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


Treatment

For neurogenic TOS, a trial of 3 to 12 months of conservative treatment directed toward correction of abnormal posture or muscle imbalance is the most accepted approach, even if an operative procedure is anticipated. Conservative treatment seeks to reduce and redistribute pressure on affected nerves and blood vessels and may include an exercise program, manual therapy to increase mobility of the shoulder girdle, shoulder braces to improve posture, or alterations to customary work habits. Physical activities that aggravate the condition should be avoided. Nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants are sometimes useful in relieving pain. An anterior scalene block can be performed to anesthetize the anterior scalene muscle, indirectly relieving pressure on the brachial plexus. Typically, this procedure is used to confirm the diagnosis and assess whether the individual may be a candidate for thoracic outlet decompression surgery, but it may also be therapeutic. The reliability, accuracy, and safety of this potentially dangerous procedure may be enhanced with the use of electrophysiology guidance to verify needle tip placement.

Surgery is usually reserved for those individuals with neurogenic TOS who have failed to improve with conservative management and are unable to live and work comfortably. Surgery involves releasing or removing the structures that cause the compression. The procedure could include releasing the scalene muscle (scalenectomy), removing an accessory rib, or removing all or part of the first rib (rib resection). In extreme cases, breast reduction surgery may prove helpful in reducing the weight load to the anterior chest wall, thereby helping to relieve symptoms. A second opinion is often helpful before surgery is performed.

There are no satisfactory medical treatments for arterial TOS; prompt surgical intervention is required to decompress the thoracic outlet and repair the artery.

Medical treatment of venous TOS consists of anticoagulant (thrombolytic) therapy and arm elevation; surgical removal of blood clots (thrombectomy) is used primarily in low-risk surgical candidates who are not able to undergo thrombolysis. The best outcomes are achieved in individuals who receive surgical decompression and thrombolytics (Kaczynski).

Source: Medical Disability Advisor