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.

Hematuria


Related Terms

  • Blood in the Urine
  • Haematuria

Differential Diagnosis

  • Artificial food colorings
  • Bilirubinuria
  • Consumption of foods such as beets, blackberries, blueberries, carrots, fava beans, paprika, or rhubarb
  • Hemoglobinuria
  • Myoglobinuria
  • Porphyrinuria
  • Treatment with drugs such as metronidazole, methyldopa, phenytoin, nitrofurantoin, chloroquine, quinine, senna, phenazopyridine, levodopa, rifampin, phenolphthalein, sulfonamides, thioridazine, prochlorperazine, or deferoxamine

Specialists

  • Gynecologist
  • Nephrologist
  • Urologist

Comorbid Conditions

  • Bleeding disorders
  • Immune system disorders

Factors Influencing Duration

Duration due to hematuria caused by trauma or exercise depends on whether the job requirements are physically strenuous. For hematuria due to a urinary tract infection, length of disability may depend on the availability of convenient restroom facilities and the ability to take frequent breaks.

Medical Codes

ICD-9-CM:
599.70 - Hematuria, unspecified
599.71 - Gross hematuria
599.72 - Microscopic hematuria

Overview

Hematuria is the presence of red blood cells in the urine, usually defined as the presence of 3 or more red blood cells per high-power field in the sediment of 3 consecutive centrifuged urine samples obtained at least 1 week apart. The red blood cells may not be detectable by the naked eye, but examination under a microscope shows variable numbers of red blood cells (microscopic hematuria). Gross hematuria can be easily seen; the urine is red or the color of cola (macroscopic hematuria).

Hematuria is a symptom alerting the physician to an underlying condition or disease. Most causes are not serious; many are listed below in Differential Diagnosis.

Hematuria occurs when blood enters the urine from any point along the urinary tract, that is, from the kidney filtering capillaries (glomeruli) to the urethral opening.

Incidence and Prevalence: The prevalence of hematuria ranges from 1% to 16% depending on the population and the way the disorder is defined and diagnosed (Fatica). Men over age 40, especially those with other urologic disorders, are at greatest risk of developing the disorder.

Source: Medical Disability Advisor



Causation and Known Risk Factors

One of the most common causes of hematuria is an infection that causes inflammation in the urethra (urethritis), bladder (cystitis), or kidneys (pyelonephritis). An inflammation of the prostate gland (prostatitis) or benign prostate enlargement (benign prostatic hypertrophy) can cause hematuria in men. Glomerulonephritis, a serious and potentially life threatening inflammation of the glomeruli (filtering units in the kidney), can also cause blood in the urine. Other causes of hematuria include cysts, tumors, stones in the kidney (renal calculi or nephrolithiasis) or bladder, trauma (injury), or bleeding disorders. Occasionally, excessive high-impact exercise, such as long-distance jogging, can cause hematuria.

Source: Medical Disability Advisor



Diagnosis

History: Concomitant symptoms vary according to the underlying cause of the hematuria. The individual may report seeing blood in the urine or experiencing pain on urination; however, the bleeding is usually painless. A fever, rash, or lower abdominal pain may also be present. Frequent urination may later change to urinary retention. Recent trauma to the abdomen, back, or flank may be reported.

Physical exam: The blood may be clearly visible as the urine comes out red; small amounts of blood may give the urine a cloudy or smoky appearance; or blood may not be visible at all except under a microscope. Fever, rash, or elevated blood pressure (hypertension) may be present. A mass in the abdomen or pelvic region may be apparent upon applying pressure to the abdominal area (palpation).

Tests: Diagnostic tests include a urinalysis and urine culture. Urine samples should be carefully collected in sequential portions (known as aliquots) to help isolate the potential source of bleeding. For example, hematuria in the first voided aliquot indicates that the bleeding may originate from the urethra and/or the prostate. In addition to red blood cells, a urinalysis may reveal white blood cells indicative of a urinary tract infection. An analysis of chemical components may reveal the presence of variable amounts of protein (proteinuria), which may be a sign of poor kidney function. Groups of cells and debris molded together in the shape of the kidneys' tiny filtering tubes (casts) can signal kidney disease. High levels of wastes filtered out from the blood and usually excreted by the kidneys through the urine may be detected by analyzing a blood specimen and is additional evidence of kidney disease.

