Gout is an extremely painful type of arthritis cause by the buildup of excess uric acid in the body. Too much uric acid can cause crystals to form in the joints, most commonly the big toe. Uric acid buildup can also lead to kidney stones.
The symptoms of gout include pain, swelling, redness, heat, and stiffness in the joints. Although the big toe is the most common location for gout, it can also form in the ankles, heels, knees, wrists, fingers, and elbows. Gout can either be chronic or acute. Acute gout is treatable with medications and lifestyle changes. Chronic gout can cause painful deformity of the joints and is less effectively treated.
If you suffer from chronic gout (sometimes referred to as refractory gout or recalcitrant gout), you may be approved automatically for disability benefits if your gout meets (fulfills the requirements of) the Social Security Administration's (SSA) listing requirements for inflammatory arthritis.
To meet the listing, you must be diagnosed by your rheumatologist with gout and experience the chronic inflammation or ongoing deformity of either:
You may want to review the requirements of the inflammatory arthritis listing with your treating physician to determine if you meet the requirements.
The symptoms of acute gout can usually be treated effectively with medication, and go away within weeks. Also, acute gout is often preventable with lifestyle modifications such as the avoidance of alcohol and fatty foods. Therefore, it may be hard to meet the standard SSA requirement that your disability last, or be expected to last, at least one year.
If your gout attack has lasted less than 12 months, the Social Security Administration (SSA) will determine if your gout is likely to satisfy the durational requirement. To make this determination, the SSA will consider lab results, treatments you have undergone, your response to the treatment, whether you have had any complications from your gout, the frequency of the attacks, and the opinions of your treating doctors about your prognosis.
If the SSA determines that your gout meets the durational requirement but not the requirements of a disability listing, it will next decide whether your symptoms prevent you from performing your old job. If the SSA decides you can still do your past work, your claim will be denied. However, if the SSA determines that your gout prevents you from performing your old job, it must next decide if there are other jobs you can do.
At this point, the SSA will prepare a residual functional capacity assessment (RFC) that discusses how your gout affects your ability to perform work-related activities. For example, people with gout often experience pain and swelling in multiple joints, especially the toes. If you have developed gout in your toes, it may be difficult for you to walk or stand for extended periods of time. This would prevent you from working some types of jobs. If you have developed gout in your dominant hand, you may be unable to perform tasks that require writing or typing. This would also reduce the number of jobs you could do. If there are no jobs left that you can do, given your skill set and education, you could be found disabled.
The pain from gout can also interfere with attendance, performance, and reliability. If you have a 20% reduction in your productivity due to gout, the SSA is supposed to find you disabled. (For more information, see our article on qualifying for disability due to reduced productivity.)
You should ask your treating physician to prepare an RFC for you detailing the limitations on your ability to work, and why your gout symptoms prevent you from working.
For more information, see our section on getting disability through an RFC.
In addition to the durational requirements discussed above, to be approved for SSDI or SSI, you may not earn more than about $1,300 per month from working, and your gout must significantly interfere with your ability to work for at least a year.
SSI is a need-based benefit for people with little employment history. To be eligible for SSI, you cannot exceed the income and asset limits set by the SSA. For more information, see our article on SSI eligibility.
SSDI is a benefit available to people with a qualifying work history with employers who paid taxes to the SSA. For more information see our article on SSDI eligibility.