If you suffer from a chronic and severe skin infection that interferes with your ability to work, you may be eligible for Social Security disability benefits.
As a general rule, the duration and severity of your skin condition are far more important to Social Security than the particular diagnosis. The location of the affected area on the body also makes a big difference—recurrent boils on the hands and feet resulting from staph infection could certainly prevent full-time work, while the same number of boils on the arms or legs might not. The key is the extent to which a person is limited in a job-related activities such as sitting, standing, walking, reaching, grasping, and performing fine motor skills.
For those with serious skin infections, there are two ways to receive disability benefits. One is to meet the criteria of an impairment in Social Security’s Blue Book, a list of conditions that SSA has determined are automatically disabling. The second is by showing that you’re unable to perform any full-time work based on your age, education, work experience, and residual functional capacity (RFC), Social Security’s term for the most you can do despite your impairments.
Skin conditions such as cellulitis, diabetic blisters, recurrent fungal infections, and recurrent bacterial or staph infections are generally evaluated under listing 8.04. To meet this listing, an individual must have a chronic infection of the skin or mucous membrane with “extensive fungating or extensive ulcerating skin lesions” lasting at least three months despite treatment.
“Extensive” lesions are defined as those that involve multiple body sites or critical body areas (for example, the palms of both hands or the soles of both feet) and result in a serious limitation.
A “fungating” skin lesion is one that involves breaks on the skin and necrosis (death of tissue), often accompanied by a foul smell.
An "ulcerating" skin lesion is one that involves breaks on the skin with a loss of surface tissue and pus.
A frequent combination of medical conditions on disability applications is diabetes with diabetes-related foot infections that cause recurring ulcerating lesions. Alternatively, some individuals with diabetes suffer from diabetic blisters on the foot (also know as bullous disease of diabetes, or bullous diabeticorum). This condition would be evaluated under listing 8.03, for bullous disease. This listing is similar to the one for skin infections: it requires extensive skin lesions that persist for three months despite treatment.
Of course, if your skin condition is caused by another disease or condition, the SSA may evaluate you under another listing as well. In addition, if your skin condition causes, for example, facial disfigurement or other physical deformities that affect your social functioning or mood, you will be evaluated under the mental disorders listings.
Even if you don’t meet a listing, Social Security could still determine that your condition is “medically equal” to one of the listed impairments. For instance, if the lesions “flare up” frequently but do not last for three months at a time, this could potentially equal a listing.
If your condition doesn’t meet or equal a Blue Book listing, you could still be awarded disability benefits through a medical-vocational allowance if you can show that your condition leaves you unable to perform any full-time work.
To prove the severity of your condition, you should provide SSA with laboratory findings (for example, biopsy results) that confirm your diagnosis. You must also supply medical evidence regarding the onset and duration of your condition, your prognosis, and the frequency and severity of any flare-ups. If your skin has lesions, you should provide evidence of their location, size, number, and appearance. Remember that Social Security will expect to see that you are attending regular appointments with your doctor and following all prescribed treatment. If your skin infection persists only because you are not taking prescribed antibiotics, you will not be found disabled.
In addition to medical evidence, it's also important to provide evidence of your functional limitations, or how your condition impacts you on a day-to-day basis. Do diabetic blisters on the soles of your feet prevent you from standing or walking for more than five minutes at a time? Do chronic boils on your hands prevent you from grasping objects or performing fine motor skills?
If your doctor is willing to complete an RFC form that details all your limitations, there is a much greater chance that Social Security will approve your disability claim. A knowledgeable disability attorney will work with your treating doctor to present the most persuasive case possible.