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.

Menstrual Disorders


Related Terms

  • Amenorrhea
  • Dysmenorrhea
  • Menorrhagia
  • Metrorrhagia
  • Oligomenorrhea

Differential Diagnosis

Specialists

  • Endocrinologist
  • Family Physician
  • General Surgeon
  • Gynecologist
  • Obstetrician/Gynecologist
  • Pathologist

Comorbid Conditions

  • Anorexia nervosa
  • Depression
  • Hyperthyroidism
  • Hypothyroidism
  • Obesity
  • Renal failure
  • Smoking
  • Stress disorder

Factors Influencing Duration

The severity and duration of symptoms, underlying cause, duration and frequency of bleeding, type of treatment, response to treatment, and individual's job requirements affect the length of disability. For amenorrhea, no disability is expected.

Medical Codes

ICD-9-CM:
625.2 - Menorrhagia
625.3 - Dysmenorrhea
625.8 - Other Specified Symptoms Associated with Female Genital Organs
626.0 - Amenorrhea
626.1 - Menstruation, Scanty or Infrequent
626.4 - Menstruation, Irregular
626.9 - Menstrual Disorders

Diagnosis

History: The individual may report absence of or changes in the menstrual cycle and related symptoms. A thorough history must be obtained, including pubertal development; age at menarche (onset of menses); typical menstrual cycle (length, flow, number of days between menses); past and current medical conditions (especially chronic illnesses such as Crohn's disease); any symptoms suggesting central nervous system disease (visual changes, headaches); bleeding disorders (both personal and family); diet (including weight loss and exercise); medications, including contraception and the use of hormones; drug or alcohol use; sexual activity; acne or excessive hair growth (hirsutism); and family members' experience of puberty. A history of trauma and surgery should also be obtained.

Dysmenorrhea is characterized by cramping, labor-like pains in the lower abdomen that usually begins just prior to or at the start of the menstrual period. Pain may come and go in waves. Individuals may also report nausea, vomiting, and a dull pain in the lower back. In 10% of women, dysmenorrhea is painful enough to be incapacitating, or to interfere with work or leisure activities (Calis). In primary dysmenorrhea, cramps begin at menarche (the first menstrual period). Secondary dysmenorrhea typically begins after a few years of painless periods. In secondary dysmenorrhea, pain begins several days before and lasts throughout the menstrual period.

A woman with menorrhagia will typically report a large amount of blood loss during her menses. The average blood loss during a menstrual period is about 2 fluid oz (60 mL); women with menorrhagia may lose 3 oz (90 mL) or more. Although this may sound like a small amount, it can lead to severe anemia.

With metrorrhagia, a woman will complain of bleeding during the interval between periods.

Physical exam: Physical examination includes vital signs, height, weight, Tanner stage (a system for categorizing sexual development), general appearance (individuals with some genetic disorders may have a webbed neck or be unusually short), palpation of the thyroid and examination for other evidence of thyroid disease, examination of the breasts for galactorrhea (production of a milk-like substance), examination of the eyes, a thorough neurologic exam, and a search for signs of elevated androgen levels (male hormones that can cause acne or hirsutism in women).

A pelvic exam is usually performed to determine if a uterus is present (the absence of a uterus indicates androgen insensitivity syndrome or agenesis), to exclude pregnancy, and to evaluate the vaginal mucosa for any effects of estrogen, mucus secretion, or lack of mucus and a dry, pale vagina suggesting ovarian dysfunction.

For women with dysmenorrhea, a bimanual pelvic exam can determine if there is uterine tenderness, enlarged ovaries, or fibroid tumors.

Tests: The type of menstrual abnormality will determine the need for tests. Blood tests may include a complete blood count (CBC) to look for anemia or infection, chemistries and endocrine tests to assess for chronic disease, and measurement of thyroid and reproductive hormones. Diagnostic tests for dysmenorrhea, menorrhagia, and metrorrhagia may include pregnancy test, Pap smear, or urine and cervical cultures.

Imaging studies may include transabdominal or transvaginal ultrasound (sonography) of the abdomen and pelvis to identify masses such as ovarian tumors or fibroids; ultrasound is also helpful in assessing uterine size and shape. Computed tomography (CT) scan or magnetic resonance imaging (MRI) can detect pituitary tumors in the brain, while abdominal or pelvic CT or MRI can show tumors of the adrenal glands. An endometrial biopsy or laparoscopy may be considered.

Source: Medical Disability Advisor






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