VA Disability Rating for Gout
Gout is a condition that causes severe inflammation in the joints, typically in the toes and feet. Veterans who suffer from gout may experience incapacitating episodes when moving the impacted joints or engaging in everyday activities is difficult. In some cases, gout can prevent you from working. Veterans Guide explains how to obtain a gout VA disability rating that will qualify you for compensation.
Joining the military offers many advantages: you’ll serve your country, see the world, and access benefits like free college tuition and low-interest home loans. However, military service isn’t for the faint of heart. You may fight in a war or be stationed in a hazardous area. Many service members are at high risk of suffering physical injuries, and some leave with psychological issues caused by experiencing traumatic incidents.
One condition that is particularly common among veterans is gout. Gout is a disease that causes excessive joint swelling, particularly in the feet and toes. Veterans who suffer from this condition may experience extreme pain, especially when they walk or perform physical activity. If you suffer from this condition, you should consider applying for a gout VA disability rating so that you can receive benefits.
Veterans and Gout
Gout is a form of arthritis caused by a buildup of uric acid in the joints. People with gout often experience sudden pain marked by swelling and inflammation of the affected area. Burning sensations are common, and symptoms can flare up anytime. When a flare-up occurs, it can be excruciating.
Risk factors for gout include eating a diet high in red meat or sugar, regularly drinking beer, being overweight, or having a family history of gout. Some medications can increase the risk of developing gout, including ACE inhibitors used to control hypertension or taking aspirin regularly.
Veterans are susceptible to gout, especially if they suffer from other conditions like obesity, diabetes, or heart disease. Experiencing a sudden trauma, like an explosion or other accident that impacts the joints, can also increase your risk of developing the condition.
Because there is a higher incidence of physical and mental disability than the general population, they tend to live a more sedentary lifestyle, which can lead to the development of gout in their joints.
Symptoms of gout include the following:
- Unexpected, intense joint pain that lasts for several hours
- Inflammation and redness surrounding the affected joints
- Pain that lingers following an initial flare-up
- Difficulty moving the joints
Usually, gout starts in the big toe. However, gout can also occur in joints like the ankles, wrists, knees, fingers, and elbows. Extreme pain in an initial flare-up can last up to 12 hours, and subsequent attacks can last longer. If gout remains untreated, it can lead to further joint damage.
How Does the VA Rate Gout?
The VA uses a rating schedule to assign a disability rating for gout. The specific code used to evaluate gout is 5017, which falls under degenerative arthritis. The VA evaluates the severity of your gout based on the limitation of motion of the joints involved. For example, an examiner will rate a veteran who suffers from gout impacting their knees according to the following schedules:
- 30 percent: Limitation of flexion to 15 degrees
- 20 percent: Limitation of flexion to 30 degrees
- 10 percent: Limitation of flexion to 45 degrees
- 0 percent: Limitation of flexion to 60 degrees
The examiner will also evaluate the ability of the veteran to extend their knee and assign the appropriate rating.
- 50 percent: Limitation of extension 45 degrees
- 40 percent: Limitation of extension 30 degrees
- 30 percent: Limitation of extension 20 degrees
- 20 percent: Limitation of extension 15 degrees
- 10 percent: Limitation of extension 10 degrees
- 0 percent: Limitation of extension 5 degrees
Veterans who can’t demonstrate a limitation of motion can still qualify for a disability rating if they have X-ray evidence of their gout. The VA provides a 20 percent disability rating for X-ray evidence that shows the involvement of two or more major joints or minor joint groups with occasional documented exacerbations. Veterans with no documented exacerbations but who have X-rays exhibiting gout in two or more major joints or minor joint groups may qualify for a 10 percent disability rating.
TDIU and Gout
In some instances, the VA may provide a veteran with Total Disability Individual Unemployability (TDIU), which allows them to receive the same compensation as a 100 percent disabled veteran, even if the total of their disability ratings is less than 100 percent. To qualify for TDIU, the veteran must meet either of the below disability rating requirements:
- At least one service-connected disability with a rating of 60 percent or higher, or
- Two or more service-connected disabilities that total at least 70 percent, with at least one disability having a 40 percent disability rating or higher
In addition to meeting the rating requirements, the veteran must prove that they can’t hold a job due to their medical condition. Evidence of frequent hospitalizations or physician-ordered medications with debilitating side effects can prove that the veteran can’t work.
If you have a VA rating for gout, it can help you increase your total disability rating and potentially meet the TDIU requirements. For instance, if you have one condition with a 40 percent disability rating, another with a 20 percent rating, and your gout has a 10 percent disability rating, you’ll meet the 70 percent combined total for TDIU. However, you’ll still need to prove you can’t work due to your health.
Gout as a Secondary Disability
In some cases, you may have a primary condition causing your gout. For instance, if you have service-connected high blood pressure and are on medications that have gout as a side effect, like ACE inhibitors or beta blockers, you may claim gout as a secondary disability to increase your overall disability rating with the VA.
Other primary conditions that may result in gout as a secondary disability include obesity, diabetes, and surgery that impacts the joints, like a bone replacement.
To claim gout as a secondary disability, you’ll want to request a nexus letter from your primary physician that connects your gout to the primary service-connected disability. A nexus letter helps the VA evaluate your claim and improves your chances of receiving a finding in your favor.
Gout Aggravated by Service
If you had asymptomatic gout before joining the military, and you feel your time in service worsened your condition, the VA may provide you with a disability rating for gout. To prove your military service aggravated your gout, you’ll want clear records demonstrating the worsening of your condition from the time you joined the service.
Physician records from your time in service and after discharge can help you prove aggravation. If any specific incidents during your time in the military worsened your condition, you should also provide your service records.
How To Obtain VA Disability Compensation for Gout?
To initiate the disability compensation process, you’ll need to file a claim with the VA. In your claim, include copies of all your medical records concerning gout and any service records that document specific incidents that led to your current condition. A qualified physician can provide you with a gout diagnosis. It helps to have a nexus letter that ties the gout to your time in the military.
Once the VA receives your claim, they’ll likely schedule you for a Compensation and Pension exam (C&P) at a VA facility near you. During the C&P exam, the provider will perform a physical exam and review your medical and service records. Following their review, they’ll complete the appropriate Disability Benefits Questionnaire (DBQ) and submit all your information to the VA.
The DBQ will vary depending on the joints affected by your gout. For instance, if gout occurs in your feet, the examiner will use the DBQ for Foot Conditions. The provider will complete the DBQ for the Knee and Lower Leg if your gout impacts your knees or ankles.
Review the appropriate DBQ before your examination so that you know what to expect. Bring copies of your medical records to ensure the provider has everything they need to complete the DBQ and your claim.
Once the VA receives the DBQ and supporting documents, they’ll make a final decision on your claim. Usually, it takes between three to four months to finalize their decision.
If you have additional questions concerning a gout VA disability rating, don’t hesitate to contact Veterans Guide. We’re here to assist you through the VA disability claims process.
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