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.

Substance/Medication-Induced Bipolar and Related Disorder


Medical Codes

ICD-9-CM:
291.89 - Alcoholic Psychoses, Other; Alcohol-induced Anxiety Disorder; Alcohol-induced Mood Disorder; Alcohol-induced Sexual Dysfunction; Alcohol-induced Sleep Disorder
292.84 - Drug-induced Mood Disorder; Depressive State Induced by Drugs

Overview

This topic follows the approach to substance-induced disorders established by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). For the approach to substance dependence/abuse established by DSM-IV-TR, please refer to specific topics including Polysubstance Dependence; Alcohol and Drug Detoxification and Rehabilitation; Alcohol Intoxication, Acute; Alcoholism; Stimulant-Related Disorders (Amphetamine-Type Substance); Stimulant-Related Disorders (Cocaine); Cannabis Use Disorder; Tobacco Use Disorder; Opioid Dependence; or Sedative, Hypnotic or Anxiolytic Dependence.

In the DSM-IV-TR, substance/medication-induced bipolar and related disorder is included in the sections Substance-Induced Mood Disorder, With Depressive Features; Substance-Induced Mood Disorder, With Manic Features; and Substance-Induced Mood Disorder, With Mixed Features, contingent on the predominant mood (DSM-5).

Incidence and Prevalence: There are no epidemiological studies about substance/medication-induced mania or bipolar disorder. Each causal substance may have its own individual risk of inducing a bipolar (manic/hypomanic) disorder.

Source: Medical Disability Advisor



Diagnosis

History: According to the DSM-5, for individuals with substance/medication-induced bipolar and related disorder the clinical picture is dominated by a prominent and persistent disturbance in mood characterized by elevated, expansive, or irritable mood with or without depressed mood, or markedly diminished interest or pleasure in all, or almost all, activities. The history reveals that the disturbance in mood developed in the course of, or shortly after (within 30 days, DSM-IV-TR), substance intoxication, or after withdrawal from or exposure to a medication. The involved substance/medication must be capable of producing a disturbance in mood.

The disturbance is not better accounted for by a bipolar or related disorder that is not substance/medication-induced. Evidence of an independent bipolar or related disorder may include the appearance of the symptoms before the onset of the substance/medication use, the persistence of the symptoms approximately 1 month after acute withdrawal from the substance/medication use, or symptoms that exceed those normally produced by the substance/medication use — as well as a history of recurrent non-substance/medication-related episodes (DSM-5), or major depressive episodes (DSM-IV-TR).

The disturbance does not occur exclusively during the course of a delirium. The disturbance produces clinically significant distress or impairment in social, occupational, or other areas of functioning. This diagnosis should be made instead of a diagnosis of substance intoxication or substance withdrawal only when the mood symptoms exceed those usually associated with the intoxication or withdrawal syndrome and when its severity warrants clinical attention (DSM-IV-TR). It is necessary to specify if the onset occurred during intoxication, or during withdrawal.

According to both the DSM-5 and DSM-IV-TR, coding of substance/medication-induced bipolar and related disorder includes specifying the offending substance: alcohol; phencyclidine or other hallucinogen; sedative, hypnotic, or anxiolytic; amphetamine or other stimulant; cocaine; other (or unknown) substance (or phencyclidine-like substance, amphetamine-like substance, inhalant, or opioid, DSM-IV-TR). In the DSM-5, coding includes "with use disorder, mild," "with use disorder, moderate or severe," or "without use disorder" for each substance based on the ICD-10-CM.

Physical exam: Please refer to the physical exam for the particular bipolar and related disorder, and for dependence on/abuse of the particular substance/medication.

Tests: Please refer to the tests for the particular bipolar and related disorder, and for dependence on/abuse of the particular substance/medication.

Source: Medical Disability Advisor



Differential Diagnosis

  • Medication side effects
  • Other bipolar disorders
  • Substance intoxication
  • Substance-induced delirium

Source: Medical Disability Advisor



References

Cited

Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. American Psychiatric Association, 2013.

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). 4th ed. Washington, DC: American Psychiatric Association, 2000.

Source: Medical Disability Advisor