The presence of cysts, stones, or tumors can be detected through images of the urinary tract using ultrasound or computed tomography (CT) scan. Intravenous pyelography (IVP) follows the route of a dye through the urinary tract using x-ray imaging and gives important information about the kidneys, ureters, and bladder. Angiography is a procedure that enables the vessels in the kidneys to be seen on film after they have been filled with a substance that shows up on x-ray (contrast medium); angiography can also be done with CT (CT angiography [CTA]) or magnetic resonance imaging (MRI) (magnetic resonance angiography [MRA]). Direct examination of the bladder and ureters may be achieved using a fiber-optic instrument inserted through the urethra (cystoscopy and ureteroscopy).

Source: Medical Disability Advisor



Treatment

Hematuria or blood in the urine is a sign rather than a disease itself. Treatment is determined by the underlying condition. In many cases, the underlying cause is not serious, and no treatment is necessary. An antibiotic is used if the hematuria is due to an infection.

Source: Medical Disability Advisor



Prognosis

Since hematuria is a sign, not a disease itself, the outcome depends on the underlying condition and its response to treatment. Most causes of hematuria either require no treatment or are easily treatable. However, hematuria may be indicative of a more serious and even life threatening condition such as kidney disease or cancer of the bladder, prostate, or kidney.

Source: Medical Disability Advisor



Complications

Potential complications are determined by the underlying condition.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Work restrictions or accommodations will be specific to the diagnosis and subsequent treatment of the underlying condition.

Risk: Jobs with heavy physical exertion may contribute to hematuria formation. Risk may be assessed based on the underlying condition or diagnosis contributing to the finding of red blood cells in the urine.

Capacity: Capacity is dependent upon the underlying diagnosis, other concomitant findings of the physical exam, and any test results. Isolated hematuria would not have an impact on capacity.

Tolerance: Because hematuria is a sign and not a disease condition, tolerance is not affected by this finding in isolation.

Source: Medical Disability Advisor



Maximum Medical Improvement

30 days.

Source: Medical Disability Advisor



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:

  • Is individual a runner or jogger?
  • Is there a history of a bleeding disorder? Trauma to the urinary system? Prostate enlargement? Infection in the prostate, bladder, or kidneys? Glomerulonephritis?
  • Was a microscopic examination done of the urine?
  • Has individual had any pain with urination?
  • Has individual had any recent trauma to the abdomen or lower back?
  • Is fever, rash, or lower abdominal pain present?
  • Was a urinalysis and urine culture done?
  • Were tests done to rule out kidney disease?
  • Did individual have imaging tests to rule out cysts, stones, tumors, or abnormalities in the blood vessels of the kidneys?
  • Did individual have a cystoscopy and ureteroscopy?
  • Were conditions such as cystitis, urethritis, pyelonephritis, prostatitis, cysts, tumors, kidney or bladder stones, glomerulonephritis, trauma, or bleeding disorders ruled out?
  • Has the underlying cause of the hematuria been accurately diagnosed?

Regarding treatment:

  • Has the underlying cause of the hematuria been specifically treated?

Regarding prognosis:

  • What is the underlying condition?
  • Has there been sufficient time to heal from trauma?
  • Have job requirements been modified?

Source: Medical Disability Advisor



References

Cited

Fatica, Richard, and Adele Fowler. "Hematuria." Cleveland Clinic Center for Continuing Education. 22 Apr. 2015 <http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/nephrology/evaluation-of-hematuria/Default.htm>.

General

Walsh, Patrick C., et al., eds. Campbell’s Urology. 8th ed. 4 vols. Philadelphia: W.B. Saunders, 2002.

Source: Medical Disability Advisor






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