Disability for gout - is it given and how to get it

Gout is a fairly serious systemic disease, as a result of which multiple disorders develop that significantly aggravate the patient’s condition.

As the pathology progresses, a person often loses the ability to move freely in space and independently serve his needs, that is, he becomes disabled. Therefore, patients with such a disease often have a question: is disability given for gout, and how to get it?

Features of the pathological process

It is men who most often suffer from gout. In women, this disease is extremely rarely detected. It is completely impossible to get rid of the disease, regardless of the patient’s age, gender, or the stage of neglect of the pathology itself.

According to experts, the development of the disease is based on a genetic factor, which explains the suddenness of the first signs of the disease, gender characteristics, as well as the fact that no method will permanently eliminate the malfunction in the body. All of the above qualities are characteristic of hereditary diseases.

Clinically, gout occurs in stages:

First stage. An increased amount of uric acid is recorded in the blood. There are no clinical symptoms. No complaints. Already at the initial stage, kidney tissue is affected, and salt deposits can be noticed in the articular formations.
Second phase. The patient develops gouty arthritis. The pathology manifests itself on the big toe of the lower limb, then affects the joints of the hands.
Third stage. A period of remission begins. The pain subsides partially or completely. If attacks do occur, they do not last long. The period of relative calm lasts from 6 to 13 months.
The fourth stage is the most severe phase of the pathological process. Tophi gout occurs. The dermal tissue is deformed due to the development of multiple nodes. The attacks become more frequent, the pain syndrome is more intense. Sometimes remission does not occur at all.

How to register a disability: about passing a medical and social examination

The decision to recognize a person as disabled is made by federal state institutions of medical and social examination based on the results of the examination. However, the Moscow Department of Labor and Social Protection receives many questions about how to register disability. We describe the algorithm of actions.

A referral for a medical and social examination (MSE) can be obtained from medical organizations, as well as from bodies providing pensions, from social protection bodies if the citizen has medical documents confirming impairment of body functions due to diseases, consequences of injuries or defects. Only the attending physician, knowing the diagnosis, results of treatment, rehabilitation and habilitation of the patient, determines whether there are signs of disability, so it is best to contact him for a referral for medical examination.

To pass the ITU, the corresponding application and necessary documents are submitted to the ITU office at the place of residence. Information on the addresses of divisions of the Bureau of Medical and Social Expertise in cities and regions can be found on the website.

List of documents for examination at the Bureau of Medical and Social Expertise:

Consent of the citizen (his legal or authorized representative);
An identification document (passport or other identification document), for foreign citizens and stateless persons permanently residing in the territory of the Russian Federation - additionally a “residence permit”; the refugee certificate is presented in person, for non-resident citizens - a certificate of registration at the place of residence;
A referral for a medical and social examination issued by a medical organization or a social protection authority, or a pension authority;
Report on an industrial accident in form N-1 (certified copy);
Act on occupational disease (certified copy);
For those discharged from military service - a certificate of illness drawn up by the Military Military Commission (certified copy, the original must be presented in person);
Conclusion of the interdepartmental expert council on the causal relationship of the disease, disability with exposure to radioactive factors (certified copy, original presented in person);
Certificate of participant in the liquidation of the consequences of the accident at the Chernobyl nuclear power plant or living in the exclusion or resettlement zone (copy, original presented in person);
A copy of the work record;
Medical or military medical documents indicating the citizen’s state of health (outpatient card, hospital extracts, consultant reports, examination results, Red Army or military record book, certificate of injury, etc.);
Professional and production characteristics from the last place of work.

During the examination, bureau specialists will study the submitted documents, as well as social, everyday, professional and other aspects of the candidate’s life.

A person recognized as disabled receives a certificate of disability indicating the assigned group, as well as an individual rehabilitation or habilitation program (IPRA).

If, based on the results of the examination, a person is not recognized as disabled, then, at the request of the applicant, he is issued a certificate of the results of the medical examination. You can appeal the decision of the ITU within a month from the date of the examination by contacting the bureau that conducted the ITU, in writing on paper or electronically on the State Services website. The bureau also operates a hotline for medical and social examination issues.

We remind you:

Re-examination of people with disabilities of group I is carried out once every 2 years, groups II and III - once a year, and children with disabilities - once during the period for which the child is classified as a “disabled child”.

Important:

During the period from October 2, 2021 to March 1, 2021 inclusive, the “Temporary Procedure for Recognizing a Person as Disabled” (Temporary Procedure) is in effect. Medical and social examination is carried out in absentia .

