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.

Radiation Therapy


Specialists

  • Radiology Oncologist

Comorbid Conditions

Factors Influencing Duration

The type and stage of the cancer are the most important factors in determining the length of disability. The side effects of radiation therapy also influence disability, as they vary depending on the treatment dose, part of the body treated, and general health of the individual.

Medical Codes

ICD-9-CM:
92.21 - Superficial Radiation; Contact Radiation [Up to KVP]
92.22 - Orthovoltage Radiation; Deep Radiation [200-300 KVP]
92.23 - Radioisotopic Teleradiotherapy; Teleradiotherapy Using: Cobalt, Iodine-125, Radioactive Cesium
92.24 - Teleradiotherapy Using Photons; Megavoltage NOS; Supervoltage NOS; Use of: Betatron Linear Accelerator
92.26 - Teleradiotherapy of Other Particulate Radiation; Neutrons; Protons NOS

Overview

Radiation therapy is the use of radiation that forms ions as it passes through tissue, which dislodges electrons from atoms. Radiation alters DNA, the genetic code that controls how a cell grows and divides, causing the cell to die. Since cancer cells grow and divide more rapidly than normal cells, radiation therapy preferentially affects cancerous tissue. About half of all individuals who undergo treatment for cancer receive radiation therapy.

Radiation therapy may be used as the only type of treatment in cancers such as Hodgkin's disease. Radiation therapy may also be used as an adjuvant therapy. Adjuvant radiation therapy is treatment given in addition to other treatments, such as surgery or chemotherapy, to prevent recurrence of the cancer. Radiation may be given both before (neoadjuvant) and after surgical treatment. Radiation therapy can be combined with chemotherapy, and in such cases both the radiation therapy and the chemotherapy may have to be reduced. A reduction in doses decreases the risk of side effects and complications.

Source: Medical Disability Advisor



Reason for Procedure

Radiation therapy may be used in the early stages of cancer to cure or control the disease. Radiation therapy can be given prior to surgery to shrink the size of the tumor. After a cancerous tumor (malignancy) is surgically removed, radiation may be used to destroy any remaining tumor cells in the area. Radiation therapy can also have an advantage over surgery by preserving more function or having an improved cosmetic result.

Radiation therapy may help relieve pain from cancer that is too far advanced to be curable. For example, reducing the size of a tumor can relieve pressure on the esophagus that inhibits swallowing. It can relieve pain caused by cancer that has spread to bone or relieve headaches or paralysis caused by a brain tumor.

Noncancerous (benign) conditions may also be treated with radiation therapy when the benefits of destroying diseased tissue far outweigh the risk of radiation damage to healthy skin. For example, an overactive thyroid gland can be treated with radiation in a liquid form. This radioactive iodine concentrates in the thyroid gland and destroys the overactive part of the gland.

Source: Medical Disability Advisor



How Procedure is Performed

Radiation therapy is carefully planned. Once the proper dose of radiation has been determined, it is usually divided into several small doses administered over several weeks to give the necessary dose of radiation to the cancer, sparing as much normal tissue as possible. Both dose and time schedule vary according to the type of cancer.

Radiation therapy can be given by an external beam or by implanting radioactive material in the cancerous growth. Other methods include intraoperative radiotherapy, total body irradiation, and radiation surgery.

In external beam radiation therapy, the most common type, the radiation is aimed at the cancer from a source outside the body. The beam penetrates through the skin to reach deeper tissues. Another method uses electrons produced by a machine called a linear accelerator.

Implantation methods (brachytherapy or seeding) use radioactive material that is placed in or very close to the tumor. These sources may be described as either interstitial or intracavitary. The interstitial method places the radioactive matter directly into the tumor, for example, into the prostate gland. The intracavitary method places the sealed radioactive source in a body cavity close to the tumor, such as in the cervical canal.

