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.

Rotator Cuff Tear


Related Terms

  • Full-thickness rotator cuff tear
  • Partial-thickness Rotator Cuff Tear
  • Torn Rotator Cuff

Differential Diagnosis

Specialists

  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist
  • Rheumatologist
  • Sports Medicine Physician

Comorbid Conditions

Factors Influencing Duration

The size of the tear, the individual's age, occupation, and overall health, dominant side involvement, the need for surgery, and the effectiveness of rehabilitation may affect the length of disability. There may be permanent restrictions on overhead work. The larger the tear, and the longer the interval from injury to surgery, the more likely that there will be some residual permanent weakness of the rotator cuff (Safran). Therefore, heavy or very heavy lifting may no longer be possible.

Medical Codes

ICD-9-CM:
726.10 - Disorders of Bursae and Tendons in Shoulder Region, Unspecified; Rotator Cuff Syndrome NOS; Supraspinatus Syndrome NOS
726.13 - Partial Tear of Rotator Cuff
727.61 - Rupture of Tendon, Nontraumatic, Complete Rupture of Rotator Cuff
840.4 - Sprains and Strains of Shoulder and Upper Arm, Rotator Cuff (Capsule)

Ability to Work (Return to Work Considerations)

Limiting use of the affected shoulder may be necessary. Reaching and arm use above shoulder level should be avoided in the initial recovery period. The arm and hand can be used at the individual's side for activities that do not require heavy lifting, pushing, or carrying. These guides may become permanent. An ergonomic evaluation of the workplace may be helpful. Changing job duties, sharing or alternating tasks, working at a reduced rate, taking more frequent rest breaks, and limiting the time and frequency of repetitive activities are important accommodations. Work site modifications may include forearm rests for individuals who use computer keyboards frequently, headsets for those who answer telephones, and alterations such that repetitive activities are performed with the arms in a lower level of elevation. For more information, refer to "Work Ability and Return to Work," page 187.

Recovery from surgical repair is the most restrictive, with limited use of the arm and shoulder for up to 2 months (depending of age and tear size), followed by a gradual increase in allowed activities. Some individuals will never regain full range of motion or strength in the affected arm. Depending on job duties, individuals may require permanent reassignment, which may necessitate retraining. Use of prescription painkillers (analgesics) and other medications can affect dexterity and alertness. Use of these medications may require review of drug policies.

Risk: Reinjury is possible, but most individuals are on modified work. For more information, refer to "Work Ability and Return to Work," page 183, table 12-2, as well as page 186.

Capacity: Capacity is dependent on age and physical conditioning before onset of symptoms. For more information, refer to "Work Ability and Return to Work," page 187.

Tolerance: The ability to work through the pain is unique to each individual. If the tear cannot be repaired to a normal anatomical position, range of motion and strength will be permanently reduced. Tolerance can be modified by education and rewards. For example, a study found 51 full-thickness rotator cuff tears in 49 NFL football players. After being injured, the majority continued to play at their usual level of activity and delayed surgery until the postseason. After surgery, most returned to professional football, but many were not totally symptom-free (Foulk). For more information, refer to "Work Ability and Return to Work," Chapter 2.

Accommodations: As the individual ages, the need for permanent work accommodations will increase. Tolerance and accommodation determine the final ability to return to work. Modifications to the workplace or modifications to the job task may allow many individual to return to modified work.

Source: Medical Disability Advisor






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