With gonarthrosis, as with any other disease that disrupts the normal functioning of a person and his ability to independently care for himself, one can become disabled. Moreover, it is possible to register a disability group not only in the later stages of pathological changes. Disability due to arthrosis of the knee joint can be given to a patient with the second degree of the disease, but in this case it will be necessary to prove that there really are significant restrictions on motor function.
Yes. As already noted, disability due to arthrosis of the knee joint can be obtained by any patient who has significant limitations in normal life activities associated with a disease in the knee area. As a rule, a disability group is issued in the case of grade 3 gonarthrosis. In some cases, as an exception, a patient who is classified as stage 2 of the disease may also receive a group. The following should be taken into account:
In this case, everything depends on the medical commission, as well as on the general condition of the structure of the bone and cartilage tissue of the knee. The decision to discharge sick leave is made only after receiving the results of the x-ray. If the results show the need for long-term treatment of the patient and the loss of the ability to independently support themselves, sick leave is issued. The duration of sick leave will be taken into account by the commission when registering disability for arthrosis of the knee joint. What legal norms govern this procedure?
Generally, health care providers are not very welcoming to new patients who wish to receive a disability group. In addition, the work of the medical commission of MREC and VTEC (may vary depending on the region) is strictly regulated by law. In practice, this can mean that getting a group can be quite problematic. For this you will need:
Pain, crunches, blockages, limitation of movements and stiffness of joints - this is not a complete list of symptoms of arthrosis. Each of them individually can poison a person’s life, and their combination can easily make it unbearable.
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You can get disability due to arthrosis. True, not everyone. There is a certain category of patients who are sent for a medical and social examination (MSE). It includes:
- patients with progressive arthrosis of the joints within 3 years from the onset of the disease, suffering from frequent (more than 3 times a year) exacerbations;
— patients after surgery for the treatment of osteoarthritis, who have disorders that limit their life activities;
- those who suffer from severe impairments of static-dynamic function, which, in fact, becomes the cause of disability.
The second group is assigned to those whose motor function is partially lost, i.e. a person can move, but often needs outside help. As a rule, the basis for the appointment of group II are: grade 3 arthrosis of the hip and knee joint, ankylosis of large joints, shortening of the limb by more than 7 cm, etc.
The third group is provided to those who have moderate or slight limitation of joint function. That is, a person can move independently, but at a much lower speed, with a large number of rest stops, etc. Among the causes that lead to disability group III are coxarthrosis and gonarthrosis of the 2nd degree, as well as combined deforming arthrosis of the extremities.
It is not difficult to completely restore JOINTS! The most important thing is to rub this into the sore spot 2-3 times a day.
There are several approaches to classifying the degrees of arthrosis; some sources distinguish 3 degrees of this disease, others – 4:
When making a diagnosis, attending rheumatologists rely on the radiological classification of arthrosis, the latest version of which was developed in 1982 by Leuquesne. Within this classification, there are 4 stages of the disease, not counting zero, in which there are no radiological changes. For medical and social examination (MSE), another classification is used, according to Kosinskaya. It is also based on X-ray data, clinical symptoms are also taken into account, but only 3 stages are distinguished.
If the image shows a moderate narrowing of the gap between the bones of the joint, and uneven, and osteophytes that have just begun to form, grade 1 deforming arthrosis is diagnosed. The limitation of mobility is mild.
With grade 2 arthrosis of the knee joint, the changes are more pronounced:
Clinical symptoms of this stage are characterized by limited movements in some directions, accompanied by a crunching sound. The first signs of muscle atrophy appear.
Deforming osteoarthritis (DOA) of the 3rd degree of the knee joint is manifested by a pronounced limitation of mobility, the patient is able to perform only rocking movements, the leg in the joint deviates from the original position by a maximum of 5-7°. X-ray signs:
A condition where even rocking movements are impossible, and the bones are fused, according to Kosinskaya is classified as ankylosis.
The results of an X-ray examination are the main criterion for MSE. But when it is carried out, the results of functional diagnostics are also taken into account, which assesses the degree of limitation of movements (contracture), the severity of disturbances in static-dynamic function (SDF). SDF is the ability to maintain support and move, provided by compensatory processes.