Recognition of a citizen as a disabled person whose re-examination period begins during the period of validity of the Temporary Order, in the absence of a referral to medical examination, is carried out by extending the previously established disability group (category “disabled child”), the cause of disability, as well as the development of a new individual rehabilitation or habilitation program for a disabled person (child). -disabled person), including previously recommended rehabilitation or habilitation measures.

Disability is extended for a period of 6 months and is established from the date until which the disability was established during the previous examination.

Extension of disability for a citizen who, during a previous examination, was assigned the category of “disabled child” before reaching the age of 18 years and whose re-examination period begins during the period of validity of the Temporary Order, is carried out by establishing disability group I, II or III for a period of 6 months in accordance with the conclusion federal state institution of medical and social examination on the severity of persistent disorders of body functions resulting from diseases, consequences of injuries or defects, information about which is available in the protocol of the citizen’s MSA at the federal state institution of medical and social examination at the last examination.

Extension of disability is carried out without requiring the citizen (his legal or authorized representative) to submit an application for medical examination. In this case, the written consent of the citizen is not required.

Press service of the Department of Labor and Social Protection of the Population of Moscow

Registration of disability

Gout gives disability . However, the organizational process itself is quite specific. This is normal for questions of this profile. To obtain such status, the patient must undergo a medical and social commission.

During this complex event, specialists must evaluate all factors that may influence, to one degree or another, the assignment of disability. After receiving the initial conclusion, I schedule an appropriate examination. Only after this can a specific disability group be assigned to the patient.

Registration process

You can register a disability by coming for a medical examination and commission, or you can go through it at home if the patient is unable to come. A disability group is established only if there is a confirmed disease included in the list on the basis of which a group can be obtained. But in addition to the above, the presence of two more factors is necessary - a persistent disruption of the functioning of the body, a complete or partial limitation of a person’s life, as well as the need for rehabilitation or social protection of people with disabilities.

If all the conditions are present, you must visit your attending physician, who will refer you to a doctor’s commission. The commission will consider this issue and provide a referral to the ITU Bureau, where a decision will be made on establishing the disability and the group. To visit the ITU office, you must have a passport, a referral from a medical institution in form 188-u and a completed application.

Disability groups

The attending physician tells the patient how to obtain disability in case of chronic gouty arthritis, as well as in the tophi form of the pathology. He can also explain what disability groups exist:

First group. Patients who belong to this group are the most difficult to evaluate based on basic parameters. This category includes patients with gout who are able to independently run a household, take care of themselves, navigate in space, and also contact with society at an optimal level. Optimal motor activity is maintained in the joint area, the range of motion is satisfactory (close to full). For people included in the first group, certain working conditions are created that allow them to work taking into account the characteristics of their pathological condition.
Second group. In this case, gout is more advanced, and disability is caused by a number of functional disorders. The range of joint movements is partially limited. People, despite constant discomfort, can take care of themselves and lead a completely active lifestyle. Patients are usually employed, but certain conditions are created at the workplace. Shortened working hours are also provided. Regarding social norms, some concessions are also required.
Third group. A similar disability for gout in Russia is assigned if a person suffers from severe impairments. Restrictions on physical activity lead to a deterioration in the quality of life, which means they can also affect the performance of a person with gout. In this case, the patient may need help from social services.

Disabled status, design and group

Disability is established in a person when he cannot work and exist independently, without restrictions and obstacles. It is associated not only with physical symptoms, but also with mental, mental and sensory deviations from normal norms. In order to obtain this status, it is necessary to undergo a medical and social examination, which will evaluate all the factors affecting the applicant for disability. Based on the results of the examination, a person is assigned certain benefits, a pension and restrictions in labor relations.

There are 3 types of disability groups, defined by certain characteristics and criteria for health and mental disorders, or acquired as a result of certain diseases or injuries. The first group of disabilities includes people who are unable to take care of themselves in everyday life, move, navigate, communicate, control their actions without additional help, or who are completely dependent on the help of another person. The second disability group is established for people who cannot care for themselves or move without assistance or other people. Such people can work only in specially created conditions; they are not able to undergo training in regular institutions, but can study in special educational centers or at home. Such people communicate and navigate either with the help of other people or with the help of certain devices, and they can control their behavior partially or completely, depending on other people.

The last, third disability group, is assigned to patients who can independently care for themselves, move around (but with more time), study in general institutions, work (with slightly reduced criteria), navigate and communicate, or perform all functions with the help of special means and devices .

How to determine membership in a specific group for gouty lesions

There is a whole table from which you can determine the main parameters that allow you to judge the disability of each patient. There are many similar “evaluation systems”. Let's consider one of them.

