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.

Mammoplasty, Reduction


Medical Codes

ICD-9-CM:
85.31 - Unilateral Reduction Mammoplasty; Unilateral: Amputative Mammoplasty, Size Reduction Mammoplasty
85.32 - Bilateral Reduction Mammoplasty; Amputative Mammoplasty, Reduction Mammoplasty (for Gynecomastia)

Related Terms

  • Breast Reduction
  • Reduction Mammoplasty

Overview

A reduction mammoplasty, or breast reduction, is a surgical procedure designed to decrease the size of one or both breasts. It involves removing excess fat, glandular tissue, and the skin overlaying it. In most cases, it also involves reconstruction of the shape of the breast.

Reduction mammoplasty may be done to relieve a range of symptoms caused by extremely large breasts, including difficulty breathing; poor posture; significant neck, back, and shoulder pain; numbness in the arms; difficulty in running and other physical activities; irritation in the inframammary folds; and shoulder grooves from weight-bearing bra straps. It may also be done as a cosmetic procedure to improve the appearance of overly large breasts and provide an easier fit in clothing. Occasionally, reduction mammoplasty may be performed to more closely match a breast reconstructed after mastectomy.

Source: Medical Disability Advisor



Reason for Procedure

A reduction mammoplasty is used to relieve certain symptoms associated with large or sagging breasts or the disproportionate size of one breast in comparison to the other. Abnormally large breast size (mammary hypertrophy) is associated with chronic back, shoulder, and neck pain; painful shoulder grooves from bra straps; slumped shoulders; and the development of a hunchback spine curvature (kyphosis). Additionally, the procedure may be used to relieve symptoms such as shortness of breath (dyspnea), nerve compression (numbness) affecting the hand and arm, and a poor self-image. The individual must be healthy enough to undergo surgery.

Source: Medical Disability Advisor



How Procedure is Performed

Breast reduction surgeries are performed under general anesthesia involving a breathing tube (endotracheal anesthesia). Generally in these procedures, an incision is made below the nipple; excess tissue, fat, and skin are removed; and then the breast is lifted up and shaped into its new form. For the vast majority of procedures, the nipples remain intact, attached to their blood vessels and nerves, while the rest of the work is done around them. The procedure performed most often is breast reduction with transposition of the nipple elevated on a pedicle (inferior pedicle breast reduction). There are situations in which the nipple is removed and replaced (free nipple and areola grafting). Removing the nipple and replacing it in a new position after the excess tissue has been excised (breast reduction with transposition of the nipple as a full thickness graft) is usually performed in elderly women to limit anesthesia time, in heavy women with pronounced breast sagging (ptosis), in women who require massive reduction (breast weighing greater than 1,500 grams), and in women who have had previous breast procedures. In any breast reduction procedure, the single most important step is the proper selection of the new nipple site.

Breast liposuction is another technique that can be used for small to moderate reductions and for women who have minimal breast ptosis. Breast liposuction is less painful than the traditional techniques and results in less scarring.

Source: Medical Disability Advisor



Prognosis

In most cases, women recover well from the surgery and experience enhanced health status and quality of life, including relief of discomfort related to heavy breasts, improved posture, and greater choice of clothing. There can be changes in breast and nipple sensation, and lactation may not be possible. Studies have shown that breast cancer risk is actually decreased after breast reduction surgery (Downey).

Source: Medical Disability Advisor



Specialists

  • Plastic Surgeon

Source: Medical Disability Advisor



Comorbid Conditions

  • Bleeding disorders
  • Immune system disorders
  • Obesity

Source: Medical Disability Advisor



Complications

Scarring is the most common complication. Scars can form around the nipple-areolar complex, in the inframammary fold, or vertically between the nipple-areolar complex and the inframammary fold. Keloids may also form in some individuals, especially those who have had keloids before. Women with larger breasts may lose the nipple-areolar complex altogether. Nipple sensation and breast-feeding capability may also be lost. Other possible complications include postsurgical infection, bleeding, discoloration of the edges of the skin as the incision heals, and the development of small cysts filled with blood and serum (seromas) under the skin. Cigarette smoking can increase associated complications.

Source: Medical Disability Advisor



Factors Influencing Duration

Factors that may influence the length of disability include the response to surgery, development of complications, preexisting medical or surgical conditions, and stress associated with the procedure.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Restrictions include lifting, pushing, pulling, and reaching. No heavy lifting is allowed for 4 weeks after surgery. Temporary transfer to duties requiring less physical activity may be required.

Source: Medical Disability Advisor



References

Cited

Downey, Susan E. "Breast Reduction, Inferior Pedicle." eMedicine. Eds. Pankaj Tiwari, et al. 5 Aug. 2008. Medscape. 25 Sep. 2009 <http://emedicine.medscape.com/article/1274715-overview>.

General

Analay, Y. "Breast Augmentation and Breast Reduction." Occupational Medicine Practice Guidelines. Eds. Lee Glass, et al. 2nd ed. Beverly Farms, MA: OEM Press, 2004. 103-115.

Source: Medical Disability Advisor