When the patient performs a series of functional tests, the range of motion in the joint is measured, and the deviation from the norm (functionally advantageous position) is assessed. There are 4 degrees of knee joint contracture.
To assess DFS, the results of functional and radiological diagnostics are taken into account. Also assessed:
The following degrees of severity of SDF violations are distinguished:
When considering the issue of recognizing a person suffering from gonarthrosis as a disabled person, the medical commission takes into account not the severity of the pain syndrome, but the degree of limitation of the mobility of the leg in the joint, violation of the SDF. The phenomena of bone deformation and cartilage destruction should be confirmed by x-rays and arthroscopy results. The duration of sick leave issued in connection with temporary disability is also taken into account.
In accordance with the law, a certificate of incapacity for work is issued for a period of no more than 12 months. If during this time the treatment prescribed to a patient diagnosed with arthrosis of the knee joint does not produce results, the condition does not improve, the question of assigning him a disability is raised. The minimum duration of sick leave, which is taken into account for MSA, is 3 months for six months.
A patient who turns to doctors with a request to recognize him as disabled is subject to a medical and social examination. It combines clinical and functional diagnostics with social ones. Whether disability is given for gonarthrosis, and which particular group, depends on a number of factors:
The last 3 points relate to social diagnostics.
To register disability due to arthrosis, you need to collect a substantial package of documents: extracts from the medical history, epicrisis from the institutions where the patient was treated, sick leave certificates confirming the disability, examination results. The attending rheumatologist, having studied the medical history, can quite accurately predict whether the commission will give a group. And the local therapist acts as an intermediary between the patient and the specialist heading the commission; he submits a corresponding application in the prescribed manner.
For arthrosis of the 1st degree, the group will not be given unambiguously. In case of gonarthrosis of the knee joint, degree 2, disability is assigned in exceptional cases:
It makes sense to submit documents to MSEC if:
In most cases, the commission assigns 3rd degree disability for arthrosis of the knee joint. The group must be confirmed annually by undergoing a re-examination . If the condition worsens or improves, the disability group may be revised. If the treatment prescribed for arthrosis of the 2nd degree of the knee joint turned out to be quite effective, or the patient with arthrosis of the 3rd degree underwent a successful endoprosthetics operation, the group can be removed.
Basically, gonarthrosis is the basis for assigning 2-3 disability groups. But if deforming arthrosis deprives a disabled person of the ability to move independently or self-care, group 1 is prescribed.
The third disability group is assigned to:
At the same time, labor productivity decreases, the patient cannot perform certain types of work, and the choice of specialties for him is limited. A disabled student can attend a general education institution, but must follow a special routine and regime. The ability to self-care is not lost; the patient is able to move short distances without assistive devices or is limited to using a cane. But performing habitual actions requires more effort and requires longer rest.
The grounds for assigning the second group are:
The patient can move only with the help of aids or other people, and experiences severe pain when moving. It is possible to work in specially equipped places, study in specialized institutions or at home.
The first group can be assigned if ankylosis has formed as a result of the progression of gonarthrosis. This pathology leads to the fact that the patient cannot walk or even stand without assistive devices or outside help, and is unable to engage in any type of physical labor.
Surgery to replace the affected joint with a prosthesis (endoprosthetics) is used to avoid disability and increase the range of motion in the joint. After surgery and rehabilitation, the patient in most cases returns to a full life, can move independently and work. Of course, you need to take a number of precautions, protect the endoprosthesis from excessive loads, and you will have to give up some types of activities. But a person with a joint prosthesis is not disabled if the operation is successful.
Cases when after endoprosthetics the patient’s condition does not improve, but, on the contrary, worsens, are rare, but not excluded. The reason may be an unsuccessful selection of the geometric dimensions of the prosthesis, its low quality, as a result of which rejection develops. In a number of cases, the patient himself is to blame for not undergoing full rehabilitation and not following the specialist’s instructions.
Often, those who have undergone surgery do not develop the joint properly due to fear of pain or simple laziness. Sometimes complications result from excessive stress on the joint and poor diet.
2 months after endoprosthetics, MSE is performed. If the patient was on a group before surgery, and the joint replacement and rehabilitation helped eliminate the limitations in life, the group is removed. On the contrary, the appearance of pronounced musculoskeletal disorders is the basis for recognizing him as disabled. As a rule, disability is assigned after unsuccessful total bilateral arthroplasty. In case of pronounced violations of the SDF, group 2 is assigned, in cases of significant impairment, with decompensation, group 3 is assigned.
