Gout and Filing for Disability
If you suffer from gout, your ability to work is most likely impacted and therefore it could be considered a valid medical condition to list on an application for Social Security Disability or SSI disability.
Gout is a chronic condition that causes recurring episodes of acute inflammatory arthritis. This inflammatory arthritis or rheumatic disease does not have a specific listing but it would most likely be evaluated under the immune system classification. Were it listed in the SSA Blue Book it would fall under 14.09 - Inflammatory Arthritis.
Immune system impairments (lupus for example) are defined by the Social Security Administration as being disorders of the immune system that are caused by dysfunctional immune responses that are directed against your body's own tissues, resulting in chronic multisystem impairments. They sometimes are referred to as rheumatic diseases, connective tissue disorders, or collagen vascular disorders.
Gout approvals, medical records, and work history
Because gout does not have its own listing in the SSA listings (in spite of being a commonly listed condition on SSD and SSI claims), a person filing for disability on the basis of gout must prove that they can no longer perform SGA level work (which means not being able to earn more than the SGA limit found here: SSA earnings limit).
This can be accomplished through A) the information contained in your medical records, and through B) the information provided in your vocational work history; specifically, the types of work you have done, the functional requirements of each of those jobs, as well as the skills you may possess that could enable a transition to some other type of work.
Very often disability applicants are surprised to learn that simply being diagnosed with a certain condition will not qualify them for disability. In actuality, Social Security considers the severity of a disability applicant's functional limitation and how those limitations impact their ability to engage in work activity.
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
More on qualifying for disability benefits with Gout
Whether or not you qualify for disability with Gout and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits with Gout will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
Facts about Gout
1) Gout is a form of painful arthritis that normally affects the big toe. It is caused by high quantities of uric acid in the bloodstream and is marked by pain, tenderness and swelling of the affected area. It can lead to acute gouty arthritis.
2) While nearly 75 percent of gout attacks are located at the big toe, it can also affect the knee, spine, fingers, ankles, heel, elbow, and other toes.
3) Many years ago gout was referred to as the "Rich man's disease" or "The Disease of Kings' and was treated with gin, although gin was eventually found to be ineffective.
4) Overall, middle-aged men experience gout more than women, but the risk of gout increases in women after menopause, when women's uric acid levels tend to increase.
5) There are four stages to gout: asymptomatic, acute, intercritical, and chronic. Gout can be a once-in-a-lifetime occurrence, or it can be recurrent. If it is recurrent, it may be treated each time.
6) Gout is treatable through over-the-counter medications, prescribed medications, and a low purine diet. During a gout attack, patients should increase the amount of water consumption, cut out all alcohol, and eat a low fat, low protein diet. Studies have shown that animal flesh consumption increases the chances of gout, and that dairy consumption decreases the chances of gout.
7) Kidney stones are a common complication with gout. Drinking water, limiting or excluding alcohol and certain medications can help treat kidney stones.
8) People who are obese, regular alcohol drinkers, and those with diseases such as kidney disease, sickle cell anemia and diabetes are more likely to develop gout. Gout can also develop in people who are eating high purine diets or those who take medications that disturb the secretion of uric acid in the body, such as low doses of aspirin and thiazide diuretics.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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