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.

Aplastic Anemia


Related Terms

  • Anemia Gravis
  • Ehrlich's Anemia
  • Hypoplastic Anemia
  • Refractory Anemia

Differential Diagnosis

Specialists

  • Clinical Psychologist
  • Family Physician
  • Hematologist
  • Infectious Disease Internist
  • Medical Toxicologist
  • Pharmacologist
  • Rheumatologist

Comorbid Conditions

Factors Influencing Duration

The length of disability may be influenced by the severity of symptoms, the underlying cause, the treatment required, the individual's compliance with and response to treatment, and the extent of fatigue or other complications. Other factors include previous blood transfusions, availability of a matched sibling donor for bone marrow transplant, presence of infection, severity of pancytopenia, availability of appropriate drugs for treatment, and rejection following transplant.

The individual's age is a significant factor in determining whether he or she is a candidate for bone marrow transplant because the risk of graft rejection increases with age.

Medical Codes

ICD-9-CM:
284.09 - Constitutional Aplastic Anemia, Other; Fanconis Anemia; Pancytopenia with Malformations
284.89 - Aplastic Anemias, Other Specified; Aplastic Anemia (Due to): Chronic Systemic Disease, Drugs, Infection, Radiation, Toxic (Paralytic)
284.9 - Aplastic Anemia, Unspecified; Aplastic NOS, Aregenerative, Hypoplastic NOS, Nonregenerative; Medullary Hypoplasia

Treatment

Individuals with mild or moderate aplastic anemia generally do not require immediate treatment. They should, however, be monitored for any decline in their blood counts. When aplastic anemia is diagnosed, all drugs or medications should be stopped, if possible. Some drugs such as chemotherapeutic drugs and some forms of radiation may be medically necessary as a treatment for another serious condition such as cancer. In these cases, the benefit of the drug or radiation as opposed to its risks must be weighed before making the decision to continue or discontinue its use. If a toxic agent is determined as the cause of the aplastic anemia, it should be removed immediately.

In many cases, removal of the toxic agent allows the bone marrow to regenerate. During this time only temporary supportive treatment may be necessary, such as transfusions of red blood cells and platelets to keep blood counts adequate and administration of antibiotics to prevent infection. Menstruation should also be suppressed.

In cases of severe aplastic anemia, a bone marrow transplant is the treatment of choice. The marrow must come from a matched donor, preferably a sibling. The risk of rejection increases with age, so bone marrow transplant is usually limited to individuals in good health under age 55. Blood transfusion should be avoided, if possible, in individuals who are candidates for a bone marrow transplant. The risk of graft rejection increases significantly with prior transfusion. When the bone marrow transplant is successful, no additional transfusions or transplants will be required.

If the individual is not a candidate for transplant or a donor is not available, immunosuppressive therapy is the next best option. One or a combination of immunosuppressive drugs is taken. Male hormones (androgens) may successfully raise blood counts in some individuals in which standard immunosuppression does not work. During immunosuppression or androgen therapy, transfusion of red blood cells and platelets is usually needed on an ongoing or temporary basis, depending on the individual's response to therapy. After approximately 50 transfusions, an iron chelator drug should be given to remove excess iron introduced into the body by the transfused blood.

Antibiotics should be given prophylactically to prevent infections. Following immunosuppressive therapy, those with severely low white blood cell counts may be given subcutaneous or intravenous doses of a bioengineered drug designed to enhance function of the more mature white blood cells. This is done as supportive therapy to reduce the risk of subsequent infections.

Individuals with Fanconi anemia are treated with androgens or bone marrow transplantation. Approximately half these individuals have increased production of red blood cells and platelets following androgen therapy, and some may have increased production of white blood cells. This type of therapy can continue for years but usually becomes ineffective over time, ultimately requiring bone marrow transplant to obtain a cure.

Source: Medical Disability Advisor






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