Hidradenitis Suppurativa, which is also commonly called simply HS, is a skin disease that primarily affects the areas of the skin in which sweat glands or sebaceous glands are present. These areas include the inner thighs, buttocks and groin, as well as the underarms, breasts and upper back. HS causes the chronic development of cysts or abscesses and may also result in gland infections. Cysts and infected glands can be large or small, but often lead to pain and discomfort regardless of size. Surgical removal of cysts is often necessary and intervention is often required to drain then and alleviate pain as well. Additionally, the disease often leads to the development of clusters of cysts and chronic scarring and pus formation, especially in the underarms, inner thighs and groin.
There is no cure for Hidradenitis Suppurativa, and while some people are able to live with the condition, and even experience lasting periods of remission, some patients have constant symptoms and ever worsening flare ups of the disease. The severity of the disease and the frequency and duration of symptoms determines if you’re able to receive Social Security Disability (SSD) benefits with this condition.
Is Hidradenitis Suppurativa A Disability?
There are many different definitions of disability. For the SSA however, a disability is a condition that leaves you unable to work for an extended period of time. For Hidradenitis Suppurativa to be considered a disability, the symptoms must be severe enough to keep you out of work for twelve months or longer. If you are able to continue working, you will not be able to qualify for disability benefits.
Social Security disability insurance (SSDI) is an SSA program that protects workers who are unable to make a living on their own. In other words, a disability must keep you from engaging in Substantial Gainful Activity. Substantial Gainful Activity is a monthly income level that the SSA has set. If you are able to make more than this number, the SSA will not consider you to be disabled. In 2020, your countable monthly income must remain under $1,260 to qualify for disability benefits. For those that are blind, that number is increased to $2100, however that should not impact your HS disability claim.
How Does The SSA Decide Who Is Disabled?
In order for HS to be considered a disability, you must expect to miss work for twelve months or more. Every situation is different, so how does the SSA decide who is physically unable to work?
There are a couple of factors that determine your disability determination. The first is the severity of your symptoms. The SSA has a publication that that lays out the specifics to qualify for many of the most common conditions. This is called the blue book. If you meet the criteria listed for Hidradenitis Suppurative, the SSA has decided that this would make it impossible to work (that specific criteria will be covered in the next section).
In addition to being unable to work and proving that you qualify medically, you must not be able to switch jobs to continue working. The SSA will take into consideration your work history and relevant skills that you have.
For example, if you have been working the same job for many years and are later in your career, it would be difficult to transition to a new role and learn new skills. On the other hand, if you have just started a job that requires physical labor, but had previously worked a job where you are sitting at a desk, it would be possible to return to the desk job if Hidradenitis Suppurative has left you unable to continue with the job that requires physical labor.
Applying for SSD with Hidradenitis Suppurativa
The Social Security Administration (SSA) does recognize Hidradenitis Suppurativa as a disease that can potentially be disabling. Hidradenitis Suppurativa appears in the Blue Book under Section 8: Skin Conditions, and has a dedicated listing under subsection 8.06.
According to the SSA’s eligibility criteria, in order to qualify for SSD benefits with Hidradenitis Suppurativa, your medical records must show that:
- You have extensive skin lesions that involve both your underarms (axillae),
- both side of the groin (inguinal areas),
- or in the perineum (area around the genitals and anus),
- Your skin lesions must last a minimum of three months even while undergoing continuous treatments as prescribed by your physician.
In addition to meeting these listed eligibility requirements, your Hidradenitis Suppurativa must also prevent you from getting and maintaining gainful employment either in your traditional field of work or in any other job for which you’d be qualified based on your skills, education, work experience, and taking into consideration the limitations that your Hidradenitis Suppurativa places on you.
Documentation to Prove Disability For Hidradenitis Suppurativa
To demonstrate to the SSA that you meet their criteria, you will have to provide extensive medical records as well as other documentation, including:
- Statements from your treating physician
- Results from any diagnostic testing
- Information from specialists that you have seen
- Medication and Treatment History
- RFC Form (optional, see below)
- Work History and Background Report
- General Personal Information
(You will be able to find all of the proper documentation either from your doctor or on the SSA website.)
If necessary, in order to make a determination on your claim for SSD benefits, the SSA may require an independent medical evaluation of your condition. If this is initiated, you must attend a medical appointment with a physician contracted by the SSA. Failing to attend the appointment will lead to denial of SSD benefits.
Other Conditions associated with Hidradenitis Suppurativa
In addition to the previously mentioned symptoms, your Hidradenitis Suppurativa may also cause:
- open wounds that result from burst skin lesions
- bacterial infections
- Cellulitis, which is inflammation in the deeper tissues around cysts and abscesses
- Depression, due to the chronic pain and other issues that come with the condition.
All of these additional symptoms and complications of your Hidradenitis Suppurativa must be documented in your medical records and will only help strengthen your claim for SSD benefits.
Qualifying For Disability Benefits Without Meeting The Blue Book Listing
If you do not meet the Blue Book standards, it is still possible to qualify for disability benefits. You can do this by having your doctor fill out a Residual Functional Capacity form. An RFC Form goes into great detail about what you can and cannot do. For example, some of the questions on the form look at physical abilities such as your ability to be on your feet all day or lift heavy objects. If those are requirements of your job and HS has made it impossible to do those tasks, it is possible for the SSA to consider your condition a disability even without meeting the specific blue book criteria.
Getting Help with Your Hidradenitis Suppurativa SSD Application
In order to qualify for SSD benefits, your Hidradenitis Suppurativa must either meet the criteria of the Blue Book listing, or it must match the listing of another listed condition. In some instances, even if your Hidradenitis Suppurativa doesn’t meet either of these eligibility tests, you may still qualify to receive benefits if you’re able to prove your condition severely limits your “residual functional capacity”. In order to establish this, your application for benefits must include the same substantial medical and other documentation to support your argument that you are in fact disabled by your Hidradenitis Suppurativa.
Regardless of how your claim is approached, medical records are a major part of proving your SSD claim. You will need to work closely with your doctor to document your condition, your medical treatments, and the ongoing affects of your Hidradenitis Suppurativa on your ability to work and to function daily in your personal life.
You will also want to consider securing legal assistance from either a Social Security advocate or disability attorney familiar with the SSD application and review processes in claims such as yours. They will be able to help you fill out your application and all other required forms and may be able to increase your chances of being found eligible for disability benefits as well.