Starting from stage 2 of gonarthrosis, the patient can be recognized as disabled. The commission that decides to assign a group takes into account not only the clinical picture and severity of functional impairments, but also social factors. Thus, if a patient with gonarthrosis is engaged in mental work, he may not be assigned a disability despite limited movements and impaired static-dynamic function. As a result of successful treatment, the group can be reduced or removed; usually, this effect is only achieved by surgery.
One of the most common diseases of our time is arthrosis - a disease of the joints. Arthrosis does not belong to the category of incurable diseases and responds well to treatment, especially in the early stages of its course. There are several versions of the causes of this disease: infections, a sedentary lifestyle, insufficient water consumption (dehydration) and others.
The symptoms accompanying this disease are varied: joint pain, swelling, limitation of movement and simply acute pain.
The attending physician usually prescribes medications that relieve inflammation in the joints: from tablets and ointments to injections (in case of acute manifestations). In some situations, the patient is referred for surgery.
What to do if long-term treatment does not lead to success, and your health condition is only getting worse or is in remission?
The law provides for the possibility of obtaining disability due to arthrosis, but only in certain cases:
In order to try to register a disability for this disease, it is necessary to carefully collect all the documents regarding the prescription of treatment for arthrosis, all the studies that had to be completed. This is necessary to confirm the fact of long-term, but not entirely successful treatment.
The following basic documents and examinations are required:
The attending physician (surgeon, most often) collects all these documents and gives a referral to a medical commission, which must be passed. As a rule, obtaining disability due to a disease, especially this one, is very difficult. Therefore, you need to be patient and go all the way necessary to register your disability. This path consists of several stages.
At the first stage, the provided package of documents, which records all types of treatment and examinations, is analyzed. The results of treatment are reviewed. The patient’s condition, his complaints, symptoms of the disease, and their degree of manifestation are also examined.
To determine the functionality of the joints, the medical commission (ITU) uses a specially developed x-ray classification, which includes three degrees of motor activity:
At the second stage, social diagnostics of the patient is carried out. The concept of social diagnostics includes the determination of the degree of disability, the level of adaptation in society, the ability to be independent, the psychological state, and so on.
At the third stage, the disability group is determined.
Group 1 is assigned to patients whose motor activity is completely impaired. The characteristics of disabled people of the first group due to arthrosis are as follows: a person cannot walk on his own, which entails severe limitations in everyday activities. This means there is no opportunity to walk, cook, eat food on your own, and so on. In a word, the presence of 3 degrees of disability and ability to live defines this disability group.
From the medical side, there is a clarification that such severe consequences most often result from arthrosis of the hip joint of the 3rd and 4th degrees, as well as the kneecap and ankle joint.
Group 2 can be given to those patients who have partial loss of motor function. This means that a person can move, often with the help of strangers, i.e. has 2nd degree of disability and disability.
According to medical indications, this group can be received by patients with arthrosis of the knee and hip joint of the third degree, with shortening of the upper or lower limb by at least 7 centimeters or more, as well as with ankylosis of large joints.
Group 3 is prescribed to patients with minor or moderate limitations in the motor functions of the joints. This means that the patient can move around on his own, but at a slower speed than normal, with more frequent stops to rest. Can perform limited labor and household functions, i.e. has 1 degree of restrictions.
This category of patients with diseases: gonarthrosis, coxarthrosis of the 2nd degree, arthrosis of the extremities with combined and deforming symptoms
It is worth noting that you will need to constantly confirm the assigned disability. This assumes a case of improvement in the health status of a disabled person.
After receiving disability, you should register a pension in the pension fund and register the benefits that are provided for each of the disability groups.
You must come to the Pension Fund with a passport, pension certificate and a certificate of disability. Write an application, and after that the pension will be credited.
It is also necessary to submit an application to local social protection departments accompanied by originals and copies of a disability certificate, passport and pension certificate. After this, you will be able to use benefits, the list of which is legally approved for each disability group. Among these are benefits for housing and communal services, use of transport, sanatorium treatment, and so on.
