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 Major or Mild Neurocognitive Disorder


Differential Diagnosis

  • NCDs arising outside the context of substance use, intoxication, and withdrawal

Medical Codes

ICD-9-CM:
291.1 - Alcohol-induced Persisting Amnestic Disorder; Alcoholic Polyneuritic Psychosis; Korsakoffs Psychosis, Alcoholic; Wernicke-Korsakoff Syndrome (Alcoholic)
291.2 - Alcoholic Dementia, Other
292.82 - Drug-induced Persisting Dementia
292.89 - Drug-induced Mental Disorders, Other; Drug-induced Anxiety Disorder; Drug-induced Organic Personality Syndrome; Drug-induced Sexual Dysfunction; Drug-induced Sleep Disorder; Drug Intoxication

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.

The DSM-IV-TR does not include major neurocognitive disorder (NCD), with the result that the present topic exclusively addresses the contents of the DSM-5 regarding substance/medication-induced major or mild neurocognitive disorder.

Incidence and Prevalence: The prevalence of these conditions is not known. For alcohol abuse, the rate of mild NCD of intermediate duration is about 30% to 40% in the first 2 months of abstinence; major NCD is rare. Substance/medication-induced mild NCD of intermediate duration may occur in 33% or more of individuals quitting cocaine; methamphetamine; opioids; phencyclidine; or sedatives, hypnotics, or anxiolytics (DSM-5).

Source: Medical Disability Advisor



Causation and Known Risk Factors

Risk factors for substance/medication-induced NCDs include older age, longer substance/medication use, and persistent use after the age of 50 (DSM-5). For alcohol-induced NCD, risk may be higher in the presence of long-term nutritional deficiencies, liver disease, vascular risk factors, and cardiovascular and cerebrovascular disease.

Source: Medical Disability Advisor



Diagnosis

History: According to the DSM-5, individuals with substance/medication-induced major or mild NCD must meet the criteria for major NCD or for mild NCD. Additionally, the neurocognitive impairments must not occur exclusively during the course of a delirium, and must persist beyond the usual duration of intoxication and acute withdrawal. The involved substance or medication and the duration and extent of use must be capable of producing the neurocognitive impairment. The temporal course of the neurocognitive deficits is consistent with the timing of substance or medication use and abstinence; the deficits remain stable or improve after a period of abstinence. The NCD is not attributable to another medical condition or is not better accounted for by another mental disorder.

In the DSM-5, coding of substance-induced major or mild NCD includes specifying the offending substance: alcohol; inhalant; sedative, hypnotic, or anxiolytic; or other (or unknown) substance. Major NCD may also include alcohol, nonamnestic-confabulatory type; and alcohol, amnestic-confabulatory type—meaning the disorder arising from alcohol use may or may not involve an unconscious misrepresentation of the individual's memories. 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 major or mild NCD, and for dependence on/abuse of the particular substance/medication.

Tests: Please refer to the tests for the particular major or mild NCD, and for dependence on/abuse of the particular substance/medication.

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






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