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, Vertebra (Pathological)


Related Terms

  • Osteoporotic Vertebral Fracture
  • Pathologic Fracture
  • Pathological Cervical Fracture
  • Pathological Compression Fracture
  • Pathological Lumbar Fracture
  • Pathological Spine Fracture
  • Pathological Thoraco-lumbar Fracture

Differential Diagnosis

Specialists

  • Endocrinologist
  • Infectious Disease Internist
  • Neurosurgeon
  • Occupational Therapist
  • Oncologist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist
  • Radiologist

Comorbid Conditions

Factors Influencing Duration

The underlying disease that resulted in the fracture is the greatest influence on the disability. If the pathologic fracture occurred in a vertebra weakened by the presence of cancer or tumor, progression of the tumor and response to treatment will determine duration.

Other factors include the individual's age, the severity of the injury, the amount of impingement on the spinal cord and nerve roots, the presence of complications (e.g., infection), the individual's occupation, and risk factors involved with work. Pain tolerance and the individual's ability to modify job responsibilities may affect the length of disability.

Medical Codes

ICD-9-CM:
733.13 - Pathological Fracture of Vertebra; Collapse of Vertebra, NOS

Overview

Pathological fractures of the vertebrae are breaks in the bones that form the spine that occur when bone is weakened by an underlying, pre-existing disease or condition. When the structure of the normal bone is altered by the primary disease, the vertebra gives way with a spontaneous fracture or with a fracture after only minimal trauma.

The vertebral fracture may result from trauma or what would seem to be normal activity. The fracture occurs throughout the weakened vertebral body, causing it to collapse. This type of fracture is often referred to as a compression fracture. Pathologic fractures can occur in any region of the spinal column, but the most common area of involvement is the thoraco-lumbar region, including the thoraco-lumbar junction, where the thoracic spine (thoracic vertebra T12) meets the lumbar spine (lumbar vertebra L1). Vertebral fractures secondary to osteoporosis may occur at more than one spinal level.

Underlying disorders that may weaken bone and result in pathological vertebral fracture include bone infections such as hematogenous osteomyelitis and bone tuberculosis; metabolic bone diseases such as osteoporosis, osteomalacia, hyperparathyroidism, and renal osteodystrophy; and tumors such as multiple myeloma, chordoma, and metastatic carcinoma. Pathologic vertebral fractures can also be secondary to rheumatoid arthritis. Individuals undergoing long-term corticosteroid treatment may also develop weakened vertebrae that can predispose them to fractures.

Unlike traumatic, nonpathologic fractures in which pain decreases with time as the fracture heals, pathologic fractures secondary to bone infection or tumor usually have pain that worsens over time, until the infection or tumor is recognized and treated.

Treatment of pathologic fracture will always include treatment of the underlying disease. Pain from compression fractures related to osteoporosis will generally improve with time as the fracture heals.

Incidence and Prevalence: In the US, approximately 700,000 vertebral fractures are caused by osteoporosis annually (Dawson). The prevalence rate increases steadily with age: it is 20% for women aged 50 and 65% in older women (Reiter). Because of the lack of a standardized definition of a vertebral fracture and the fact that mild pathological compression fractures are often missed, prevalence estimates vary.

Source: Medical Disability Advisor






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