Put or not a disability in rheumatoid arthritis: which group give?
How to get disability in rheumatoid arthritis and which group give?
Rheumatoid arthritis (RA) is a severe disease of autoimmune etiology. In the process of development of the disease affects the connective tissue at the cellular level, usually dystrophic violations occur in small peripheral joints.
When the General condition of the patient gradually deteriorates, and the acute stage occur with an increase in intensity of symptoms, it is possible to speak about the temporary loss disability. Even if modern methods of treatment used in rheumatoid arthritis, do not bring the desired recovery, conduct medical – social examination, the results of which the patient is exposed to the disabilities of a particular group.
What factors affect the receipt of disability
Not every person diagnosed with rheumatoid arthritis are disabled. To give a group of disability requires the presence of at least one of the mandatory factors. If suffering from diagnosed severe stage of RA, and has all the necessary information, he is entitled to insist on receiving group in all ways, even if he denied this.
Be sure to carry out medico – social examination in the following cases:
- if the disease progresses rapidly;
- if diagnosed visceral-articular form of the disease, which is accompanied by damage to the kidneys or blood vessels (in other words – complicated by the development of neuropathy);
- if diagnosed articular pathology form with a long stage of exacerbation;
- if a man can’t do the usual professional activities.
Be sure to take into account the percentage of the possibility of self-service, motor functionality.
Functional classes of RA
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The concept of «functional class of the disease,» and indicates the percentage for the possibility of independent service, which assigns the patient with rheumatoid arthritis. Before considering the direct classes, it is worth noting that their definition is affected by the severity of the disease, which depends on the severity of symptoms and radiographic progression.
According to the severity of manifested symptoms are the following the degree of development of rheumatoid arthritis:
- Zero degree. Stiffness of the joints is not observed. For the development of the disease is characterized by normal C-reactive protein level and erythrocyte sedimentation rate with an index of less than 15 mm/s.
- Of the second degree. Stiffness of the joints only occurs in the morning (after waking up) and there is not more than 1 hour. C-reactive protein increased several times. Figure ESR – 30 mm/s.
- Of the third degree. The feeling of stiffness can be observed all day. C-reactive protein increased 3 times, and the rate of ESR in the range of 30-45 mm/s.
- Of the fourth degree. Stiffness is present throughout the day. In this case it is diagnosed with increased C-reactive protein in 4 times, and erythrocyte sedimentation rate is 45 mm/s and above.
On the basis of what x-ray pattern is observed in the development of rheumatoid arthritis, the disease can have one of the following types:
- first: there is periarticular osteoporosis;
- second: in addition to the osteoporosis observed narrowing periarticular slit;
- third: the above symptoms are supplemented by the formation of multiple uzur;
- fourth: there is osteoporosis, periarticular contraction cracks, Uzury, and osseous ankylosis.
On the basis of what is the radiological pattern and severity of symptoms, define the functional class of the patient with rheumatoid arthritis, according to which in the future is determined or not entitled to disability specific patient:
- First class. The man able to take care of themselves: dress, eat, perform personal hygiene. Also, the patient may engage in professional and non-professional activities, for example, work and study, go to sports clubs etc.
- Second class. Man to serve himself, to engage in any easy sport activity, but to master some professions are not.
- Third grade. Self-service is retained, but the implementation of professional and non-professional activities is limited.
- Fourth grade. The person is not able to serve himself: need a help. Occupation professional and non-professional activities impossible.
To determine to what class a particular person suffering from RA can only qualified doctor.
Group definition: medical-social examination
On mediko-social examination the patient gives the direction of the attending physician, which pre-assigns the appropriate diagnostic tests. After the necessary diagnostic man pass medical Commission in the clinic by place of residence.
After the approval is necessary to establish a disability group sheet sent a messenger in the Bureau of medico-social examination, and the patient apprised of the date and time of the examination.
Important! To the medical Commission at the place of residence adopted a decision on the need of a person at ITU is required in at least one case of hospitalization over the year.
Before you can determine whether you can assign a specific disability group of the patient with rheumatoid arthritis, the members of the expert medical Commission considers the following factors:
- how severe pathology;
- how often throughout the year there are periods of exacerbation;
- some complications are observed;
- if there are extra-articular complications;
- what is the form of disease;
- how long is the recurrence;
- what stage of the disease according to x-ray picture;
- how effective treatment.
Based on the results of consideration of these factors, the Commission may render judgment on the award of the person suffering from rheumatoid arthritis, one of the following disability groups.
Group III – assigned, if:
- arthritis occurs at stage 1;
- man can serve himself, to move, to work, but not as efficiently as before the onset of disease;
- the patient requires a change of profession to lighter work or improvement of its conditions.
Group II – is assigned if:
- diagnosed with rheumatoid arthritis 2 or 3 degrees;
- man can not fully take care of themselves and needs assistance;
- movement without AIDS is limited;
- to conduct professional activities: the patient can only be in remission and only at home.
I group – assigned, if:
- the disease progresses to the severe stage;
- independent movement is impossible: the person is bedridden or moves only with a wheelchair;
- self-service, and professional activity impossible;
- the patient requires constant care.
To accurately determine the group of disability only after laboratory and instrumental studies, as well as studying the history of the disease.
In some cases, prescribed the revision of the fee
In that case, if people disagree with the outcome of the ITU, he has the right to appeal the decision of writing a letter and sending it to the Bureau, which considered the application about establishment of groups of disability.
The Bureau is obliged, within 3 days after receiving the application, forward it to the Directorate, attaching all available documents. In the main office make a decision about holding a new medico-social examination. If people do not agree with the new result of the Commission, he may appeal it by filing another statement in the main office, which sends all the documentation to the Federal Department.
Re-examination is necessary not only to confirm previously established disability, but in order to adjust the rehabilitation program to monitor the dynamics of changes in the General condition of the patient.
The frequency of re-examination will be different in a particular case, that is determined depending on the disability group:
- disabled 3 groups must pass the Commission 1 once a year;
- disabled 2 groups must pass the Commission 1 once a year;
- the disabled of the 1st group must be a 2 times a year;
- children with disabilities are required to Board 1 time to the end of the period, which was defined by a disability.
If the disability was established for an indefinite period, that is, indefinitely, to undergo the procedure of re-examination is also possible by writing an application.
Of course, get a group of disability is not so easy, which is confirmed by stories from real life:
The groups receiving other forms of arthritis
In septic arthritis, which is caused by infection of the joint by bacteria, viruses, parasites or fungi, disability set only in the case of pronounced dysfunction of affected areas.
Reactive arthritis resulting from infection outside the joints, can cause the production of disability also with severe lesions and severe disruption of their function. As a rule, the development of reactive arthritis person determine the temporary incapacity for the period of treatment.
Gout a form of arthritis develops on the background of increasing levels of uric acid and deposits them in the joints, the tissue surrounding their internal organs. Mediko-social examination is carried out if the patient has a pronounced disruption of the functioning of the affected joints. What group would be most appropriate in a particular case, the Commission decides taking into account the severity of violations.
Psoriatic form of arthritis develops as a result of such skin diseases as psoriasis. Secondary pathology is chronic. The treatment itself is directed only at alleviating the symptoms and increasing stages of remission. Primary symptoms of psoriatic arthritis are not the reason for the referral of a person for medico-social examination. Her conduct is prescribed only when the loss of a person’s ability to self-service and maintaining their traditional way of life.
Articulate any disease with late diagnosis and lack of treatment can lead to disability. For this reason, it is important to consult a doctor when the first alarming symptoms.