Hidradenitis suppurativa (HS) is a skin disease characterized by painful acne-like cysts and abscesses that can become infected. Hidradenitis suppurativa usually begins after puberty (often in your teens or early 20s). And if it isn't diagnosed and treated early, HS symptoms tend to get worse over time.
Hidradenitis suppurativa can affect one part of the body or several different areas, but it usually occurs in your hair roots near sweat glands (like your armpits and groin). It's also common in areas where skin rubs together, like on the inner thighs.
Hidradenitis suppurativa causes chronically inflamed skin, including painful, itchy lumps, cysts, and abscesses. These can break open, ooze, and become infected.
HS usually affects both sides of your body, and symptoms can be severe enough to keep you from working. Some of the potentially disabling symptoms include:
Hidradenitis suppurativa can sometimes occur along with other impairments, like certain types of inflammatory bowel disease (such as Crohn's disease).
And HS can cause serious complications. If the affected area is in the armpits, thighs, or groin, and the symptoms are severe, movement can be very painful. This pain can make it difficult to use your arms and legs.
Hidradenitis suppurativa can also lead to potentially life-threatening conditions, including cellulitis, a serious skin infection that can spread to the bloodstream, causing sepsis. HS can also cause squamous cell carcinoma (skin cancer that can spread to other parts of the body).
While there's no cure for hidradenitis suppurativa or severe acne, there are treatment options that give some people relief. Some common medications prescribed for hidradenitis suppurativa include:
In some cases, surgery is needed to drain lesions. In extremely severe cases, the affected skin may be removed and replaced with skin grafts.
Some people with hidradenitis suppurativa have symptoms that aren't debilitating and can be eased by things like:
Other people with HS have disabling symptoms that don't respond to treatment. If you have very severe symptoms that last over a year, you might qualify for Social Security disability benefits.
For the Social Security Administration (SSA) to consider any medical condition a disability, it must be severe enough to keep you from working for at least 12 months, or be expected to keep you from working for at least 12 months. If you can't work because of hidradenitis suppurativa and your condition isn't likely to improve, you could qualify for disability benefits.
Also, the SSA limits the amount of money you can earn each month before it's considered "substantial gainful activity" (SGA). The agency won't consider your hidradenitis suppurativa disabling if you can work enough to make more than the SGA level ($1,350 per month in 2022).
Medically, Social Security has three ways that HS can qualify for benefits. You can:
Listed impairments are conditions that Social Security recognizes as potentially serious enough to keep you from working enough to support yourself. If you have a listed condition like HS that keeps you from working, you might automatically qualify for disability benefits under the listing. But to do so, your condition must match the listing requirements.
HS listing. To qualify for disability under the SSA's medical listing for hidradenitis suppurativa (8.06), your medical records must include a diagnosis of hidradenitis suppurativa with skin lesions on either:
To qualify under the listing, the lesions must be extensive and persistent, lasting for at least three months (despite treatment).
Related listings. If you don't meet the SSA's listing for hidradenitis suppurativa, you might meet the requirements of a related listing—like the listing for skin infections/cellulitis or Crohn's disease.
To meet the listing for chronic skin infections, you must have extensive festering or ulcerating sores (sores that don't heal) despite following a doctor's prescribed treatment for at least three months. In reality, unless you have severe ulcerating lesions that make it hard to walk or use your hands, you're unlikely to qualify under this listing.
If you don't meet one of Social Security's medical listings, the SSA will determine whether the severity of your symptoms is "equal to" another medical listing—like the one for ichthyosis (8.02).
For example, if you have hidradenitis suppurativa that isn't located in any of the three areas specified in the hidradenitis suppurativa listing, but you do have "extensive skin lesions" that have persisted for at least three months, your condition might "medically equal" the listing for ichthyosis.
If Social Security doesn't find you disabled after considering all of the above, you might still qualify for benefits. The SSA must next look at what's called your RFC, or "residual functional capacity." Your RFC assessment will show what kinds of work you should be able to do despite the limitations your impairment causes.
An RFC for hidradenitis suppurativa. The RFC assessment of people with hidradenitis suppurativa often includes limitations based on lesions on the hands, which would restrict actions such as:
Lesions on the feet or other areas of the lower body might lead to restrictions on how much you can be expected to stand, walk, sit, or kneel, which might limit you to sedentary work.
When your RFC doesn't allow work. Whether your RFC is limiting enough for the SSA to agree that you can't work because of HS depends a great deal on your prior work. If your past jobs all involved heavy lifting, and you get an RFC of sedentary work, you clearly can't do your past job.
Or, if you have a sedentary RFC that limits the use of your arms because of painful lesions in the armpits, there really wouldn't be many other jobs you could learn to do. In this case, you could be found disabled because your RFC is actually for less than sedentary work.
Alternately, if your hidradenitis suppurativa (or a related infection like cellulitis) has caused you to be hospitalized numerous times in the past year, you probably missed a lot of work. The number of absences your skin condition causes is a good argument that you wouldn't be unable to hold down a full-time job.
Learn more about getting disability benefits based on medical-vocational allowances.
If your hidradenitis suppurativa prevents you from working, you can apply for Social Security disability benefits. There are three ways to get your application started:
No matter which method you choose, to complete the application, you'll need your Social Security number (and those of your family members). You'll also need to answer several questions about your work history, living situation, current income and assets, and your medical condition.
It's important to give honest answers, but don't downplay your impairment. Everything you say should be truthful but also help you build your case. Learn what not to say to Social Security when applying for disability benefits.
Updated August 19, 2022