Getting Social Security Disability Benefits for Psoriasis

Psoriasis is a chronic skin condition in which patches of skin become white and scaly. Inflammation and lesions are also common, and the affected skin is frequently itchy. Psoriasis can occur anywhere on the skin, typically on the elbows and knees.

Many people with psoriasis find the condition to be a manageable nuisance. But for others, psoriasis can cause joint pain, arthritis, and frequent skin infections that can make it difficult to work. If you have psoriasis that keeps you from working full-time for at least twelve months, you might qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.

Getting Disability for Psoriasis Under a Listing

Listed impairments are conditions that the Social Security Administration (SSA) considers severe enough to qualify a disability applicant for benefits "automatically." If your medical record contains specific evidence that satisfies the requirements of the listing, you'll qualify for benefits without needing to show that you can't do any job.

Social Security evaluates psoriasis under listing 8.09 for chronic skin lesions. In order to be eligible for disability under the dermatitis listing, you must have a diagnosis of psoriasis with skin lesions that last for at least three months and are not responding to prescribed treatment. You could get benefits under this listing if you have serious difficulty standing, walking, using your hands and arms, or standing from a seated position with stability.

Here are some examples of lesions that could qualify you for benefits under this listing:

• lesions on your knees or elbows that make it difficult to get dressed in the morning
• lesions on the soles of both feet that keep you from walking without a cane, or
• lesions on both palms that cause you to constantly drop small objects.

What Treatment Do I Need?

Social Security acknowledges that skin conditions frequently respond to treatment, but that response to treatment can vary widely, with some disorders becoming resistant to treatment. So to qualify for disability under the dermatitis listing, you'll need to show that your skin lesions persist despite three months of treatment.

Examples of treatment for psoriasis include:

• topical gels or creams
• photodynamic (light) therapy, and
• medications such as corticosteroids, anti-inflammatories, or vitamin A derivatives.

Keep in mind that the three-month requirement in the listing criteria is different from the SSA's twelve-month durational requirement in order for the agency to consider your psoriasis a severe impairment. If you've been diagnosed with psoriasis for several years but experience "flare-ups" that don't respond to months of treatment, you might qualify for disability under the dermatitis listing.

Disability Listings for Psoriasis-Related Conditions

Some people with psoriasis also have a type of arthritis called psoriatic arthritis. Psoriatic arthritis doesn't have its own specific listing, but if your psoriasis symptoms don't meet the requirements for listing 8.05 and you're also getting treatment for psoriatic arthritis, you may meet a related listing.

Listing 1.18, Abnormality of a Major Joint

Psoriatic arthritis can cause severe functional loss to major joints, such as the ankles, knees, and wrists. You might qualify for disability under listing 1.18 if your medical record contains documentation of all of the following:

• chronic joint pain or stiffness
• abnormal motion, instability, or immobility of the affected joint
• physical examinations or medical imaging (like an MRI) showing that something's wrong with the joint, and
• evidence (such as a prescription for a cane or walker) that you can't walk or use your hands effectively.

If your psoriatic arthritis is bad enough, you might undergo reconstructive surgery on the affected joint. While most reconstructive surgeries are successful at restoring joint function, if you still have significant functional limitations twelve months after your surgery, you might qualify under listing 1.17 for reconstructive surgery of a weight-bearing joint. For surgery on the spine in particular, see our section on getting disability benefits for back problems.

Listing 14.09, Inflammatory Arthritis

People with psoriatic arthritis might also qualify for disability under listing 14.09 for inflammatory arthritis. Similar to the listings described above, meeting the inflammatory arthritis listing requires that you have a significant loss of functioning, as demonstrated by one of the following:

• persistent inflammation of your arms or legs to the point that you can't walk independently or use your hands effectively
• deformity of a lower joint that also involves another body system (typically an organ) and causes symptoms such as severe fatigue, fever, or involuntary weight loss
• presence of a type of immune disorder called ankylosing spondylitis that results in a certain degree of stiffness in your spine, or
• repeated flare-ups of arthritis that cause a very significant ("marked") reduction in your ability to carry out daily activities, function socially, or focus on tasks.

The listing criteria are often complex and can be difficult even for disability claims examiners to understand. So if you think you might meet the criteria for a listed impairment, you should ask your doctor to complete a medical source statement explaining why you qualify for disability. The SSA values the opinions of doctors whom you've seen regularly for medical treatment, especially if they specialize in treating your condition—such as a dermatologist for psoriasis or a rheumatologist for psoriatic arthritis.

Can I Get Disability if I Don't Qualify Under a Listing?

While psoriasis is quite common, it's not often severe enough to meet the listing criteria. But you can still qualify for disability if your psoriasis or psoriatic arthritis affects your functioning enough to keep you from working. If Social Security doesn't find that you're disabled according to a listing, the agency will then need to assess your residual functional capacity (RFC).

What Does My RFC Contain?

Your RFC is a set of restrictions describing how much you're able to do in a work setting despite your psoriasis. The SSA will review your medical records and activities of daily living in order to determine what you can and can't do at work. Your RFC will include all the functional limitations caused by your psoriasis (and any other medical conditions).

For example, if you have psoriasis or psoriatic arthritis on your fingers or hands, your RFC might limit you from work activities that involve typing, writing, or grasping objects. Likewise, if your psoriasis affects your feet, ankles, hips, or groin, your RFC will likely restrict you from jobs that require frequent walking, standing, or kneeling.

How Does Social Security Use My RFC to Determine If I'm Disabled?

The SSA will look at your work history and compare the exertional and non-exertional requirements of your old jobs with the restrictions in your current RFC to see if you could do those types of jobs today. If the agency thinks you can return to your past work, you won't be found disabled, and your disability claim will be denied.

If the SSA doesn't think you can do your past jobs, then—depending on your age, education, and skills—the agency will usually need to see whether you can do other, less-demanding work. But if no jobs exist in the national economy that somebody with your RFC can do, Social Security will award you disability benefits under what is called a medical-vocational allowance.

Proving that you can't do any jobs is difficult, but not impossible. For more information, see our article on getting disability by showing you can't do even sedentary work.

_{Updated October 10, 2023}