What Is Gout?
Gout is a complex and common form of degenerative arthritis that is characterized by sudden, severe attacks of pain, swelling, redness and tenderness in one or more joints. An attack of gout can occur suddenly, often in the big toe, and feel as if the toe is on fire. The affected joint usually becomes hot and swollen, and so tender that even the slightest weight on it may seem intolerable. The most common signs and symptoms of gout are:
- Intense joint pain. While gout commonly affects the big toe, it can also occur in other joints, such as the knees, ankles, elbows, wrists and fingers. The pain is often the most severe within the first four to twelve hours after onset.
- Lingering discomfort. After the most severe pain subsides, the affected joint(s) may feel uncomfortable for a few days to weeks afterwards.
- Inflammation and redness. The affected joint often becomes swollen, warm, tender and red during a gout episode.
- Limited range of motion. As gout progresses, the affected joints may not move normally or may lose some range of motion.
Gout is caused by the accumulation of urate crystals in the joint, which leads to the inflammation and intense pain associated with gout attacks. Urate crystals often form when one has high levels of uric acid in the blood. Uric acid is a byproduct of the breakdown of purines, so consumption of purine-rich foods is one of the most common causes of uric acid build up. Alcoholic beverages, fructose-sweetened drinks, red meat, and several different types of seafood are all purine-rich foods which could lead to an increased concentration of uric acid in the blood. Normally, uric acid dissolves in the blood and is filtered out by the kidneys into urine. However, the body sometimes produces too much uric acid or the kidneys excrete too little uric acid, which can then cause a build up in the bloodstream and lead to the formation of sharp, needlelike urate crystals in the joints, causing gout.
Gout And Veterans
Because diet, weight, certain medical conditions like diabetes and obesity, and certain medications can all contribute to the development of gout, veterans are a key population group affected by this disease. Many veterans who have physical or mental disabilities caused by their military service lead a more sedentary lifestyle than the general population, which can lead to the development of gout in their joints. Due to the high occurrence of gout among veterans, with nearly six percent of all VHA patients reporting a diagnosis of gout in 2014, the existence of a VA disability rating schedule for gout is absolutely necessary to ensure that veterans are being justly compensated for their service-connected condition.
How The VA Rates Gout
Under 38 CFR § 4.71a, the VA evaluates gout (diagnostic code 5017) as degenerative arthritis, and assigns a rating based on the limitation of motion of the affected joints. Each joint in the body has its own disability rating schedule for limitation of motion, so the VA evaluates each gout-affected joint based on that joint’s specific disability rating schedule. For example, the limitation of movement disability rating schedule for the leg (at the knee joint) is as follows:
Diagnostic Code 5260: Leg, limitation of flexion of
- 30 – Flexion limited to 15°
- 20 – Flexion limited to 30°
- 10 – Flexion limited to 45°
- 0 – Flexion limited to 60°
Diagnostic Code 5261: Leg, limitation of extension of
- 50 – Extension limited to 45°
- 40 – Extension limited to 30°
- 30 – Extension limited to 20°
- 20 – Extension limited to 15°
- 10 – Extension limited to 10°
- 0 – Extension limited to 5°
Get Help With Your Gout VA Claim
If you are a veteran with gout, and are looking to apply for service connection for your condition or appeal an unfavorable VA rating decision, please contact our office today. Our experienced veterans disability attorneys are ready to get you the compensation you deserve.