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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.

Thoracic Outlet Syndrome


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Diagnosis

History: Individuals report pain as well as tingling and numbness (paresthesia) in the neck, shoulder, arm, and hand, or in all four locations. In neurogenic TOS, hand pain can be severe in the fourth and fifth fingers. Individuals may report that the pain is aggravated by use of the arm, and fatigue of the arm is often marked. Pain and paresthesia may be enough to awaken individuals from sleep. Other symptoms may include recurrent headaches, particularly in the back of the head (occipital headaches), and neck pain. Individuals experiencing venous TOS may also report swelling of the arm, a bluish tinge to the skin (cyanosis), and coldness of the affected arm and hand. Arterial TOS often is not detected until migration of a blood clot obstructs an artery (thromboembolic event). Some individuals may report a history of neck trauma preceding symptoms, usually from a motor vehicle accident or repetitive work activity.

Physical exam: True neurogenic and vascular TOS are uncommon, and such a diagnosis should be made cautiously. Physical signs are not always obvious. The exam should include careful palpation of the scalene muscles as well as the subclavian artery and vein. There may be tenderness in the area above the clavicle or abnormal pulsations from the vasculature. Symptoms can often be reproduced by pressure on the scalene muscles on the affected side, combined with movement of the arm away from the body (abduction) and external rotation of the arm. During these maneuvers, the radial pulse in the wrist may diminish or disappear (Adson's sign); however, since this sign can also occur in up to 50% of individuals without TOS, it is no longer considered distinctly characteristic (pathognomonic) of TOS. The fingers may turn cyanotic when the arm is raised overhead. One of the most important aspects of the physical exam is to diagnose or rule out other problems of the neck and arm.

Tests: X-rays of the cervical spine can confirm the presence of a cervical rib. A computed tomography (CT) scan can help rule out cervical disk disease, spinal stenosis, or tumors of the upper lung. Nerve conduction studies may reveal decreased sensory potentials in individuals with neurogenic TOS. Vascular tests such as brachial artery angiography are usually reserved for individuals with suspected arterial blockage or dilation of the wall of a blood vessel (aneurysm). Venography or noninvasive vascular tests such as Doppler ultrasonography can help assess vascular status if a blockage in a vein (venous thrombosis) is suspected. Magnetic resonance imaging (MRI) of the cervical spine and supraclavicular/brachial area may be useful to identify other causes of symptoms.

Source: Medical Disability Advisor