Gout is a form of inflammatory arthritis that can cause joint stiffness, swelling, and redness. For people who suffer from the most severe cases of gout, permanent damage can occur in the kidneys and joints. In most cases, you must undergo an examination of persistent inflammation and deformities to determine your level of severity. So, can you get disability for gout? Below, we’ll explain the eligibility requirements to get Social Security disability benefits for gout before you apply.
What is Gout? Symptoms and Side Effects
Gout is a type of inflammatory arthritis caused by the accumulation of uric acid crystals in the joints. This condition causes sudden and severe pain, swelling, redness, and warmth in the affected joints, usually starting with the big toe. Gout attacks can happen suddenly, often waking you up at night with a feeling that the affected joint is on fire. Repeated episodes can lead to chronic gout which can cause joint damage and deformity. Gout can also cause kidney stones and decreased kidney function.
Does the SSA Consider Gout a Disability?
To be eligible for disability benefits due to gout, the Social Security Administration (SSA) requires that the condition meets the criteria under the listing for inflammatory arthritis (Listing 14.09). This means showing that gout causes severe functional limitations such as being unable to walk or do daily activities.
To qualify, gout must severely impact your ability to work and daily activities. The condition must be well documented, showing persistent or frequent flare-ups that severely limit joint function. Medical records including doctor’s notes, imaging studies, and lab results are essential to show the extent of the disability. Without enough evidence, proving gout as a disabling condition can be difficult.
Disability Criteria From the SSA
The SSA evaluates disability claims based on specific criteria to determine if you are eligible for benefits. The condition must severely limit your ability to do basic work activities for at least 12 months. The SSA uses a 5 step process that includes non-medical criteria, the severity of the condition if it meets or equals a listed impairment, and whether you can do your past work or any other work. Medical evidence must be comprehensive to support your claim and show the severity of the condition.
How Hard Is It to Get Disability for Gout?
Obtaining disability benefits for gout can be challenging due to the stringent criteria set by the SSA. The difficulty lies in proving that gout significantly limits your ability to work and perform daily activities. Successful claims require extensive medical documentation, including evidence of frequent and severe flare-ups, treatment history, and the impact on physical functions. The SSA also considers your age, education, and work history, making it essential to present a comprehensive case that demonstrates the severity and persistence of your condition.
Which Gout Symptoms Might Limit Your Ability to Work?
Gout symptoms will severely limit your ability to work and daily activities. Intense joint pain especially in the big toes, feet, ankles, and knees will make standing or walking difficult. Swelling, redness, and painful warmth in the affected joints will further limit movement. Chronic gout can cause joint damage and deformity, which will impair dexterity and coordination. Kidney stones can exacerbate the condition and cause other health issues. These symptoms will cause significant work limitations and impact your job performance and daily living.
Other Medical Conditions & Comorbidities That May Help You Get Disability for Gout
Other medical conditions and comorbidities like diabetes and kidney disease can help your gout disability claim. Gout patients may also suffer from related conditions, such as rheumatoid arthritis, Crohn’s disease, celiac disease, and chronic fatigue syndrome.
These conditions will exacerbate gout symptoms and cause more frequent and severe flare-ups. Documenting these comorbidities along with your gout diagnosis will show the overall impact on your health and ability to work and increase your chances of getting disability benefits.
Medical Evidence You’ll Need for Your Gout Disability Claim
You need to prove your gout disability claim with substantial medical evidence to show the severity and impact of the condition on your ability to work. Extensive documentation, including medical records, doctor’s notes, and lab results, is necessary. Evidence that work activities trigger your symptoms and proof of related medical conditions will help as well.
Medical Records
Providing medical records will support your gout disability claim. This includes a detailed medical history and documentation of your gout diagnosis. Imaging studies like X-rays and MRIs showing joint damage are also important.
Medical Evidence
Doctor’s notes showing the severity and frequency of your gout attacks and lab results showing high uric acid levels are the foundation of your medical evidence. These will show the impact of gout on your daily living.
Evidence that Work Triggers Your Symptoms
Gathering evidence that work activities trigger your symptoms will help your claim. This includes documentation of work-related flare-ups and statements from employers or coworkers about your observed limitations.
Proof of Other Conditions
Finally, providing proof of related health conditions, such as kidney disease or diabetes, can support your claim. These conditions often exacerbate gout symptoms, demonstrating a more significant impact on your ability to work.
How to Apply for Gout Disability Benefits
Before you can get Social Security disability benefits for gout, a rheumatologist must first diagnose you with the condition. Then, you must meet all criteria that proves it forces you to stop working for at least 12 months. The SSA defines your gout as “debilitating” if the following applies to you:
- Chronic inflammation is present in a weight-bearing joint that limits your ability to perform your job duties.
- Daily tasks are affected by major damage in each upper extremity, such as both arms, wrists or shoulders.
In order to receive disability benefits, your health must prevent you from working at all for at least one year. That extends to include other jobs that pay similar wages and use the same skillset you currently possess. If your symptoms improve in less than 12 months or your gout goes away, then the SSA will deny you benefits.
Applying for Social Security Disability Insurance (SSDI) With Gout
To apply for SSDI, you must demonstrate that your gout significantly impairs your ability to work. Begin by filling out the SSA’s application form, including detailed medical records, doctor’s notes, and evidence of how gout affects your daily activities. It’s crucial to show that your condition meets the SSA’s criteria for inflammatory arthritis and has lasted, or is expected to last, at least 12 months.
SSDI is based on your work history and the Social Security taxes you have paid. As of 2024, SSDI benefits range from $100 to $3,822 per month, with the average monthly benefit being about $1,537.
Applying for Supplemental Security Income (SSI) With Gout
The SSI application process is similar but is designed for individuals with limited income and resources. You must provide the same medical documentation and demonstrate that your gout prevents you from working. SSI does not require a work history, making it accessible to those who haven’t worked enough to qualify for SSDI.
As of 2024, the federal SSI benefit rate is $943 per month for an individual and $1415 per month for a couple. Financial eligibility criteria must be met, including having limited income and resources below $2,000 for an individual or $3,000 for a couple.
Work With a Disability Lawyer to Improve Your Odds of Approval
Consulting disability attorney or advocate is the fastest, easiest way to see if you have a valid claim. Many people don’t realize you won’t pay anything now to get a Social Security attorney or advocate to file your application. An experienced legal representative can give you advice over the phone without charging you any out-of-pocket fees. Unless your representative helps you win Social Security disability benefits for gout, you pay $0 for legal assistance. And if your case wins, then you’ll only pay a small, one-time fee.
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Shay Fleming is the SEO Content Manager at LeadingResponse. A proud graduate of Texas State University, she has been based in Austin since 2016, where she lives with her dog. Shay has contributed extensively to various domains, writing and publishing articles about real estate, investing, disability, and urban living.
