VA Disability Rating for Gout

Diagnostic Code 5017 · 38 CFR §4.71a

What Is It?

Gout is an inflammatory arthritis caused by the buildup of uric acid crystals in your joints. It produces sudden, severe attacks of joint pain, swelling, redness, and warmth, most commonly in the big toe but also in ankles, knees, wrists, and fingers. Chronic gout can lead to permanent joint damage and deposits called tophi under the skin. Veterans may develop gout from dietary patterns during service, kidney damage from service-connected conditions, medications taken during service, or the physical demands of military life. DC 5017 has no percentage column of its own, and it is no longer rated like rheumatoid arthritis. Before the February 2021 rewrite of the musculoskeletal schedule, the Note to DCs 5013 through 5024 sent gout to DC 5002 and its attack-based criteria. Today DC 5002 reads "Multi-joint arthritis (except post-traumatic and gout)," and DC 5017 sits under the shared Note: "Evaluate the diseases under diagnostic codes 5013 through 5024 as degenerative arthritis, based on limitation of motion of affected parts." The evaluation is taken from the motion each affected joint has lost, measured in degrees under that joint's own limitation-of-motion code, and two or more joints combine under 38 CFR 4.25. The low end is set by two provisions. Where limitation of motion of the specific joint is noncompensable under its own code, DC 5003 provides 10 percent for each major joint or group of minor joints affected by limitation of motion, objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. And 38 CFR 4.59 entitles actually painful, unstable, or malaligned joints, due to healed injury, to at least the minimum compensable rating for the joint. DC 5003 Note (2) bars the X-ray-based 20 and 10 percent ratings for every code from 5013 to 5024, gout included. Attacks still matter — they are when the joint loses the most motion — but they matter as evidence of limitation of motion during flares, not as a count that maps to a percentage.

Rating Criteria

Rating	Criteria
See pathways	DC 5017 assigns no percentage of its own. The Note governing diagnostic codes 5013 through 5024 directs: "Evaluate the diseases under diagnostic codes 5013 through 5024 as degenerative arthritis, based on limitation of motion of affected parts." The evaluation is therefore taken from the limitation-of-motion code for each affected joint. Where limitation of motion of the specific joint is noncompensable under the appropriate code, DC 5003 provides 10 percent for each such major joint or group of minor joints affected by limitation of motion, which must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Under 38 CFR 4.59, actually painful, unstable, or malaligned joints, due to healed injury, are entitled to at least the minimum compensable rating for the joint. DC 5003 Note (2) bars the 20 and 10 percent ratings based on X-ray findings for conditions under diagnostic codes 5013 to 5024.

Rating

Criteria

See pathways

DC 5017 assigns no percentage of its own. The Note governing diagnostic codes 5013 through 5024 directs: "Evaluate the diseases under diagnostic codes 5013 through 5024 as degenerative arthritis, based on limitation of motion of affected parts." The evaluation is therefore taken from the limitation-of-motion code for each affected joint. Where limitation of motion of the specific joint is noncompensable under the appropriate code, DC 5003 provides 10 percent for each such major joint or group of minor joints affected by limitation of motion, which must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Under 38 CFR 4.59, actually painful, unstable, or malaligned joints, due to healed injury, are entitled to at least the minimum compensable rating for the joint. DC 5003 Note (2) bars the 20 and 10 percent ratings based on X-ray findings for conditions under diagnostic codes 5013 to 5024.

Evidence Needed

Blood work showing elevated uric acid levels
Joint fluid analysis showing uric acid crystals if performed
Range of motion in degrees for every joint gout has affected, with painful motion noted — this is what the evaluation is taken from
Medical records documenting gout attacks with dates, joints affected, and duration, including any measurement of the joint during an attack
Imaging showing joint damage or tophi deposits
Medication records showing ongoing treatment

C&P Exam Tips

Ask that range of motion be measured for each joint gout has affected, not just the one bothering you that day
Say where in the motion pain begins, and stop there rather than pushing through
Keep a log of every gout attack including date, joints affected, and duration, and describe how much motion you lose during one so the examiner can estimate flare-up loss
Show any visible tophi deposits under the skin
Bring your complete medication list including preventive medications
Explain how unpredictable attacks affect your ability to maintain employment

How to File

File under DC 5017 for gout, and name every joint it has affected. DC 5017 assigns no percentage itself: the Note to DCs 5013 through 5024 directs that gout be evaluated as degenerative arthritis, based on limitation of motion of affected parts, so the decision needs range-of-motion findings for each joint. Where a joint's limitation is noncompensable under its own code, ask for DC 5003's 10 percent for that major joint or group of minor joints, and for the 38 CFR 4.59 minimum compensable rating for a painful joint. Include laboratory results showing uric acid levels and any imaging showing joint damage or tophi, and keep a log of attacks — it is the evidence of how much motion the joints lose during flares.

Common Mistakes

Arguing attack frequency as if it set the percentage. Since the February 2021 rewrite, gout is evaluated on limitation of motion of the affected joints; DC 5002 now expressly excludes gout.
Having only one joint measured. Every major joint or group of minor joints gout affects can carry its own evaluation, combined under 38 CFR 4.25.
Relying on X-ray findings for a percentage. DC 5003 Note (2) bars the X-ray-based 20 and 10 percent ratings for conditions under DCs 5013 through 5024.
Only seeking medical attention during severe attacks and not documenting milder ones.
Failing to mention the impact of unpredictable attacks on employment.

Frequently Asked Questions

How does VA rate gout?

On limitation of motion. DC 5017 has no percentage column. The Note to DCs 5013 through 5024 directs that these diseases be evaluated as degenerative arthritis, based on limitation of motion of affected parts, so each affected joint is evaluated under its own limitation-of-motion code. Where a joint's limitation is noncompensable, DC 5003 provides 10 percent for each major joint or group of minor joints affected, and 38 CFR 4.59 entitles a painful joint to at least the minimum compensable rating for that joint.

Isn't gout rated like rheumatoid arthritis?

Not any more. Before the February 2021 rewrite of the musculoskeletal schedule, gout was rated under DC 5002 on the frequency of exacerbations. DC 5002 now reads "Multi-joint arthritis (except post-traumatic and gout)," and DC 5017 sits under the Note to DCs 5013 through 5024, which evaluates it on limitation of motion of the affected parts.

I was rated for gout before 2021. Can VA reduce me because the criteria changed?

Not on that basis alone. 38 CFR 3.951(a) provides that a readjustment to the rating schedule "shall not be grounds for reduction of a disability rating in effect on the date of the readjustment unless medical evidence establishes that the disability to be evaluated has actually improved." A reduction that would lower the compensation currently being paid also has to follow 38 CFR 3.105(e): a proposed rating with detailed reasons, notice to you, and 60 days to send evidence that payments should continue at their present level.

Can diet-related gout from military service be service-connected?

Yes, if you can establish that your gout developed during service or was aggravated by conditions of service, including diet, stress, and physical demands. Having your first documented gout attack during service is strong evidence for service connection.

Can X-ray evidence of two or more joints get me 10 or 20 percent?

No. DC 5003's Note (2) states that the 20 and 10 percent ratings based on X-ray findings will not be utilized in rating conditions listed under diagnostic codes 5013 to 5024, inclusive. DC 5017 sits inside that block, so the evaluation has to come from measured limitation of motion, from DC 5003's 10 percent per joint where that limitation is noncompensable, or from 38 CFR 4.59 for a painful joint.