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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.

Fracture, Ankle


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Diagnosis

History: A thorough history should be obtained including any medical conditions (especially diabetes, osteoporosis, peripheral vascular disease), medication history (corticosteroids), history of foot and ankle injuries and surgeries, and events surrounding the current injury. The individual may be able to recall the foot either turning or rolling in or out in relation to the lower leg. The ankle may be swollen, painful, and discolored. Individual may report inability to bear weight immediately after the injury and an audible popping sound may have occurred at the time of injury.

Physical exam: Observation of the lower extremity and ankle may reveal swelling, bruising (ecchymosis), deformity, and open wounds. Using the fingers to feel the ankle (palpation) can reveal focal bony tenderness and may localize the area of fracture. The presence and quality of pulses in the posterior tibial and dorsalis pedis arteries should be noted and compared with the unaffected ankle. Capillary refill time and neurological exam should be noted for both feet. Active and passive range of motion should be documented.

The physician will determine if the injury is stable or unstable; instability may include bony and ligamentous injury on both the inside and outside (medial and lateral sides) of the ankle. Unstable fractures usually require urgent orthopedic attention. The physician will also assess for joint dislocation and presence of other traumatic injuries.

Tests: Since about 90% of ankle injuries are due to strains or sprains, ankle x-rays are reserved for suspected fractures. The Ottawa ankle rules developed by Stiell and colleagues are helpful in determining which individuals should receive X-rays. Three views of the ankle are standard. A standing view can help evaluate ligamentous instability. Radiographic comparison of the injured foot with the non-injured may be helpful in some cases. Occasionally, a CT or MRI may be ordered to evaluate joint surface changes, fracture position, ligaments, and soft tissue. After the bones have been realigned in their anatomically normal position (reduction) follow-up x-rays usually are necessary.

Source: Medical Disability Advisor