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.

Ligation and Stripping of Varicose Veins


Related Terms

  • High Ligation
  • Phlebectomy

Specialists

  • General Surgeon
  • Vascular Surgeon

Comorbid Conditions

Factors Influencing Duration

The extent of the condition, the presence of complications, and the individual's job requirements will influence the length of disability. If the individual has a sedentary job and can keep the legs elevated, the period of disability may be shorter than if the individual has a job that requires prolonged standing or walking.

Medical Codes

ICD-9-CM:
38.50 - Ligation and Stripping of Varicose Veins, Unspecified Site
38.53 - Ligation and Stripping of Upper Limb Varicose Vessels
38.59 - Ligation and Stripping of Lower Limb Varicose Vessels

Overview

© Reed Group
Ligation and stripping of varicose veins is the surgical removal of superficial veins that have become damaged, enlarged, and twisted (varicose veins). The enlarged veins lie just under the skin and are easily seen. The leg is the most common site for varicose veins.

This disorder is often seen in women, especially related to pregnancy, obesity, trauma, in those with a family history of varicose veins, and in individuals with weak-walled veins. Prolonged standing does not cause varicose veins but may intensify the disorder. Varicose veins sometimes result from blockage of the deep veins in the leg (deep venous thrombosis [DVT]). In this case, varicose veins should not be removed because they provide a bypass for venous return and hence are hemodynamically helpful.

Source: Medical Disability Advisor



Reason for Procedure

Ligation and stripping of varicose veins may be indicated for individuals with varicose veins accompanied by swelling and aching pain in the legs that is worse with standing and relieved by elevating the legs. Ligation and stripping of varicose veins is frequently performed for broken/ruptured varicose veins, or skin ulcerations due to varicose veins. While inflammation in the veins (superficial phlebitis) and blood clotting in the veins (thrombophlebitis) are primarily medically managed, ligation and stripping is sometimes performed. Varicose veins may also be removed for cosmetic reasons.

Source: Medical Disability Advisor



How Procedure is Performed

This procedure is usually performed on an outpatient basis but requires the individual to be placed under regional anesthetic block, spinal or general anesthesia.

The surgical removal of varicose veins is done through small incisions between the ankle and groin. The individual's varicose veins are located, tied off (ligated), and then severed. A flexible wire is used to strip out the main superficial leg vein (saphenous vein) from ankle to groin. The leg is then bandaged tightly to prevent bleeding. Newer injection procedures (sclerotherapy) are also used to treat varicose veins. Sclerotherapy requires a series of injections of a chemical that irritates the lining of the vein, causing it to form scar tissue that will block blood flow through the vein.

Source: Medical Disability Advisor



Prognosis

Although varicose veins cannot be cured, a vast majority have a good outcome from surgery and the progression of the disease is arrested (Lew). Veins that are treated surgically will not develop varicosities, but new varicose veins frequently appear.

Source: Medical Disability Advisor



Complications

Postoperative infection, formation of blood clots (thrombi), subcutaneous hematoma, and adverse reactions to general anesthesia or other medications might complicate this procedure. Distorted sensation (dysesthesia) from damage to the sural nerve or the saphenous nerve may also appear. Accidental treatment of the femoral vein may lead to DVT.

Postoperative infection, formation of blood clots (thrombi), and adverse reactions to general anesthesia or other medications might complicate this procedure.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

The individual's legs will be bandaged for several weeks. Prolonged standing or sitting must be avoided during the recovery period. Elevation of the legs while sitting will be required. Walking is encouraged for healing but should not be done for prolonged periods. Activities that cause straining, such as pushing, pulling, and lifting, should be avoided during the recovery period.

Risk: Postoperatively the individual should follow the surgeon's restrictions on prolonged immobility and walking during recovery. Individuals who perform heavy or very heavy work may require temporary job reassignment.

Capacity: Capacity for physical exertion and prolonged sitting, standing, and walking may be temporarily reduced during the recovery period. The individual will require breaks during which the legs should be elevated. Exercise treadmill testing my help clarify walking distance capacity.

Tolerance: Tolerance is typically not a concern following this procedure. Once the individual has fully recovered and the surgeon has lifted any postoperative restrictions, no ongoing disability is anticipated. Jobs that allow more freedom of movement may be more conducive to a return to work. Those who had DVT may benefit from use of support stockings.

Source: Medical Disability Advisor



Maximum Medical Improvement

60 days.

Source: Medical Disability Advisor



References

Cited

Lew, Wesley K., and Fred A. Weaver. "Varicose Vein Surgery Treatment and Management." eMedicine. Ed. Francisco Talavera. 11 Nov. 2013. Medscape. 2 Dec. 2014 <http://emedicine.medscape.com/article/462579-treatment>.

Source: Medical Disability Advisor






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