If the VA already service-connected your gout (also called gouty arthritis, gouty, gout attack, gout attacks), it can cause or worsen other conditions that are ratable on their own. These "secondary" claims are where many veterans leave money on the table. Below is what a service-connected gout commonly leads to, why, and what evidence each one takes.
Gout is listed in 38 CFR 4.71a as DC 5017. The note to DCs 5013 through 5024 says these conditions are rated as degenerative arthritis, based on limitation of motion of the affected parts. In practice:
Because gout often attacks different joints at different times, ask the examiner to measure every joint that has had attacks, and describe what happens during a flare in your own statement. Range of motion during a flare is often very different from a good day.
The most common are kidney stones, reduced kidney function, and joint or back strain from limping. See kidney disease ratings, knee secondaries, and the nexus letter sample and template.
A secondary claim only works if the primary condition (gout) is already service-connected, and you have a nexus — a doctor's opinion that it is "at least as likely as not" the cause. Nexus letter sample and template →
The same excess uric acid that triggers gout attacks also forms uric acid kidney stones. This is a recognized complication of long-standing gout, not a coincidence.
What you'd need: Imaging or an ER or urology record documenting stones, stone composition analysis if it was done, and a record of how often you need treatment.
Long-standing high uric acid can deposit in the kidneys and lower kidney function over time, and some medications taken long term for gout pain carry their own kidney risk.
What you'd need: Blood work trending your creatinine and eGFR across years, a nephrology note, and your medication history.
Gout most often hits the big toe, ankle or knee. Months and years of limping off the painful joint loads the other joints and the lower back differently, which is a familiar VA secondary chain.
What you'd need: A treatment record noting the altered gait or limp, imaging or range-of-motion findings on the other joints, and a nexus opinion tying them to the gout.
Unpredictable attacks that stop you walking or working are a recognized driver of secondary depression and anxiety, the same as any chronic painful condition. Note that the VA evaluates gout itself on the limitation of motion it leaves in the affected joints, so ask that every attacked joint be measured, not just the worst one.
What you'd need: A mental health diagnosis and a provider opinion connecting the mood symptoms to living with the gout.