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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.

Laryngitis


Text Only Home | Graphic-Rich Site | Overview | Risk and Causation | Diagnosis | Treatment | Prognosis | Differential Diagnosis | Specialists | Comorbid Conditions | Complications | Factors Influencing Duration | Length of Disability | Ability to Work | Maximum Medical Improvement | Failure to Recover | Medical Codes | References

Medical Codes

ICD-9-CM:
464.00 - Acute Laryngitis without Mention of Obstruction
464.01 - Acute Laryngitis with Obstruction

Related Terms

  • Acute Laryngitis
  • Chronic Laryngitis
  • Suppurative Laryngitis

Overview

Laryngitis is an inflammation of the voice box (larynx) that causes swelling of the vocal cords due to infection, overuse, or irritation. Laryngitis is characterized by difficulty in speaking (dysphonia) usually with a husky, grating voice (hoarseness) and a weak voice, or loss of voice (temporary aphonia) and may also cause pain in the laryngeal area during swallowing or speaking (sore throat). Laryngitis may last only a few days (less than three weeks; acute) or persist over a long period (over three weeks; chronic).

Incidence and Prevalence: Nearly one third of the population will experience impaired voice production at some point in their lives. Laryngitis is equally prevalent in men and women and can affect individuals of any age (Schwartz).

Source: Medical Disability Advisor



Causation and Known Risk Factors

Acute laryngitis is most often caused by viral infections in the upper respiratory tract. It may occur along with a common cold, bronchitis, flu (influenza), or pneumonia. Chronic laryngitis is most commonly caused by overuse or misuse of the voice (e.g., singing, screaming); chronic irritation by smoke, dust, or other airborne substances; excessive alcohol consumption; postnasal drainage; or the reflux of acid from the stomach (gastroesophageal reflux disease [GERD]). Less commonly, laryngitis may result from direct trauma or more serious conditions such as laryngeal polyps, a benign or malignant tumor, or laryngeal paralysis (Schwartz).

Source: Medical Disability Advisor



Diagnosis

History: Individuals may report hoarseness or aphonia, soreness when clearing the throat or swallowing, and a dry, irritated cough. Fever may or may not be present.

Physical exam: The physician visually inspects the larynx using a mirror held against the back of the roof of the mouth. A viewing instrument (laryngoscope) may be passed down the throat in order to view the larynx directly (laryngoscopy) or to take a biopsy.

Tests: Tests are not required for the diagnosis of laryngitis. However, a throat culture and sensitivity test may be performed to identify organisms responsible for a bacterial infection and its antibiotic sensitivity.

Source: Medical Disability Advisor



Treatment

Laryngitis is most often treated by resting the voice as much as possible, increasing fluid intake, using a humidifier, and avoiding common irritants (e.g., cigarette smoke, alcohol). Over-the-counter analgesics or throat lozenges may be used if soreness or throat pain is present. Antibiotics are prescribed only if a bacterial infection is present. Chronic laryngitis is treated differently depending on the cause. Symptoms persisting for longer than 2 weeks without relief from common treatment methods or hoarseness accompanied by a lump in the neck or blood-tinged sputum require further diagnostic evaluation.

Source: Medical Disability Advisor



Prognosis

Full recovery is expected.

Source: Medical Disability Advisor



Differential Diagnosis

  • Allergy
  • Epiglottitis
  • Exposure to inhaled environmental toxins or irritants
  • Malignant or benign tumor of larynx or neck
  • Paralysis of vocal cord(s)
  • Trauma
  • Vocal cord polyps

Source: Medical Disability Advisor



Specialists

  • Otolaryngologist

Source: Medical Disability Advisor



Comorbid Conditions

Source: Medical Disability Advisor



Complications

Rarely, severe respiratory distress develops that requires immediate medical intervention. In some individuals, infectious laryngitis may spread to other parts of the respiratory tract. Persistent laryngitis (more than 2 weeks) may be a symptom of a more serious underlying condition, such as a tumor or cancer in the neck, larynx, or vocal cords.

Source: Medical Disability Advisor



Factors Influencing Duration

Situations resulting in persistent overuse or misuse of the voice may aggravate and prolong symptoms. Smoking may increase the duration of laryngitis.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

The voice should be rested as much as possible. Inhaled irritants (e.g., smoke, dust, pollution) and extremely cold air should be avoided.

Risk: In an immune-compromised individual, working with heavy public contact, indigent or incarcerated populations, or in health care settings, may place the individual at increased risk of further or recurrent infection. A person with symptom onset within the last 24 to48 hours is at a more infectious state and should avoid working in settings with immune compromised individuals. Some risk can be mitigated by frequent hand washing, gloves, or masks. Jobs that require high vocal use or loud sound production may be required to be avoided.

Capacity: There should be no impact on capacity in individuals with acute laryngitis. Chronic laryngitis may require voice assistive aids.

Tolerance: Individuals may benefit from variable combinations of antipyretics/analgesics, anti-histamines, decongestants, and nasal sprays to permit greater tolerance in the work environment. Accommodations to limit voice use may be needed.

Source: Medical Disability Advisor



Maximum Medical Improvement

14 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:

  • Was diagnosis of underlying condition, such as common cold, influenza, pneumonia, bronchitis, malignant tumor or polyps on the vocal cords, paralysis of the vocal cords, allergies, or trauma, confirmed?
  • Has a throat culture and sensitivity test been performed to identify the causative agent and its antibiotic sensitivity?
  • In the case of persistent laryngitis (more than 2 weeks), was laryngoscopy and/or biopsy performed to rule out benign or malignant tumors?

Regarding treatment:

  • Is individual receiving appropriate treatment for an underlying viral or bacterial infection? Has individual complied with prescribed treatment?
  • Have symptoms persisted longer than 2 weeks?
  • Has a laryngoscopy and/or biopsy been performed to rule out benign or malignant tumors?
  • Once identified, is underlying condition receiving appropriate treatment?

Regarding prognosis:

  • How long has laryngitis been present?
  • Has a laryngoscopy and/or biopsy been performed to rule out benign or malignant tumors?
  • Is the underlying condition responding to treatment?

Source: Medical Disability Advisor



References

Cited

"Laryngitis." MayoClinic.com. 28 Jun. 2012. Mayo Foundation for Medical Education and Research. 17 Sep. 2014 <http://www.mayoclinic.org/diseases-conditions/laryngitis/basics/definition/con-20021565>.

Schwartz, S. R., et al. "Clinical Practice Guideline: Hoarseness (Dysphonia)." Otolaryngology--Head and Neck Surgery 141 (2009): S1-S31.

Source: Medical Disability Advisor