Monthly pension for disabled people in 2014:
Monthly monthly allowance for disabled people in 2014:
To receive disability due to arthrosis, you have to go through a certain number of stages of examination, which are united under the general name of medical and social examination.
Disability caused by arthrosis of the lower extremities is given for a period. Periodically (every year) you will have to confirm by re-taking examinations in order to receive your previous degree again. This is because surgery can be done to improve the condition. After such changes, the degree of disability will be changed, for example, from first to second.
For any disease, arthrosis is no exception, there are three groups that are given to the patient based on the results of a medical and social examination after research.
The main criteria that guide specialists during a medical and social examination are:
People who are classified as the first group of disabilities do not have the opportunity to exist independently. They do not get out of bed, moving, in many cases even standing brings unbearable pain for them, and a lot of other complications. They are unable to perform simple hygiene operations on their own; they have no opportunity to change clothes, eat, or do usual household chores on their own.
The group is prescribed to patients whose lower limb joints have been significantly damaged by deforming arthrosis of the legs. Limited ability to move independently. Actions are possible only with the assistance of outsiders and auxiliary means. Actions bring discomfort, significant pain with any movement. There is an opportunity to work in specially equipped places. You can study in specialized educational institutions for this kind of people, at home.
Disability group 2 is assigned to patients if:
To assign a third disability group to a patient, participants in the medical and social examination are guided by the presence of moderate signs of arthrosis of the legs. The ability to move independently, perform usual work, and household chores is limited to a small extent. The person has not lost the ability for self-service and independent action. They do not require auxiliary aids; more often, a cane can be used to relieve stress from the joints when walking. They need more time to perform their usual actions; after moderate physical activity, patients will need a longer rest than healthy ones.
At work, people who receive the third group of disability due to various types of arthrosis show lower results in terms of labor productivity, work becomes less fruitful, and in certain types of work it is completely impossible.
It is impossible to work in some specialties if a person is diagnosed with the third group of disability due to arthrosis, especially of the ankle joint. Training will require adherence to a special routine, regime, and sometimes the help of outsiders.
Symptoms for which the third disability group is assigned for joint arthrosis:
Not everyone can experience disability due to arthrosis. It is not prescribed to patients who have the following symptoms:
Such patients are more often recognized as able to work.
You should consult your doctor about the possibility of obtaining a disability group. He will give a correct assessment of the condition of arthrosis of the knee, hip, ankle joint, tell you what the probability of a positive result of the medical and social examination will be, and which group can be assigned. You should listen to the doctor’s recommendations first of all.
Doctors are convinced that coxarthrosis of the hip joint is perfectly treatable in the early stages. But the further the disease progresses, the more complicated the situation becomes. Eventually, the patient's mobility is significantly limited. The disease can progress so far that a person loses the ability to move independently.
If the disease affects the upper limbs, the patient will not be able to perform basic activities, such as dressing. The inability to perform daily activities is considered one of the primary criteria for disability.
To confirm the diagnosis, the patient must undergo an MSE - medical and social examination. The group is formed only based on its results. These powers to the ITU are granted by the state commission.
But this process is very lengthy and the plaintiff does not always manage to prove his case.
Getting a disability is quite a troublesome matter. Government authorities explain the need for regular medical and social examination by the fact that nowadays coxarthrosis of the hip joint of the 2nd degree can be easily treated surgically.
If a patient has a second disability group and was scheduled for surgery, which was successful, the ITU may remove the patient’s disability group or lower it.
People suffering from arthrosis often experience severe pain. Even the initial degree of coxarthrosis of the hip joint is characterized by intense pain, which painkillers cannot always cope with.
Using modern diagnostic methods, such disorders in coxarthrosis of the hip joint can be confirmed. To do this, they resort to help:
The degrees of coxarthrosis and the group assigned to the patient are not interrelated. The presence of one degree or another of arthrosis does not give a person the right to receive the “automatic” group. The same situation arises with exemption from military service or with obtaining a deferment from it.
What about arthrosis of the third stage? As a rule, those people who are diagnosed with the following in the ankle joint fall into the category of disabled people:
Pathology entails disturbances in the motor function of the body. The severity of the condition is determined by the assignment of one group or another. If the limitation of life activity is minor and the disease does not cause major problems for the patient, the ITU group may not be assigned.
