Gout is a form of inflammatory arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in the joints. It often affects the joint at the base of the big toe. The U.S. Department of Veterans Affairs (the VA) considers gout a compensable disability for some military service veterans.
Here, we’ll cover how the VA assigns disability ratings for successful gout claims, how to make a claim for gout VA benefits, what causes gout, and the symptoms of the condition.
To learn more about how to file an initial or supplemental claim for VA disability benefits for gout, call Stone Rose Law at (480) 498-8998.
If the VA approves your disability benefits claim for gout, then the VA will assign a disability rating for you. The VA will give you a higher or lower rating depending on several factors, including:
The VA’s medical code to evaluate gout is 5017, the code for degenerative arthritis. The VA will evaluate the severity of your gout based on degree-based limitation of flexion and limitation of extension motions of the joints involved. Here are some of the disability ratings the VA can assign to you based on these measurements:
If you are experiencing no limitation of motion, then the VA will rate your gout disability as follows:
The most common VA rating veterans receive for gout is 10% or 20% for each affected body part or joint.
If you have a 0% disability rating, you cannot receive monthly compensation benefits from the VA. However, you can still be eligible for other VA benefits, including healthcare benefits for your gout condition.
In addition to limitations in your range of motion, the VA will also consider the frequency of gout flare-ups or exacerbations you experience each year.
For example, if you have one or two gout flare-ups annually, this could lead to a 20% VA disability rating, but if you have three or more flare-ups, this could produce a 40% VA rating.
Four or more flare-ups per year, combined with other symptoms like anemia or documented weight loss, could lead to a 60% disability rating.
Even though a VA disability rating for gout may not reach 100%, if your gout condition exists in combination with one or more VA disabilities and you cannot obtain or keep substantially gainful employment, you may qualify for total disability benefits based on total disability individual unemployability (TDIU).
There are two main ways you can qualify for TDIU benefits with an eczema VA rating: schedular and extraschedular.
To find out more about how combined VA disability ratings work, see our VA Disability Calculator page.
In some cases, if the VA considers your gout condition to be uniquely severe enough to keep you from substantially gainful employment, the VA can still give you TDIU.
The VA disability claims process for gout is the same as for other claims that are not presumptive in nature. You need to:
You file a claim for gout using VA Form 21-526EZ. You can submit this form online, by mail, or in person at your nearest VA Regional Office.
Along with this form, you will need to include supporting documentary medical evidence in the form of medical records of diagnosis, treatment history, a nexus letter your treating doctor prepares for you, and “buddy letters” from people you know who can attest to the effects your gout condition is having on your life and your ability to work.
Sometimes, another disability that you already have a VA disability rating for can lead to a gout condition. This is known as a secondary service connection.
Examples of other medical conditions that can contribute to gout as a secondary service connection include:
Proving a secondary service connection depends on establishing a nexus to the primary disability. This nexus must convince the VA that it is at least as likely as not that the primary disability led to your gout secondary condition.
You may have had a mild gout condition that was asymptomatic when you entered military service. If the conditions of your service made this pre-existing condition worse, then this worsening can be the basis of a disability claim based on aggravation.
Once you have submitted your benefits claim to the VA, you may receive a request to meet with a VA examiner in a C&P examination. This exam gives the VA the chance to gather more information about your claim, your symptoms, and the effects that gout is having on your life.
The C&P exam usually consists of the VA examiner reviewing your claim documentation, including your personal medical records, any VA medical records you may have, as well as supporting documents. The examiner will ask you questions about your gout condition, and may have you undergo a physical examination.
If your treating doctor has not already completed a Disability Benefits Questionnaire (DBQ) for you as part of your benefits claim submittal, then the VA examiner may complete a DBQ as part of the C&P exam. Although no DBQ form exists specifically for gout, the examiner will use a form corresponding to the body part or affected joint, such as the DBQ for foot conditions or the DBQ for knee, ankle, and lower leg conditions.
Upon completing the C&P exam, the VA examiner will prepare a written report and send it along with the DBQ to your local regional office for evaluation on whether to approve your disability benefits claim and to assign you a VA disability rating if it does.
Gout results from a buildup of uric acid in your body. Uric acid is a natural waste product that comes from your digestion of foods containing purine.
Purines are molecules made up of carbon and nitrogen atoms. These molecules are found in your cell’s DNA and RNA. If the amount of purines in your body is out of balance with your ability to process them, too much uric acid can build up in your bloodstream. This condition is called hyperuricemia, which can lead to the formation of urate crystals and cause you to develop gout.
Aside from excess amounts of purines, several other factors can contribute to elevated levels of uric acid in your system. These include your dietary choices, your weight, whether you suffer from diabetes or heart disease, your family history, and whether you are taking certain medications.
Some specific contributors to gout are:
For military veterans, the risk of gout developing during service is generally lower than it is for the civilian population because your higher level of physical activity and conditioning means you are less likely to lead a sedentary lifestyle. Still, your chances of a gout condition can increase from experiencing sudden trauma events like accidents or explosions that affect your joints.
Gout symptoms often arise in the big toes of your feet, with an intense burning sensation, like they are on fire. Sometimes, gout affects other parts of your body, including your ankles, knees, elbows, wrists, and fingers. You can also see redness, swelling, and feel tenderness in affected areas.
Episodes of gout frequently start at night when you are sleeping. The pain is worst in the first four to 12 hours but can linger at a lower level for a couple of days or even weeks.
Other signs and symptoms of gout may include limited range of motion in affected body parts and the development of kidney stones. Sometimes, however, gout may be asymptomatic, meaning it may not manifest through pain or other noticeable symptoms.
The VA does not always approve benefits claims on the first attempt. This can be for several reasons, like an incomplete application or not enough supporting documentary evidence for the VA to decide on the claim. Sometimes, the VA itself can make a mistake in processing your claim.
Regardless of the reason for a claim denial, you still have options. These include filing a supplemental claim that provides the VA with new and relevant evidence to consider in support of your claim or more formal appeals procedures like requesting a higher authority to review your claim, requesting a different reviewer, or a formal request for an appeal hearing.
At Stone Rose Law, our board-certified VA claims lawyers assist veterans nationwide with affordable, high-quality legal assistance. Our veterans lawyers provide professional legal representation to help you through the VA process to receive all the VA disability compensation you deserve.
A Stone Rose Law VA disability lawyer can help you prepare your gout disability claim, monitor your claim status, and consult with you before disability examinations at no cost to you. If the VA denies your original claim, then our VA benefits law firm will assign a VA disability appeals lawyer to help you prepare a supplemental claim with new and relevant information, or to pursue a VA appeal with the Board of Veterans Appeals while providing free representation on a contingency fee basis.
For more information about how one of our VA disability lawyers can help you with your gout VA compensation initial claim, supplemental claim, or appeal, request a free consultation at (480) 498-8998. Or reach us online.