If the tumor is deep within the body, radiation therapy can be given at the time of surgery (intraoperative radiotherapy), when surrounding organs can be moved out of the way. This allows a larger single dose to be delivered directly to the tumor without damaging surrounding normal tissues. Due to complexity and expense, this method is only used in special cases.

Total body irradiation is used in certain cases, such as when an individual is preparing for bone marrow transplantation. Radiation can be given in higher doses than normal because the bone marrow will be replaced.

Other radiation treatment methods include neutron and proton therapy and the use of heavy ions and pions. These treatments are used primarily in specialized radiation oncology centers.

Source: Medical Disability Advisor



Prognosis

The outcome of radiation therapy varies widely with the type of cancer treated, degree of spread of the tumor(s), type of radiation therapy administered, and location of the cancer. Radiation therapy can provide curative treatment for individuals with limited Hodgkin's disease, skin tumors, laryngeal cancer confined to the vocal cords, and early-stage breast cancer after lumpectomy. The outcome of radiation therapy used as an adjuvant therapy to prevent the spread of cancer is often good. Palliative radiation therapy does not cure the cancer but can improve the quality of life temporarily.

Source: Medical Disability Advisor



Complications

Complications from radiation therapy and their severity depend on several factors, including the dose of radiation and tissues radiated. Many tissues of the body are affected, and some resist the effects of radiation therapy better than others. Tissues that rapidly divide, such as bone marrow and the cells that line the intestinal tract, are very sensitive to the effects of radiation therapy. Complications may occur within the first 6 months of therapy (acute effects), the second 6 months (subacute effects), or years later (late effects).

Radiation therapy to the skin may cause complications such as redness (erythema), peeling (desquamation), hair loss, and itching (pruritus). Radiation to the gastrointestinal tract may produce a number of complications, depending on the area radiated. Complications can include loss of appetite (anorexia), mouth dryness (xerostomia), inflammation of the mucous membranes of the mouth (mucositis), mouth and throat pain, nausea, vomiting, abdominal pain, diarrhea, and rectal pain and bleeding.

Radiation to the liver may cause radiation hepatitis, with symptoms such as a general feeling of ill health (malaise), fever, right-sided upper abdominal quadrant pain, and fluid accumulation in the abdominal cavity (ascites). Radiation to the lungs may cause radiation pneumonitis. Symptoms can include difficulty breathing (dyspnea), fever, chest pain, and a cough. Permanent damage to lung tissues (fibrosis) can occur. Radiation to the heart may cause pericarditis. Symptoms of pericarditis include pain and difficulty breathing. The heart may be severely damaged by radiation therapy.

Radiation to the bladder and kidneys can result in radiation cystitis. Symptoms include painful or difficult urination (dysuria), frequency, urgency, excessive nighttime urination (nocturia), and blood in the urine (hematuria). The ovaries or testes may be affected, often resulting in infertility. Radiation to the brain may kill brain cells (necrosis). The symptoms of brain necrosis are similar to the symptoms of recurrence of the brain tumor. Radiation to the spinal cord may result in shock-like sensations going from the back to the extremities (Lhermitte's sign). Radiation myelopathy may also develop with spinal cord radiation. Symptoms can include sensations of numbness, prickling or tingling (paresthesias), and loss of control over muscular movement, bowel, and bladder function. Finally, other types of cancer such as leukemia may develop several years after treatment by radiation therapy.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Work restrictions and accommodations depend on what side effects are present and their severity. Many individuals can work while receiving radiation therapy. Others find they need more rest than usual and are limited by fatigue. These workers may temporarily require more sedentary work. Individuals may need to work a reduced number of hours on a part-time schedule or work at home.

Source: Medical Disability Advisor



References

General

Salmon, Sydney, and Joseph Bertino. "Principles of Cancer Therapy." Cecil Textbook of Medicine. Eds. Lee Goldman, et al. 22nd ed. Philadelphia: W.B. Saunders, 2004. 1036-1049.

Source: Medical Disability Advisor






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