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.

Keloid


Related Terms

  • Hypertrophic Scar

Differential Diagnosis

  • Hypertrophic scars
  • Lobomycosis

Specialists

  • Dermatologist
  • Family Physician
  • Plastic Surgeon

Comorbid Conditions

Factors Influencing Duration

There are no factors influencing length of disability.

Medical Codes

ICD-9-CM:
701.4 - Keloid Scar; Cheloid; Hypertrophic Scar

Overview

A keloid is a raised, hard, thick, itchy scar on the skin secondary to abnormal proliferation of connective tissue.

A keloid occurs when the scar tissue response is out of proportion to the amount needed for normal repair and healing. Because of a defective healing process, excess collagen forms at the site of a healing injury or surgical incision. Keloids may continue to enlarge over time and become unsightly. Most eventually flatten out and stop itching.

Although keloids can occur anywhere on the body, the most common sites are the chest, upper back, and shoulder muscle (deltoid) areas. Keloids can also develop at the site of acne pustules. Although they generally occur secondary to a wound, keloids may arise spontaneously. There is a genetic tendency to form keloids; dominant and recessive inheritance patterns have been described. Keloids must be differentiated from a related condition called "hypertrophic scar." While a hypertrophic scar is a thick scar that remains within the borders of a wound, the keloid extends over the skin beyond the original wound borders in a claw-like growth pattern; however, it almost never extends into subcutaneous tissue. In the past, keloids and hypertrophic scars were considered as a part of a spectrum. Now there is a tendency to consider them as separate entities.

Source: Medical Disability Advisor



Causation and Known Risk Factors

Keloid formation is most common between the ages of 10 and 30 years. There is a greater incidence of keloid formation in blacks than in whites. Keloids are also more common in Asian women.

Source: Medical Disability Advisor



Diagnosis

History: Keloids are typically asymptomatic, but individuals may complain of itchy, tender, or painful scars at the site of a previous injury or surgical incision. Keloids may also cause a burning sensation. In addition to relieving any associated pain, people seek medical care primarily for cosmetic reasons.

Physical exam: The exam may reveal an overgrowth of scar tissue at the site of an injury or surgical incision. The scar extends beyond the border of the wound. The keloid is smooth, shiny, and slightly pink in color.

Tests: Typically, keloid diagnosis is made on the appearance of the scar. Skin biopsy may be used to distinguish between a hypertrophic scar and a keloid; however, biopsy is not recommended to avoid stimulating the growth of a keloid.

Source: Medical Disability Advisor



Treatment

Injections of corticosteroids (anti-inflammatory drugs) directly into the keloid may cause some shrinkage and reduce the itchiness. Surgical removal of the keloid (keloid excision) consists of cutting the skin around the keloid and removing it as a single piece, then sewing (suturing) the skin edges back together; the outcome improves with immediate application of topical or intralesional corticosteroids. Other treatment options include laser therapy, pressure devices, radiation, extreme cold to destroy excessive tissue (cryosurgery), and chemotherapy.

Source: Medical Disability Advisor



Prognosis

No treatment option or combination of treatments is particularly effective. Simple surgical removal (without corticosteroid application) and cryosurgery are of little value because a new keloid usually forms at the site. Most keloids eventually flatten and cease to be itchy, even without treatment. Nonsurgical treatments usually hasten this result. If successful, surgical treatment (keloid excision) will replace a keloid with a flat, painless scar.

Source: Medical Disability Advisor



Complications

There are no complications of untreated keloids. Treated keloids may recur.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

If an individual requires surgery, a short leave of absence may be required, depending on the size of the keloid and its location.

Risk: There is no risk to working with keloids.

Capacity: Capacity is typically unaffected by this disorder.

Tolerance: Tolerance is not usually a concern with keloids, unless a keloid is present at a location that rubs against the individual's clothing. Tolerance of a symptomatic keloid may be improved by placing adequate padding over the keloid, or with treatment to remove the keloid followed by corticosteroids.

Source: Medical Disability Advisor



Maximum Medical Improvement

7 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:

  • Are symptoms consistent with a keloid?
  • Has diagnosis of keloid been confirmed?

Regarding treatment:

  • Did the keloid resolve over time? If not, were interventions considered?
  • Were corticosteroids effective in resolving the keloid?
  • Did treatment include more aggressive measures such as keloid excision, laser therapy, pressure devices, radiation, cryosurgery, or chemotherapy?

Regarding prognosis:

  • Was treatment effective in resolving the keloid?
  • Does individual have any coexisting conditions, such as rash, burns or other scarring in the keloid area, peripheral vascular disease, or systemic lupus erythematosus, that may complicate treatment or impact recovery?
  • Since most keloids eventually flatten and cease to be itchy, even without treatment, is further therapy indicated?

Source: Medical Disability Advisor



References

Cited

Berman, Brian, et al. "Keloid and Hypertrophic Scar." eMedicine. 19 Mar. 2014. Medscape. 24 Apr. 2015 <http://emedicine.medscape.com/article/1057599-overvie>.

Source: Medical Disability Advisor






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