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.

Delirium


Related Terms

  • Acute Encephalopathy
  • Acute Organic Brain Syndrome

Differential Diagnosis

  • Acute stress disorder
  • Alcohol/substance-related delirium
  • Anxiety disorders
  • Brief psychotic disorder
  • Delirium due to a general medical condition
  • Dementia
  • Mood disorders
  • Other psychotic disorders

Specialists

  • Cardiologist, Cardiovascular Physician
  • Internal Medicine Physician
  • Neurologist
  • Psychiatrist
  • Pulmonologist

Comorbid Conditions

  • Alcohol or substance abuse disorders
  • Dementia
  • Depressive disorders

Factors Influencing Duration

The nature and responsiveness to treatment of the underlying disorder greatly influence duration of disability. Individuals with terminal medical conditions, such as end-stage renal or liver disease, end-stage AIDS, or terminal cancer, show long-lasting symptoms of delirium. Individuals with higher premorbid performance in cognitive and physical areas generally have better recoveries.

Medical Codes

ICD-9-CM:
291.0 - Alcohol Withdrawal Delirium; Alcoholic Delirium; Delirium Tremens
292.81 - Drug-induced Delirium
293.0 - Delirium Due to Conditions Classified Elsewhere; Acute Confusional State, Infective Psychosis; Organic Reaction, Posttraumatic Organic Psychosis, Psycho-organic Syndrome; Acute Psychosis Associated with Endocrine, Metabolic, or Cerebrovascular Disorder; Epileptic Confusional State, Twilight State
293.1 - Subacute Delirium; Confusional State; Infective Psychosis; Organic Reaction; Posttraumatic Organic Psychosis; Psycho-organic Syndrome; Psychosis Associated with Endocrine or Metabolic Disorder

Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Because a comprehensive psychiatric and medical evaluation is essential in developing a treatment plan, did evaluation include a detailed history of past and present substance or medication use, a general medical and psychiatric history and examination, history of all prior psychiatric treatments with outcomes, family and social history, screening of blood, breath or urine for abused substances, and laboratory tests to help confirm the presence or absence of general medical conditions often associated with delirium, such as hypoglycemia or other disturbance in blood chemistry, fever, infection, liver or kidney failure, hypoxia, head injury, AIDS, or end-stage cancer? If evaluation was not this comprehensive, what areas were omitted? Would this information affect the current treatment plan? What changes can now be made?
  • Were other psychiatric disorders ruled out?
  • Since delirium may have multiple causes, were underlying medical disorders identified, treated, or ruled out?
  • Are any medications contributing to altered mental status?

Regarding treatment:

  • If medications are contributing to altered mental status, can these be changed or discontinued?
  • Is an improvement in nutrition or general medical condition decreasing delirium symptoms? Is underlying medical condition responding to treatment?
  • Was hospitalization required?
  • Did treatment include strategies to protect individual from wandering or self-injury?
  • Did therapy include reorientation activities?
  • Because supportive and educational therapy for the family may not only be helpful, but their presence may provide a calming and stabilizing effect, is family involved in the therapy process?

Regarding prognosis:

  • Was underlying cause identified? Is underlying cause being effectively addressed through a comprehensive treatment plan?
  • Is family actively involved in therapy process?
  • Were preventive measures initiated to identify and help ward off future episodes?

Source: Medical Disability Advisor






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