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.

Heart Failure, Congestive


Related Terms

  • Cardiac Decompensation
  • Cardiac Insufficiency
  • CHF
  • Compensated Heart Failure
  • Congestive Heart Failure
  • Decompensated Heart Failure
  • Heart Failure
  • Left Ventricular Failure
  • Ventricular Failure

Differential Diagnosis

Specialists

  • Cardiologist, Cardiovascular Physician
  • Cardiovascular Surgeon
  • Critical Care Internist

Comorbid Conditions

  • Anemia
  • Diabetes mellitus
  • Hyperlipidemia
  • Hypertension
  • Hyperthyroidism
  • Myocardial infarction
  • Obesity
  • Renal failure
  • Thyrotoxicosis

Factors Influencing Duration

Factors that might influence the length of disability include cardiac function, severity of heart failure, underlying cause of the condition, type of treatment, individual's response to treatment, presence of complications, and presence of concomitant illness. Surgical treatment may increase duration.

The physical demands of the job will be a major determining factor in the expected length of disability. The availability of lighter or part-time work on either a temporary or permanent basis may help to reduce duration. The individual's willingness to address correctable risk factors (i.e., smoking, sedentary lifestyle, obesity) may be a fundamental determinant of the length of disability. A cardiac rehabilitation program may facilitate recovery and shorten the period of disability. Severe mental stress or exertion may trigger increased symptoms and complications.

Medical Codes

ICD-9-CM:
428 - Heart Failure
428.0 - Heart Failure, Congestive
428.1 - Heart Failure, Left
428.9 - Heart Failure, Unspecified; Cardiac Failure NOS; Heart Failure NOS; Myocardial Failure NOS; Weak Heart

Ability to Work (Return to Work Considerations)

Work activities may be continued and encouraged to the extent that the individual's symptoms allow. Modifications and/or restrictions may be required with work duties that involve medium to heavy physical activity. In this situation, it may be necessary for the individual to return to work at a completely different level, job function, or activity. Individuals whose underlying heart disease can be dramatically improved (such as through coronary artery bypass grafting or valve replacement) may be able to return to moderate or heavy work. Individuals whose disease can only be controlled by medical therapy and who thus have “compensated” but ongoing heart failure can usually only do sedentary or occasionally light work. Most of these individuals meet the U. S. Social Security Administration's criteria for total disability (inability to do any gainful employment).

In work settings that are primarily sedentary, materials and supplies should be organized nearby, and restroom facilities should be easily accessible. Ergonomic seating with the ability to raise the legs may be needed. It may be necessary to limit walking distances that are required to function at work. There should be easy access to the work area and facilities such as parking, elevators, and lunch or break areas. Alternating physical activities with rest periods may be necessary. Shortened work hours or work weeks may be necessary, but this requirement will vary according to the severity of the individual's symptoms.

Risk: As job duties require increasing cardiac demands, the minimum time to return to work will increase. Stress testing and arrhythmia monitoring will help determine safe activity levels. Please refer to “Ability to Work,” pages 271-273.

Capacity: Capacity as determined by stress testing will guide both therapy and give indications on work recommendations. Restrictions are often needed in more advanced disease despite maximum medical therapy. Please refer to “Ability to Work,” page 274.

Tolerance: Some work accommodations may allow a patient to work despite concerns over their persisting symptoms. Please refer to “Ability to Work,” page 274.

Source: Medical Disability Advisor






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