Syndrome." Journal of Hand Surgery 35 1 (2010): 147-152.

Bland, J. D. , et al. "Treatment of carpal tunnel syndrome." Muscle Nerve 36 (2007): 167.

Bland, J. D. , et al. "Treatment of carpal tunnel syndrome." Muscle Nerve 36 (2007): 167.

Bostrom, L. , and H. Lugnegard. "Surgery cures numbness of the hand. Long-term follow-up of carpal tunnel decompression." Acta Orthopaedica Scandinavia 87 32-33 (1990): 2497-2500.

Bostrom, L. , and H. Lugnegard. "Surgery cures numbness of the hand. Long-term follow-up of carpal tunnel decompression." Lakartidningen 87 32-33 (1990): 2497-2500.

Cebesoy, O. , et al. "Use of a splint following open carpal tunnel release: a comparative study." Advances in Therapy 24 3 (2007): 478-484.

Evans, R. B. "The Therapist’s Management of Carpal Tunnel Syndrome." Rehabilitation of the Hand and Upper Extremity. Eds. E. J. Mackin, et al. 5th ed. Philadelphia: Mosby, Inc., 2002. 660-671.

Gerritsen, A. A., et al. "Splinting vs Surgery in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial." Journal of American Medical Association 288 10 (2002): 1245-1251.

Hayes, E. P., et al. "Carpal Tunnel Syndrome." Rehabilitation of the Hand and Upper Extremity. Eds. E. J. Mackin, et al. 5th ed. Philadelphia: Mosby, Inc., 2002. 643-659.

Hegmann, Kurt T., et al., eds. "Chapter 11: Hand, Wrist and Forearm Disorders." Occupational Medicine Practice Guidelines: Evaluation and Management of Common Health Problems and Functional Recovery in Workers. 2008 Revision 2nd ed. ACOEM, 2008. 627-652.

Jarvik, J. G., et al. "Surgery versus non-surgical therapy for carpal tunnel syndrome: a randomised parallel-group trial." Lancet 374 9695 (2009): 1074-1081.

Melhorn, J. Mark, and William Ackerman, eds. Disease and Injury Causation, Guides to the Evaluation of. AMA Press, 2008.

Melhorn, J. M. "Unnecessary Disability - Why Can't I Work?" Impairment without Disability. Ed. W. G. Buchta. Mayo Clinic, 2011.

Melhorn, J. M. "Unnecessary Disability - Why Can't I Work?" Impairment without Disability. Ed. W. G. Buchta. Mayo Clinic, 2011.

Netscher, D. , et al. "Temporal changes in grip and pinch strength after open carpal tunnel release and the effect of ligament reconstruction." Journal of Hand Surgery 23 (1998): 48.

Netscher, D., et al. "Temporal changes in grip and pinch strength after open carpal tunnel release and the effect of ligament reconstruction." Journal of Hand Surgery 23 (1998): 48.

Pomerance, J., and I. Fine. "Outcomes of carpal tunnel surgery with and without supervised postoperative therapy." Journal of Hand Surgery 32 8 (2007): 1159-1163.

Szabo, R. M. , and M. Madison. "Carpal tunnel syndrome as a work-related disorder." Journal of the American Academy of Orthopaedic Surgeons (1995): 421-434.

Szabo, R. M. , et al. "Carpal Tunnel Syndrome as a Work-related Disorder." Repetitive Motion Disorders of the Upper Extremity. Rosemont, IL: American Academy of Orthopaedic Surgeons, 1995. 421-434.

Talmage, J. B. , J. M. Melhorn, and M. H. Hyman, eds. Work Ability and Return to Work, AMA Guides to the Evaluation of. Second ed. Chicago: AMA Press, 2011.

Thomsen, N. O. , et al. "Clinical outcomes of surgical release among diabetic patients with carpal tunnel syndrome: prospective follow-up with matched controls." Journal of Hand Surgery 34 7 (2009): 1177-1187.

Thomsen, N. O. , et al. "Clinical outcomes of surgical release among diabetic patients with carpal tunnel syndrome: prospective follow-up with matched controls." Journal of Hand Surgery 34 7 (2009): 1177-1187.

Wright, Phillip E. "Chapter 73 - Carpal Tunnel, Ulna Tunnel and Stenosing Tenosynovitis." Campbell's Operative Orthopaedics. Eds. S. Terry Canale and James H. Beaty. 11th ed. Philadelphia: Mosby Elsevier, 2008.

Source: Medical Disability Advisor






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