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.

Menopause


Related Terms

  • Change of Life
  • Climacteric

Differential Diagnosis

Specialists

  • Clinical Psychologist
  • Endocrinologist
  • Family Physician
  • Gynecologist
  • Internal Medicine Physician
  • Psychiatrist

Comorbid Conditions

  • Pre-existing psychological conditions

Factors Influencing Duration

The individual's overall state of physical or mental health prior to experiencing menopause may influence the length of disability. Other factors that may affect length of disability include severity of symptoms, especially sleep disturbances.

Medical Codes

ICD-9-CM:
627.2 - Menopause
627.8 - Menopausal and Postmenopausal Disorders, Other Specified
627.9 - Menopausal Disorder, Unspecified

Overview

Menopause is not a disease or an illness; it is a profound, natural transition in a woman's life. The signs and symptoms associated with natural menopause may extend over a period of years and encompass the interval marked by a decline in ovarian function and the cessation of menses. In most women, menstruation tapers off, in both quantity and length of flow. Often, the interval between menstrual periods changes, becoming more closely or more widely spaced. This irregularity may last for 2 to 3 years until menstruation ultimately ends. Clinically, menopause is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity or follicle depletion.

A decrease in estrogen and progesterone production is associated with menopause. The symptoms of menopause are caused by these changes in estrogen and progesterone levels. A gradual decrease of estrogen (as seen in natural menopause) allows the body to slowly adjust to the hormone change. In some individuals, the estrogen level decreases suddenly, causing more severe symptoms. This sudden decrease in estrogen is also seen when the ovaries are surgically removed (surgical menopause).

Incidence and Prevalence: In the US in 2000, it was reported that 31.2 million women went through menopause. By 2020, that number is expected to rise to 45.9 million (Weismiller).

Source: Medical Disability Advisor



Causation and Known Risk Factors

Women between the ages of 40 and 55 years.

Source: Medical Disability Advisor



Diagnosis

History: Individuals may present with symptoms that include hot flashes (the most common symptom) and skin flushing, mood changes, decreased sex drive (libido), irregular menstrual periods, urinary incontinence, and vaginal dryness. Other symptoms may include disturbed sleep patterns, headaches, joint pain, weight gain, and heart palpitations.

Physical exam: On physical exam, changes (thinning) in the vaginal lining caused by changes in estrogen levels may be noted.

Tests: Blood and urine tests may be used to check hormone levels (e.g., estrogen, progesterone, plasma estradiol, estrone, and follicle stimulating hormone [FSH]).

Source: Medical Disability Advisor



Treatment

Generally, natural menopause requires no treatment. Hormone replacement therapy (HRT) may be recommended for certain women who are at high risk for postmenopausal osteoporosis, but each individual should discuss the benefits and risks of HRT with her physician as HRT significantly increases the risk for breast cancer, coronary heart disease, dementia, stroke, and thrombophlebitis. Incidence of these harmful long-term side effects increases with longer duration of HRT use. Although HRT may alleviate many symptoms of menopause, it has many short-term side effects including vaginal bleeding, nausea, vomiting, breast tenderness, uterine cramps, and abdominal bloating.

Estrogen-only therapy also reduces risk for osteoporosis, but some women may not be able to take estrogen if they have had certain types of breast cancer, other cancers, or blood clots. Estrogen-only therapy has been associated with increased risk for stroke and uterine cancer. Other medication may be substituted instead, such as beta-blockers and calcium supplements. Bone resorption inhibitors prevent bone loss but do not alleviate hot flashes. Severe psychological symptoms may warrant treatment with antidepressant medication.

Source: Medical Disability Advisor



Prognosis

While symptoms of menopause may last only a month or persist for several years, most women experience menopause without long-term problems. Many woman report an increase in energy and self-confidence after menopause. Some women may experience a loss in bone mass of 2% to 5% per year for the 5 years following menopause.

Hormone replacement therapy (HRT) involving supplementation of combined estrogen and progesterone increases risk of heart attacks, stroke, thrombophlebitis, and breast cancer. Many studies have been done to assess the effects of estrogen-only treatment, with conflicting results. Estrogen does seem to reduce the severity of menopausal symptoms and help prevent osteoporosis without producing breast cancer, but appears to increase risk of stroke, blood clots, and uterine cancer.

Source: Medical Disability Advisor



Complications

The hormonal changes (primarily decreased estrogen levels) associated with menopause increase the long-term risk for developing osteoporosis and also increase the long-term risk of cardiovascular disease.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

No general work restrictions or accommodations apply, but specific cases may have unique needs. Sleep deprivation may create issues around concentration. Working with machinery may need to be assessed.

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 the individual have natural or surgical menopause?
  • Does the individual present with hot flashes and skin flushing, mood changes, decreased libido, irregular menstrual periods, and vaginal dryness?
  • Does the individual also report disturbed sleep patterns, headaches, joint pain, and heart palpitations?
  • On physical exam, was thinning in the vaginal lining noted?
  • Did the individual have blood and urine tests to check hormone levels?
  • Have conditions with similar symptoms been ruled out?

Regarding treatment:

  • Has the individual discussed hormone replacement therapy (HRT) with her physician?
  • Is the individual being treated with HRT?
  • Were other treatment such as beta-blockers, calcium supplements or bone resorption inhibitors recommended? Counseling and/or antidepressants?

Regarding prognosis:

  • Is the individual's employer able to accommodate any necessary restrictions?
  • Does the individual have any conditions that may affect her ability to recover?
  • Does the individual have any complications such as osteoporosis or cardiovascular disease? Does the individual have any side effect of HRT, such as vaginal bleeding, nausea, vomiting, breast tenderness, uterine cramps, or abdominal bloating?

Source: Medical Disability Advisor



References

Cited

Weismiller, D. "The Perimenopause and Menopause Experience: An Overview." Clinics in Family Practice 4 1 (2002): 1-12.

Source: Medical Disability Advisor






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