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.

Sprains and Strains, Shoulder and Upper Arm


Related Terms

  • Pulled Shoulder Muscle
  • Rotator Cuff Strain
  • Shoulder Separation
  • SLAP Lesion
  • Stretched Shoulder Ligaments
  • Superior Labrum Anterior Posterior
  • Torn Shoulder Muscle

Specialists

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

Factors Influencing Duration

Length of disability depends upon the age of the individual, severity of the sprain or strain, whether the dominant or nondominant arm is affected, underlying medical conditions, complications, whether treatment is conservative or surgical, the individual's age, and the individual’s compliance with treatment and rehabilitation. If a grade III injury has occurred, there is an increased likelihood that permanent weakness may result in the inability to perform heavy or very heavy work.

Medical Codes

ICD-9-CM:
840.1 - Sprains and Strains of Shoulder and Upper Arm, Coracoclavicular (Ligament)
840.2 - Sprains and Strains of Shoulder and Upper Arm, Coracohumeral (Ligament)
840.3 - Sprains and Strains of Shoulder and Upper Arm, Infraspinatus (Muscle) (Tendon)
840.4 - Sprains and Strains of Shoulder and Upper Arm, Rotator Cuff (Capsule)
840.5 - Sprains and Strains of Shoulder and Upper Arm, Subscapularis (Muscle)
840.6 - Sprains and Strains of Shoulder and Upper Arm, Supraspinatus (Muscle) (Tendon)
840.7 - Sprains and Strains of Shoulder and Upper Arm, Superior Glenoid Labrum Lesion; SLAP Lesion
840.8 - Sprains and Strains of Shoulder and Upper Arm, Other Specified Sites of Shoulder and Upper Arm

Treatment

In most cases, conservative treatment is recommended to resolve painful symptoms unless a rupture of the affected ligament, muscle, or tendon is present and results in significant shoulder instability or weakness.

Grade I and II shoulder sprains and strains are initially treated with rest, cold therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce painful symptoms. A sling may be used for the first few days following injury to allow symptoms of acute pain to subside; however, prolonged use of a sling may lead to shoulder stiffness and slowed recovery time. Early range of motion exercises should be performed as tolerated to promote healing and reduce the risk of a frozen shoulder (adhesive capsulitis). Whereas grade I injuries will typically heal with conservative treatment, grade II injuries may also require physical therapy to improve range of motion and promote muscle strengthening.

Grade III shoulder sprains and strains may be initially treated with a sling and cold therapy, but many cases may require surgery to repair the ruptured ligament, muscle, or tendon. Acromioclavicular dislocations and grade III strains in older individuals are typically treated conservatively unless the individual engages in heavy overhead work or is very active. However, muscles and tendons that have sustained full thickness tears often require surgery to trim torn muscle or tendon fibers (débridement), to reattach the ruptured muscle or tendon, or to repair torn or detached cartilage (labral tear and SLAP lesion). Surgical repair of the shoulder muscles, tendons, or cartilage may be performed arthroscopically through tiny incisions using a fiberoptic scope and small instruments, or with open surgery to reconstruct larger, more complicated, or avulsed tears with grade III injury. A mini-incision between 4 cm to 6 cm long also may be used to access and repair torn soft tissues in certain individuals, promoting reduced healing time. Upper arm and shoulder surgery may be performed with either a regional or general anesthesia. Following surgery, rehabilitation is important to help the individual regain functional strength and mobility.

Source: Medical Disability Advisor



ACOEM

ACOEM's Practice Guidelines, the gold standard in effective medical treatment of occupational injuries and illnesses, are provided in this section to complement the disability duration guidelines.*
 
Shoulder Disorders
 
* The relationship between the MDGuidelines (MDA) content and ACOEM's guidelines is approximate and does not always link identical diagnoses. The user should consult the diagnostic codes in both guidelines, as well as the clinical descriptions, before assuming an equivalence.

Source: ACOEM Practice Guidelines






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