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October 4, 2024

Guide to Winning a Gout VA Rating

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Are you a veteran dealing with gout? If so, you may be wondering if you qualify for VA disability and what your VA rating for gout might be.

In this Insider’s Guide, we explore gout VA disability questions and provide tips and facts about how you can qualify for VA compensation and benefits for gout.

Let’s begin.

VA RATING FOR GOUT.

Can I Get a VA Rating for Gout?

Yes. However, not all cases are severe enough to qualify for a gout VA disability rating. The key is prove that your military service caused your condition—either directly (primary connection) or due to another service connected disability (secondary connection).

If you can prove that your gout is a service connected condition that significantly impairs your ability to work or engage in daily activities, you may be eligible for assistance in the form of benefits and VA monthly compensation.

It’s essential for veterans seeking a VA rating for gout to provide medical evidence of their condition and its effects when applying for VA benefits to ensure they receive the appropriate support and compensation.

The severity of your gout symptoms and its impact on your ability to work and perform daily activities will determine your gout rating, which determines the VA monthly compensation you will receive.

Gout VA Disability Ratings

In theory, gout VA disability ratings range from 0% to 100% in increments of 10%, based on factors including limitation of motion of the joint(s) affected. The most common VA rating for gout is 10% or 20% (for each joint that has gout).

If there is no limitation of motion, gout is rated as follows:

  • With X-ray evidence of involvement of 2 or more major joints or two or more minor joint groups, with occasional incapacitating exacerbations (20%)
  • With X-ray evidence of involvement of 2 or more major joints or two or more minor joint groups (10%)

To qualify for disability benefits and compensation, your condition must be service-connected, which means it was either caused or aggravated by your military service.

VA DISABILITY GOUT

Gout VA Rating Criteria

The VA evaluates gout under Diagnostic Code 5003, degenerative arthritis. To establish a VA disability rating for gout, you will need to provide medical evidence showing a diagnosis of gout and its severity. 

The VA rates gout based on factors such as:

  • Limitation of Motion: In simpler terms, it means that the joint affected by gout may not move as freely or fully as a healthy joint would. This limitation can result from pain, stiffness, inflammation, or joint damage caused by gout.
  • Frequency and Severity of Attacks: The VA will consider how often you experience gout attacks and their severity. Frequent and severe attacks may result in a higher disability rating.
  • Functional Impairment: If your gout significantly impairs your ability to walk, stand, or perform tasks necessary for employment, you may be eligible for a higher rating.
  • Joint Involvement: Gout can affect multiple joints. The more joints affected, the higher your potential disability rating.
  • Chronic Joint Changes: If you have chronic joint damage or deformities as a result of gout, this can also impact your rating.
  • Medication and Treatment: The VA will consider the effectiveness of your treatment and the side effects of medications you are taking for gout.
  • Evidence of Flare-Ups: Documentation of gout flare-ups and their impact on your daily life is crucial for establishing the severity of your condition.

How To Receive a VA Disability Rating for Gout

To receive a VA rating for gout, you will need a service connection for gout. This can be a direct service connection for gout or a secondary service connection (e.g., gout secondary to hypertension).

To get service connected for gout,  you’ll need:

  1. A current diagnosis
  2. An in-service event, injury, aggravation, or illness
  3. A medical nexus (link) between the current diagnosis and the in-service event, injury, aggravation, or illness. 

Secondary Service Connections for Gout

A secondary condition occurs when a primary or direct service-connected disability has caused (or aggravated) a new or pre-existing condition, illness, or injury.  

For example, if you are service-connected for hypertension and develop gout because of your hypertension, you could be eligible for VA compensation for gout secondary to hypertension. 

The same secondary service connection is possible if you develop gout secondary to PTSD. 

The VA rates secondary conditions the same as primary conditions, and it’s very possible to increase your combined VA rating through a secondary service connection. Oftentimes with a secondary service connection, a Nexus Letter is crucial in proving the link between your primary and secondary condition.

Conclusion

Gout can be a painful and debilitating condition, and veterans suffering from it may be eligible for a VA rating for gout. Understanding the VA rating system for gout and providing adequate medical evidence is crucial to receiving the compensation you deserve. Additionally, a Nexus Letter for gout can increase your chances of service connection, especially if you are pursuing a secondary service connection for gout.

If your condition affects your ability to work or enjoy a good quality of life, don’t hesitate to schedule your FREE VA Claims Insider Discovery Call.

Our expert Veteran Coaches have successfully educated and guided over 25,000 veterans through the VA disability claims process.

(FAQs) Frequently Asked Questions

What is Gout?

Gout is a form of arthritis characterized by the accumulation of uric acid crystals in the joints, leading to sudden and severe bouts of pain, inflammation, and swelling. Gout often affects the big toe, ankle, and knee joints but can occur in any body joint.

What are the signs and symptoms of gout?

  • Intense joint pain. Gout usually affects the large joint of the big toe but can also affect the ankles, knees, elbows, wrists, and fingers. 
  • Lingering discomfort. After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks.
  • Inflammation and redness. The affected joint(s) become swollen, tender, warm, and red.
  • Limited range of motion. As gout progresses, you may be unable to move your joints normally.

Is there gout VA disability?

Yes, although not all cases of gout are severe enough to qualify for a VA rating for gout.

What evidence do I need to qualify for gout VA disability?

To apply, gather medical evidence such as diagnosis records, Independent Medical Opinion or Nexus Letter, treatment history, documentation of gout attacks, and any supporting information from healthcare professionals. This evidence will be crucial in establishing the severity of your condition.

Yes, if you have developed chronic joint damage or deformities, it can impact your gout VA disability rating and compensation level.

What happens during a Compensation and Pension (C&P) examination for gout?

The VA may schedule you for a C&P exam to assess the severity of your gout. A healthcare provider will evaluate your condition and provide a report that the VA will use to determine your disability rating.

How long does it take to receive VA disability benefits for gout?

The processing time for VA disability claims can vary but typically takes several months. Factors such as the complexity of your case, the VA backlog, and the availability of medical evidence can influence the timeline.

Can I appeal a VA disability rating decision for gout if I disagree with it?

Yes. If you disagree with the VA’s rating decision, you have options. You can request a higher-level review or a supplemental appeal or choose to appeal to the Board of Veterans Appeals (BVA).

What should I do if my gout worsens after my initial VA disability rating is assigned?

If your gout worsens or your condition changes, you can apply for a gout VA disability increase by providing updated medical evidence of the increased severity of your condition. This can result in a higher disability rating and increased compensation.

NEED MORE ASSISTANCE?

Most veterans are underrated for their disabilities and, therefore, not getting the compensation they’re due. At VA Claims Insider, we help you understand and take control of the claims process, so you can get the rating and compensation you deserve—FAST.

If you’ve filed your VA disability claim and have been denied or have received a low rating—or you’re unsure how to get started—reach out to us! Take advantage of a VA Claim Discovery Call. Learn what you’ve been missing—so you can get the VA rating you deserve!

Brian Reese
Brian Reese

Brian Reese

Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.

A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.

Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.

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