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.

Nerve Injury


Related Terms

  • Nerve Transection
  • Nerve Trauma

Differential Diagnosis

Specialists

  • Hand Surgeon
  • Neurologist
  • Neurosurgeon
  • Occupational Therapist
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist

Comorbid Conditions

Factors Influencing Duration

Duration depends on the site and severity of the nerve injury. The severity of associated injuries to bones, blood vessels, muscles, and tendons may influence functional outcome and contribute to disability. Disability depends on specific job duties and specific nerves injured; it is not only related to grade of nerve injury but also to specific loss of function related to job requirements. Elderly individuals have poorer outcomes with surgical nerve repair.

Medical Codes

ICD-9-CM:
951.0 - Injury to Oculomotor Nerve; Third Cranial Nerve
951.1 - Injury to Trochlear Nerve; Fourth Cranial Nerve
951.2 - Injury to Trigeminal Nerve; Fifth Cranial Nerve
951.3 - Injury to Abducens Nerve; Sixth Cranial Nerve
951.4 - Injury to Facial Nerve; Seventh Cranial Nerve
951.5 - Injury to Acoustic Nerve; Auditory Nerve; Eighth Cranial Nerve
951.6 - Injury to Accessory Nerve; Eleventh Cranial Nerve
951.7 - Injury to Hypoglossal Nerve; Twelfth Cranial Nerve
951.8 - Injury to Other Specified Cranial Nerves; Glossopharyngeal [9th Cranial] Nerve; Olfactory [1st Cranial] Nerve; Pneumogastric [10th Cranial] Nerve; Vagus [10th Cranial] Nerve
951.9 - Injury to Unspecified Cranial Nerve
953.0 - Injury to Nerve Roots and Spinal Plexus; Cervical Root
953.1 - Injury to Nerve Roots and Spinal Plexus; Dorsal Root
953.2 - Injury to Nerve Roots and Spinal Plexus; Lumbar Root
953.3 - Injury to Nerve Roots and Spinal Plexus; Sacral Root
953.4 - Injury to Nerve Roots and Spinal Plexus; Brachial Plexus Injury
953.5 - Injury to Nerve Roots and Spinal Plexus; Lumbosacral Plexus
953.8 - Injury to Nerve Roots and Spinal Plexus; Multiple Sites
953.9 - Injury to Nerve Roots and Spinal Plexus; Unspecified Site
954.0 - Injury to Other Nerve(s) of Trunk, Excluding Shoulder and Pelvic Girdles; Cervical Sympathetic
954.1 - Injury to Other Nerve(s) of Trunk, Excluding Shoulder and Pelvic Girdles; Other Sympathetic; Celiac Ganglion or Plexus; Inferior Mesenteric Plexus; Splanchnic Nerve(s); Stellate Ganglion
954.8 - Injury to Other Nerve(s) of Trunk, Excluding Shoulder and Pelvic Girdles; Other Specified Nerve(s) of Trunk
954.9 - Injury to Other Nerve(s) of Trunk, Excluding Shoulder and Pelvic Girdles; Unspecified Nerve of Trunk
955.0 - Injury to Axillary Nerve
955.1 - Injury to Median Nerve
955.2 - Injury to Ulnar Nerve
955.3 - Injury to Radial Nerve
955.4 - Injury to Musculocutaneous Nerve
955.5 - Injury to Cutaneous Sensory Nerve, Upper Limb
955.6 - Injury to Digital Nerve
955.7 - Other Specified Nerve(s) of Shoulder Girdle and Upper Limb
955.8 - Multiple Nerves of Shoulder Girdle and Upper Limb
955.9 - Unspecified Nerve of Shoulder Girdle and Upper Limb
956.0 - Injury to Sciatic Nerve
956.1 - Injury to Femoral Nerve
956.2 - Injury to Posterior Tibial Nerve
956.3 - Injury to Peroneal Nerve
956.4 - Injury to Peripheral Nerve(s) of Pelvic Girdle and Lower Limb; Cutaneous Sensory Nerve, Lower Limb
956.5 - Other Specified Nerve(s) of Pelvic Girdle and Lower Limb
956.8 - Injury to Peripheral Nerve(s) of Pelvic Girdle and Lower Limb; Multiple Nerves of Pelvic Girdle and Lower Limb
956.9 - Injury to Peripheral Nerve(s) of Pelvic Girdle and Lower Limb; Unspecified Nerve of Pelvic Girdle and Lower Limb
957.0 - Injury to Superficial Nerves of Head and Neck
957.1 - Injury to Other Specified Nerve(s)
957.8 - Injury to Multiple Nerves in Several Parts
957.9 - Nerve Injury, Unspecified; Nerve Injury NOS

Treatment

The timing of treatment of open wound nerve injuries is critical. Primary nerve repair is usually completed within 7 days of the injury. The timing is dependent on the wound and associated comorbidities and the individual's overall condition. With primary repair, the wound is explored, and if a clean cut of the nerve is found, the proximal and distal nerve ends are matched and brought together using microneurosurgical repair (neurorrhaphy). The goal of repair is to mend the ends of the nerve covering that contains the blood supply to the nerve (epineurium) so that new axonal nerve fibers can reconnect inside this covering (AAOS).

Repair may be done later (a delayed repair, usually after 7 days); the timing of nerve repair is dictated by the nature of the nerve injury and may be performed after the wound has healed, when some of the swelling and scarring has resolved, and the wound is clean. Delayed repairs usually require nerve grafting using a piece of another nerve (autograft) to bridge the injured area or using a conduit. A nerve guidance conduit (also referred to as an artificial nerve conduit or artificial nerve graft, as opposed to an autograft described above) is an artificial means of guiding axonal regrowth to facilitate nerve regeneration when there is a small gap between the two ends of the nerve. Other surgical strategies may involve flexing the joint (to gain nerve length) or shortening a nearby bone to create relative length in the injured nerve if the nerve ends have retracted (Sharon).

In a closed injury (crush or shear) with partial sensory function distal to the injury and no obvious motor loss, there is no indication for immediate surgery. However, the degree of nerve injury should be diagnosed as soon as possible. The individual is examined repeatedly over a 3-month period. During this period, gentle active and passive motion of the involved extremity keeps the joints and soft tissue supple. The individual may be given medications (e.g., analgesics, anticonvulsants, corticosteroids) to control pain. If by 3 months there is some clinical or electrical evidence of recovery, the individual continues to be monitored. However, if there is no clinical or electrical (EMG) evidence of return of function at 3 months, the nerve may be explored and/or repaired or a muscle-tendon transfer may be considered. Again, the injured area is cut out (excised) and a graft is performed; if nerve repair is not possible, the surgeon may choose to alter the course of a tendon (tendon transfer) to improve function in the affected area (Sharon).

Source: Medical Disability Advisor






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