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.

Malaise


Related Terms

  • Asthenia

Differential Diagnosis

  • Adverse reaction to medication
  • Chronic fatigue syndrome
  • Depression
  • Stress

Specialists

  • Clinical Psychologist
  • Family Physician
  • Infectious Disease Internist
  • Internal Medicine Physician
  • Neurologist
  • Psychiatrist
  • Pulmonologist
  • Rheumatologist

Comorbid Conditions

  • Cardiovascular disease
  • Connective tissue disorders
  • Endocrine disorders
  • Immune system disorders
  • Psychiatric disorders

Factors Influencing Duration

Factors that influence length of disability may include the individual's response to treatment and underlying causes of the malaise.

Medical Codes

ICD-9-CM:
780.79 - Other Malaise and Fatigue; Asthenia, NOS; Lethargy; Postviral (Asthenic) Syndrome; Tiredness

Overview

Malaise is a feeling of weakness, fatigue, or discomfort usually associated with an illness.

Malaise may be experienced in many diseases including most acute viral disorders, HIV-associated infections, Lyme disease, chronic fatigue syndrome (CFS), and fibromyalgia. Other illnesses associated with malaise are allergic rhinitis, respiratory tract infections, inflammation of blood vessels (systemic vasculitis), Alzheimer's disease, meningitis, influenza, and multiple sclerosis.

Malaise particularly with accompanying fatigue is a very common complaint of individuals who have musculoskeletal disease such as rheumatoid arthritis. Other underlying causes of malaise may include bronchitis, pneumonia, tuberculosis, hepatitis, infectious mononucleosis, emphysema, congestive heart failure, metabolic (endocrine) disorders, anemia, and cancer.

Certain medications could cause malaise in some individuals, including interferons (used in immune therapy) or GM-CSF used for individuals with low white blood count (neutropenic) that may occur with HIV infection. Chronic exposure to allergens may cause malaise in susceptible individuals. Malaise can be associated with depression and other psychological conditions.

Incidence and Prevalence: Because malaise is a nonspecific symptom that can occur with almost any significant acute or chronic infectious disease, endocrine disorders, neoplasms, or systemic disorders including organ failure, cardiopulmonary disease, blood disorders, and connective tissue disorders, incidence rates for occurrence of the symptom alone are not available.

Source: Medical Disability Advisor



Diagnosis

History: Individual may report muscle pain, generalized body discomfort, fever, headache, lethargy, altered mental status, fatigue, sore throat, chest discomfort, nonproductive cough, joint pain, memory impairment, and unrefreshing sleep.

Physical exam: The exam may reveal a low-grade fever, redness in the throat, swollen glands, low pulse, and low blood pressure.

Tests: Blood tests (CBC, sedimentation rate) should be done to rule out infection, anemia, and other conditions.

Source: Medical Disability Advisor



Treatment

Treatment for malaise should be directed toward treating the underlying conditions, which may require rest, fluids, and pain relievers (analgesics).

Source: Medical Disability Advisor



Prognosis

Outcome is directly related to the underlying cause and treatment. Malaise is a predominant symptom of chronic fatigue syndrome, with accompanying headache, pain, low energy, and depression generally improving with appropriate treatment.

Source: Medical Disability Advisor



Rehabilitation

Individuals experiencing malaise, or generalized fatigue, may require physical and occupational therapy if symptoms persist. Frequency and duration of the therapy depend on the underlying cause of the malaise. In general, occupational therapy addresses any fatigue that may occur during activities of daily living. Individuals learn to utilize equipment such as a shower chair to decrease the energy expended during bathing, or a long-handled sponge to decrease the amount of arm work an individual has to perform. Occupational therapists may teach energy conservation techniques, in which activities of daily living such as meal preparation are broken up into smaller components thereby making tasks more manageable.

Physical therapy addresses decreased endurance, strength, and range of motion. Individuals learn to perform stretching and strengthening exercises of the arms and legs to improve overall endurance. Individuals may perform aerobic activity such as walking on a treadmill or riding a stationary bicycle to further increase endurance. Individuals learn to gauge the amount of energy they expend by utilizing a rating of perceived exertion scale. This is a numbered scale that rates exercises from "very, very light" to "very, very hard." Individuals use this scale to stay within tolerable exercise parameters.

Source: Medical Disability Advisor



Complications

Emotional stress, impaired social interaction, and decreased work productivity are possible complications of malaise.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

A less stressful work environment may help the individual. Work hours may need to be temporarily altered to reduce individual's discomfort. Frequent rest breaks during the day can also be helpful.

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:

  • Since malaise is considered a symptom, has underlying condition been identified?
  • Are additional diagnostic tests needed to confirm the condition?
  • Is emotional stress, medication, or coexisting medical or psychological conditions complicating diagnosis and treatment of the underlying condition?

Regarding treatment:

  • Once identified, is the underlying condition(s) responding to treatment?
  • Is malaise decreasing as underlying condition resolves?
  • If caused by medications, can medication type or dose be changed?
  • If malaise persists despite treatment, or because of a necessary treatment, what palliative measures can be instituted?

Regarding prognosis:

  • If underlying cause has not yet been determined, are further diagnostic studies planned?
  • How is individual dealing with the psychological and emotional stress of malaise?
  • Would individual benefit from psychological counseling?

Source: Medical Disability Advisor



References

General

"Malaise." GPnotebook. 21 May 2005 <http://www.gpnotebook.co.uk/simplepage.cfm?ID=-53477334>.

Moder, Kevin G., and Gene G. Hunder. "History in the Patient with Musculoskeletal Disease." Kelley's Textbook of Rheumatology. Eds. Edward Harris, et al. 7th ed. Philadelphia: W.B. Saunders, 2005.

Owens, Thomas A., ed. "Malaise." MedlinePlus. Ed. Thomas A. Owens. 24 Jan. 2005. National Library of Medicine. 21 May 2005 <http://www.nlm.nih.gov/medlineplus/ency/article/003089.htm>.

Source: Medical Disability Advisor






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