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.

Lipoma


Related Terms

  • Adipoma
  • Adipose Tumor
  • Dercum’s Disease
  • Fatty Tumor

Differential Diagnosis

Specialists

  • Dermatologist
  • General Surgeon
  • Internal Medicine Physician
  • Pathologist
  • Plastic Surgeon

Comorbid Conditions

Factors Influencing Duration

Factors include the type and location of the lipoma and whether it requires treatment by injection or removal. The length of disability may be affected by job requirements, especially the ability to keep the surgical area clean postoperatively. For internal lipomas requiring major surgery, the length of disability will depend on the extent of the surgery, whether complications develop, and whether the job is physically demanding.

Medical Codes

ICD-9-CM:
214.0 - Lipoma; Skin and Subcutaneous Tissue of Face
214.1 - Lipoma; Skin and Subcutaneous Tissue, Other
214.2 - Lipoma; Intrathoracic Organs
214.3 - Lipoma; Intra-abdominal Organs
214.4 - Lipoma; Spermatic Cord
214.8 - Lipoma; Specified Sites, Other
214.9 - Lipoma, Unspecified Site

Overview

© Reed Group
A lipoma is a noncancerous (benign) tumor composed of fat cells (adipose tissue). Lipomas are usually small. They may remain the same size or grow larger when an individual gains weight. They do not, however, generally decrease in size with weight loss. Lipomas do not usually cause any discomfort unless they are positioned in a way that presses on a nerve. A type of lipoma called angiolipoma has blood vessels scattered through it, which can cause pain.

Lipomas may occur virtually anywhere there are fat cells, including the internal organs (usually in the esophagus, stomach, or small intestine), but appear most often beneath the skin (subcutaneous lipoma) on the trunk, neck, back, upper thighs, armpits, and upper arms. They may occur singly or in groups. Certain disorders are characterized by multiple lipomas, including diffuse congenital lipomatosis, benign symmetric lipomatosis, Dercum's disease, and familial multiple lipomatosis. Although lipomas are found in all these conditions, the characteristics of the conditions vary.

Incidence and Prevalence: The incidence of lipoma is 210 per 100,000 individuals (Pandya). Lipoma is prevalent in 1% of the general population (Nickloes), arising in multiples 5% of the time (Pandya).

Benign soft tissue tumors such as lipomas occur 10 times more frequently than cancerous (malignant) tumors (Shidham).

Source: Medical Disability Advisor



Causation and Known Risk Factors

Lipomas are the most common noncancerous tumor found in adults. Lipomas usually occur between the ages of 40 and 60 in both sexes, although they can arise at any age. Single lipomas are more common in women, whereas multiple lipomas are more common in men (Moraru).

The tendency to develop lipomas is probably inherited, but the way it is inherited is not known (Nissl). Lipoma may also be triggered by a minor injury (trauma).

Source: Medical Disability Advisor



Diagnosis

History: Most individuals report a lump under the skin that may have been present for several years, increasing in size very gradually or growing larger if the individual gained weight. Pain may be reported, depending upon the size and location of the tumor, but the majority of lipomas do not cause pain. On occasion, a lipoma may be painful if it rubs against a nearby nerve.

Physical exam: Most subcutaneous lipomas are dome-shaped and 2 to 10 centimeters in diameter. They can be felt under the skin as a smooth, mobile, rubbery growth. The skin covering the lipoma is normal in appearance and can be moved back and forth over the nodule.

Tests: Usually no tests are required. If the individual's history or physical examination suggests the possibility of a malignant liposarcoma, microscopic examination of lipoma cells extracted via fine-needle aspiration (biopsy) is indicated. With irregularly-shaped or large lipomas (greater than 5 cm in diameter), CT scan or MRI may be performed to help differentiate a lipoma from a liposarcoma (Pandya).

Source: Medical Disability Advisor



Treatment

Lipomas generally require no treatment unless they are large, painful, in an inconvenient spot, and / or are unsightly. To reduce their size, lipomas may be injected with steroids. They may also be removed by surgical excision or liposuction.

Source: Medical Disability Advisor



Prognosis

Recovery from removal of lipomas is generally uneventful and represents a cure. No fatalities have been reported with subcutaneous lipomas. Steroid injection can shrink the size of a lipoma by as much as 75% (Pandya). After surgical excision, a subcutaneous lipoma may recur in 2% of cases; the recurrence rate for an intramuscular lipoma is 19% (Pandya).

Source: Medical Disability Advisor



Complications

Lipomas under the skin (subcutaneous) rarely cause complications, but large nodules may interfere with muscle function or may cause nerve pain. Lipomas occurring on a joint may limit movement. If they develop in the bowel, lipomas can cause potentially serious obstructions. Injury to a lipoma may require immediate treatment, including excision. Rarely, a lump that initially appears to be a lipoma may actually be a liposarcoma (cancerous), requiring further treatment.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

For symptomatic subcutaneous lipomas, few work restrictions or accommodations are required. If the job involves significant exposure to dirt, and if the individual has had the lipoma surgically removed, temporary reassignment may be necessary in order to keep the area clean postoperatively. Lipomas in or near internal organs may require major surgery for removal. This may necessitate a leave of absence for the employee, the length of which will depend upon job requirements.

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:

  • Does individual have a family history of lipomas?
  • Has individual recently gained weight?
  • Does individual have single or multiple lipomas?
  • Is lipoma causing pain? Bowel obstruction?
  • Were conditions with similar symptoms, such as liposarcoma or other malignant tumor, and hibernomas ruled out?
  • Is lipoma large or irregularly shaped?
  • Is CT scan or MRI necessary?

Regarding treatment:

  • Was it necessary to inject the lipoma(s) with steroids? Remove the lipoma(s) surgically?

Regarding prognosis:

  • Is individual obese?
  • Is individual on a weight-reduction program?
  • Were the lipomas located in the bowel or other regions that necessitated major surgery?
  • Did individual have any complications?
  • Did lipoma recur?

Source: Medical Disability Advisor



References

Cited

Moraru, Robert A. "Lipomas." eMedicine. Eds. Janet Fairley, et al. 8 May. 2008. Medscape. 26 Aug. 2009 <http://emedicine.medscape.com/article/1057855-overview>.

Nickloes, Todd A., Daniel D. Sutphin, and Klaus Radebold. "Lipomas." eMedicine. Eds. Juan B. Ochoa, et al. 15 Jan. 2009. Medscape. 26 Aug. 2009 <http://emedicine.medscape.com/article/191233-overview>.

Nissl, Jan. "Lipoma." WebMD. Eds. Susan van Houten, et al. 8 May. 2007. 26 Aug. 2009 <http://www.webmd.com/skin-problems-and-treatments/tc/lipoma-topic-overview>.

Pandya, Kartik A., and Frederick Radke. "Benign Skin Lesions: Lipomas, Epidermal Inclusion Cysts, Muscle and Nerve Biopsies." Surgical Clinics of North America 89 3 (2009): 677-687. MD Consult. Elsevier, Inc. 26 Aug. 2009 <http://www.mdconsult.com/das/article/body/156451568-4/jorg=clinics&source=MI&sp=22173932&sid=880045999/N/699453/1.html?issn=0039-6109#S003961090900036X>.

Shidham, Vinod B., et al. "Benign and Malignant Soft Tissue Tumors." eMedicine. Eds. Howard A. Chansky, et al. 30 Mar. 2009. Medscape. 26 Aug. 2009 <http://emedicine.medscape.com/article/1253816-overview>.

Source: Medical Disability Advisor






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