Social Security recognizes that chronic skin conditions, such as hidradenitis suppurativa (also called acne inversus) can significantly interfere with your daily activities and ability to function at work. If you have severe hidradenitis suppurativa that keeps you from working full-time for at least twelve months, you might qualify for disability benefits.
Hidradenitis suppurativa (high-drah-dun-EYE-tis su-pure-uh-TIE-vuh) is a skin disease characterized by painful acne-like cysts and abscesses that can become infected. Hidradenitis suppurativa (HS) usually begins after puberty, often in your teens or early 20s. If it isn't diagnosed and treated early, symptoms of the condition tend to get worse over time.
HS 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, such as the inner thighs.
Hidradenitis suppurativa causes chronically inflamed skin, including painful, itchy lumps, cysts, and abscesses. These can break open, ooze, and become infected.
Symptoms of HS usually affect both sides of your body. Some of the potentially disabling symptoms include:
Hidradenitis suppurativa can sometimes occur along with other disorders, like certain types of inflammatory bowel disease (for example, Crohn's disease). HS can also 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 lead to potentially life-threatening conditions such as cellulitis, a serious skin infection that can spread to the bloodstream. HS can also cause squamous cell carcinoma, a type of skin cancer that can spread to other parts of the body.
While there's no cure for HS, doctors have multiple treatment methods that can help control symptoms. Some common medications for hidradenitis suppurativa include antibiotics, corticosteroids, and immunosuppressants. More severe cases might require surgery in order to drain lesions or graft skin.
Many people with HS have symptoms that they control with minimal or moderate treatments, such as frequent washing, antibacterial medication, using warm compresses, or making dietary changes. They're unlikely to qualify for disability benefits. But people with severe cases of hidradenitis suppurativa can struggle to control symptoms, to the point that HS significantly interrupts their life and ability to work. They may be eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
Social Security doesn't provide "temporary" or "short-term" disability benefits. You'll need to show that your hidradenitis suppurativa is severe enough to keep you from working for at least 12 months. The agency limits the amount of money you can earn each month before it's considered "work," so you won't be able to get disability for HS if you can work enough with the disorder to make more than about $1,500 per month.
Once Social Security determines that you meet the technical requirements for the SSDI or SSI disability programs, the agency will review your doctor's notes to determine whether you meet the medical definition of disability. You can qualify for benefits in one of two ways:
Listed impairments are conditions that Social Security recognizes as serious enough for the agency to find you disabled without having to determine that you can't do any jobs. If you have evidence of a listed condition, you might automatically qualify for disability benefits—but you'll need medical documentation that your condition matches the listing requirements.
Hidradenitis suppurativa used to have its own listing in Social Security's "Blue Book" of impairments, but the agency recently (as of October 2023) changed how it evaluates skin conditions. Social Security now considers skin disorders such as HS under listing 8.09, Chronic conditions of the skin or mucous membranes.
You can meet the requirements of listing 8.09 if you can show that your HS causes skin lesions or contractures (permanent scar tissue that inhibits movement) that last for at least 3 months despite regular medical treatment. You'll also need to show that your lesions or contractures cause the following functional limitations:
Basically, in order to get disability under listing 8.09, you'll need to have extensive sores that don't heal despite medication and that make it hard to walk or use your hands. Few people will have symptoms intense enough to meet the listing requirements. However, if you have symptoms of HS in addition to another disorder, Social Security might find that you equal listing 8.09—even if you don't match the requirements exactly.
Even if Social Security doesn't find you disabled under listing 8.09, you might still qualify for benefits if your symptoms keep you from performing any job. Social Security reviews your medical records and your activities of daily living in order to determine your residual functional capacity (RFC). Your RFC assesses what kinds of work you're able to do despite the limitations from your medical conditions. The more limitations you have in your RFC, the fewer jobs you'll be able to do.
RFCs for hidradenitis suppurativa. A typical RFC assessment for applicants people with hidradenitis suppurativa will likely include limitations on activities involving the parts of the body affected. For example, if you have lesions on your hands, your RFC will restrict the amount of time you're able to write, type, and move small objects around. If you have contractures on your legs and feet, you'll be limited in how long you can stand and walk, which might limit you to sedentary (sit-down) jobs.
How Social Security decides if your RFC doesn't allow work. Whether your RFC is limiting enough for the agency to find that you can't work depends on your age, education, and past work history. For example, if your past jobs involved standing all day and your current RFC limits you to sedentary work, you'll be unable to do your past work.
If you're 50 years of age or older, being unable to return to your old jobs might be enough for Social Security to find you disabled using the medical-vocational grid rules. But applicants younger than 50 will generally need to prove that they can't do even the easiest sit-down jobs. This can be accomplished in several ways—missing too much work because of HS flare-ups, for example, or being unable to keep up with job tasks due to pain. (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, you'll need your Social Security number (and those of your family members) to complete the application. 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 October 10, 2023