If the disease is accompanied by shortening of the limb, the patient is given the second group. Those people whose legs have been shortened by seven centimeters or more have a real chance of becoming disabled.
The disease significantly limits the patient's ability to self-care. With deforming arthrosis of the hip joint, the patient may well count on being assigned to the first disability group.
An equally important factor is chronic stress. They can provoke the development of arthrosis, gonarthrosis and coxarthrosis. When the human body is under stress, it begins to produce substances that destroy joint tissue. In joint exudate, the amount of hyaluronic acid, which is extremely necessary for joints for their mobility, is reduced.
There are many more reasons for the development of secondary coxarthrosis. Almost all of them relate to diseases provoked by nervous tension:
Disability due to arthrosis is a sad but common fact. Advanced osteoarthritis, which was not paid attention to in time, or treatment was not carried out seriously, leads, unfortunately, to a person’s legal capacity. It is expressed in the patient’s inability to perform simple movements of the limbs, bending the spine, accompanied by severe pain.
This question worries many. Indeed, if a patient’s examination reveals a significant limitation in the mobility of joints, the inability to perform everyday operations (get dressed, go down the stairs, etc.), then disability due to arthrosis can be diagnosed. Usually they put the third disability group, less often - the second, but usually there is no talk about the first disability group.
Typically, one or another disability group for arthrosis is temporary, which will have to be confirmed at intervals once a year or, depending on the provisions of the law. This practice is used because the patient has the opportunity to undergo arthroplasty or any other surgical intervention (arthroscopic debridement, arthrodesis of the knee or hip joint, periarticular osteotomy) and correct a difficult situation. The operation will allow you to restore almost full functionality of joint movements, which will give grounds to lower the disability group (instead of group ll they will put lll) or remove it altogether.
By the way, the presence of one of the most striking symptoms of arthrosis - severe pain - is not a reason for giving a person a disability. To do this, you need to fall under the definition of life activity limitation - when significant deformations in the bones and disorders of the musculoskeletal system are detected, confirmed by radiography and arthroscopy. That is, it is difficult to take pain into account; you need documentary evidence of certain problems caused by arthrosis.
In fact, when they ask what stage of arthrosis is necessary to obtain the third group of disability, it is impossible to give an unambiguous answer. As is the case with conscription into the army. here everything is decided individually. The diagnosis of “arthrosis” is considered from the perspective of how joint disease affects the limitation of life activity.
Of course, the more severe the degree of osteoarthritis, the stronger the severity of OA, but the relationship is not directly proportional. Simply put, the law does not provide that, for example, in case of second degree knee arthrosis, a third disability group is assigned. However, most often the third stage of osteoarthritis is a reason for disability, if it concerns gonarthrosis, coxarthrosis, arthrosis of the ankle joints. Such issues are resolved by a medical commission after a thorough examination.
Mildly expressed problems of static-dynamic functions of arthrosis of 1-2 degrees do not provide grounds for obtaining disability. Violations at these stages are considered minor.
Moderate violations of static-dynamic functionality are considered coxarthrosis of the 3rd (third) degree when one hip joint is affected or when both joints are affected with high problems of movement at the second stage of coxarthrosis. The same applies to gonarthrosis: at the second stage, with damage to both knee joints with the inability to move, or gonarthrosis of the third stage with the identification of violations of static-dynamic functions. Stable, clearly expressed contractures of these functions are a reason for issuing the criterion of life support, since a person is unable to fully work, move, or be socially active. This formulation of the definition of disability provides grounds for obtaining disability of the third group.
Ankylosis of the knee joints, as well as ankle and hip joints, coxarthrosis of 2-3 degrees with shortening of the limbs by 7 cm or more (without taking into account compensation for orthopedic devices), with endoprosthetics of two or more joints, manifested in a stable violation of motor functions, gives grounds for considering receiving the patient disability of the second group.
Disability of the first group with deforming arthrosis occurs when a person constantly needs outside help, is unable to take care of himself in everyday life, and is unable to move without the help of special devices (wheelchairs).