Category of violations of the functional qualities of all organs and systems	Main clinical manifestations, symptoms, characteristics, features	Restrictions that are taken into account by the commission
Second	Arthritis of a gouty nature affected no more than two articular formations. The kidney structures are damaged, but to a minor extent. The level of uric acid in the blood averages 0.50 µmol/l. The X-ray shows a “punch” symptom. The amplitude of movement is limited to no more than 50 in the shoulders and hip joint, in the elbow formations - up to 45.	None
Third	Arthritis worsens frequently and can occur in an acute form for a long period of time. Three or more joints are affected. The renal structures are so involved in the pathological process that the functional potential of the urinary system is significantly deteriorated. The uric acid level is more than 0.55 µmol/l. The “punch” symptom is clearly visible on the x-ray. Also noticeable is X-ray negative tophi, localized inside the bone elements. Limitation of the degree of freedom of movement - about 15. In the affected structures there may be complete immobilization	There are minor restrictions in everyday life, during self-care, as well as when moving long distances
Fourth	Arthritis of gouty origin is characterized by particularly large tophi. Exacerbations occur frequently - every 2 - 3 months. In addition to local symptoms, there is always a total deterioration in health - chills, fever, trembling throughout the body. The kidneys are affected, the cardiovascular system suffers. The level of uric acid in the blood is 0.53 µmol/l. The X-ray image clearly shows the “punch” symptom. Intraosseous tophi is also clearly visible. There is complete immobilization of the affected articular formations	Significant degree of limitation in all aspects of life. A person is dependent on outside help

About the disease

The main reason for the development of gout is an increase in the level of uric acid and the deposition of its salts in articular and periarticular tissues, as well as internal organs, which is accompanied by the gradual development of the inflammatory process. The disease is quite dangerous because it is rarely diagnosed in a timely manner, which can lead to certain complications.

Gout more often affects men than women, and even less often children. The period after forty years is considered a dangerous age. The pathological process can be described as the deposition of uric acid salts, which look like small and sharp needles. Over time, they can destroy not only cartilage in joints, but also bones. As a result of kidney damage, urolithiasis occurs.

Symptoms appear in the form of intense joint pain at night and in the morning. Characterized by unilateral damage to joints that swell. The skin over them becomes red and swollen. There is also a local increase in temperature.

Most often, the disease affects the big toes, less often the knee and elbow joints. Over time, movement restrictions occur.

The causes leading to the development of the disease are usually divided into two main groups. Primary gout develops due to a genetic predisposition when the body has a deficiency of the enzyme responsible for removing uric acid from the body. Often noted with:

arterial hypertension;
diabetes mellitus;
obesity.

Secondary gout occurs as a result of other diseases that lead to its development (kidney and blood diseases). Taking certain groups of drugs in large quantities and intense physical activity over a long period of time can also provoke gout.

Only a doctor in a medical institution can diagnose the disease using additional diagnostic methods. An accurate diagnosis requires examination of the synovial fluid, which can detect uric acid salts. Timely diagnosis and therapy play a role in preventing complications.

More about some criteria

The “punch” symptom is the presence of osteophytic accumulations. At the same time, the joint space is abnormally narrow. The bone tissue is partially deformed. Characteristic defective formations in the form of a semicircle or round epiphyseal elements.

It is difficult to say whether disability for gout is given to all patients. This process is very complex in every way. A serious and grueling procedure requires a lot of moral strength and financial costs. If certain signs and symptoms are recorded, which are combined in a certain combination, the patient with gout is assigned one or another disability group.

In fact, any disease that prevents a person from leading a normal lifestyle and working at full capacity requires additional diagnostics and enhanced treatment. If a particular pathological condition is classified as incurable, this means that the patient will be in a state of relative discomfort all the time.

Degrees of disease and groups

Gout is included in the list of diseases that define disability (clause 1.8.3. Gout. M10 (M10.0-M10.9), M11). Disability group I is established for grade 4 gout development. These are constant manifestations of arthritis with a frequency of 2-3 months, which are accompanied by fever, tophi, severe kidney damage, trembling, etc. In this case, the patient can move and care for himself in the 3rd degree of disability. Disabled people can receive disability group II for exacerbation of arthritis with exacerbations every 3-4 months, with diseases of 2-3 joints, kidney damage, small tophi in the joints. In this case, a person must have 2 degrees of self-care and movement, 2-3 degrees of ability to carry out work activities. Disability group III is established for people with the manifestation of arthritis at intervals of 1-2 times a year, with diseases of 1-2 joints, the initial stage of kidney damage and 1 degree of limitation in self-care, movement and the ability to carry out work activities.