Based on the severity of the disease with arthrosis, disability is determined by a medical commission that considers how well a person fits the criteria for limited ability to live. In order to prevent disability, it is necessary to pay attention to the slightest symptoms of osteoarthritis, to prevent the disease from affecting the joints to such an extent that it remains either to undergo an expensive operation or to receive a disability group. In addition, as practice shows, it is not so easy to prove this very group to medical luminaries and officials responsible for receiving benefits for legal capacity.
Naturally, arthrosis must be treated. Pain cannot be ignored. And besides, only a doctor can refer a patient for disability.
Very often, with arthrosis, pain occurs in the knee, in the lower part of the leg (ankle), etc. In some cases, surgery is even used to treat arthrosis and arthritis. However, this is not always an effective method.
- patients with progressive arthrosis of the joints within 3 years from the onset of the disease, suffering from frequent (more than 3 times a year) exacerbations;
— patients after surgery for the treatment of osteoarthritis, who have disorders that limit their life activities;
- those who suffer from severe impairments of static-dynamic function, which, in fact, becomes the cause of disability.
Medical and social examination is a necessary step in obtaining disability. And it will not be possible to avoid it. It is also worth considering the fact that you will need to undergo such an examination to confirm your disability constantly.
During the MSE, the disability group will be determined. This will take place in several stages. In the first, clinical and functional diagnostics are examined and analyzed: complaints, the severity of symptoms, etc. are analyzed. The second stage involves social diagnostics, during which the patient’s ability to independently care for himself is assessed, as well as an assessment of the patient’s adaptation to the social environment and the degree of his disability.
The first group is given to those whose motor activity is completely impaired due to arthrosis. Group I disabled people, due to a developed disease, are not able to walk, cook, eat, walk, study, etc. Doctors note that this stage usually occurs with diagnosed arthrosis of the hip joint of 3-4 degrees, as well as with damage to the patella and ankle joint.
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Disability due to coxarthrosis of the hip joint is a fairly common phenomenon. The disease in the second degree is incurable. The only thing that remains for the patient is to resist the disease, slowing down the destructive processes in the joints. In people over forty years of age, the risk of coxarthrosis increases.
There are many reasons for this, but the main one is a metabolic disorder in the cartilage tissue. Statistics clearly demonstrate that the disease has become significantly younger. Today, not only pensioners, but also young people are at risk. In general, all joint diseases have become more common in young patients, which was not the case before.
In what situation is a disability group assigned to coxarthrosis? What should Russians suffering from this disease know about group assignment?
Important! If the patient is not satisfied with the disability group assigned to him or has been completely denied recognition of his disability, the patient can go to court to restore his rights.
Usually, with arthrosis of the hip joint of the second degree, the patient is given the third group. Getting the second group is much more difficult. It is almost impossible (according to the patients themselves) to get the first group.
There is no prohibition on assigning the first disability group for coxarthrosis of the hip joint, but it is very difficult to prove your rights to it. The patient must be prepared for the fact that disability must be regularly confirmed. If the patient does not undergo medical examination in a timely manner, he is deprived of the status of a disabled person, and along with it, of receiving state support.
Limitation of motor function is the main criterion on which the assignment of a group in the Russian Federation is based. Of course, many will quite reasonably ask: why are pain symptoms not taken into account?
To confirm disability, the patient must provide evidence of serious deformations of bone tissue resulting from coxarthrosis. Impaired functioning of the musculoskeletal system is the main sign of limitation of human life activity and recognition of this fact by the ITU.
Note! Only documentary evidence of disability will entitle the patient to register for a group and receive government support. To confirm the diagnosis, an x-ray of the diseased joint must be attached to the documents.
With moderate deformities, which is typical for coxarthrosis of the third stage, a person can achieve assignment to the third group. This rule usually applies to those patients in whom coxarthrosis was diagnosed relatively recently.
This is due to the fact that deforming arthrosis of the joints deprives a person of the ability to move independently. Most often, the first group is assigned to wheelchair users.
According to the disappointing forecasts of doctors, we can conclude that the number of people suffering from coxarthrosis in Russia will increase every year. This fact is explained by two reasons:
Genetic predisposition to pathology is expressed in metabolic disorders and is transmitted from parents to children. The older a person with a hereditary predisposition becomes, the higher the likelihood of developing the disease.
Therefore, for the purpose of prevention, whenever possible, every person should try to avoid stress and anxiety.