This post discusses if you can receive Social Security Disability for Hidradenitis Suppurativa. The Bishop Law Firm represents Social Security Disability clients in North Carolina and we do not get paid unless we win your case. Call us, 919 615-3095, for a free case review or start online now.
Social Security Disability Benefits
The first step in attaining benefits is to apply online or at your local SSA office. Before you apply, you need to know the types of benefits that SSA offers.
There are two main types of disability benefits that SSA offers: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI is based on the credits from the work that you have done in your life while SSI is a need based program.
Social Security Disability Insurance (SSDI)
SSDI is based on the credits from the work you have done in your life. You must be found disabled before your date last insured (DLI) to be found eligible for SSDI. Your DLI is calculated by counting your “quarters of coverage” from your earnings record. You must have 20 “quarters of coverage” of the last 40 quarters. Simply put, you must have worked 5 years of the last ten years (in general). In addition, Adult Disabled Children can be eligible for benefits off their parent’s account.
Supplemental Security Income (SSI)
SSI (Supplemental Security Income) is a need-based program and you must meet income/asset standards in addition to being found disabled under the five steps below. In 2024, SSI is $943 a month for an individual and $1,415.00 for an eligible couple. SSI will be reduced by 1/3 if you are receiving financial help from others. In NC, SSI recipients are also entitled to Medicaid.
SSI is also available for disabled children and is evaluated under a different standard than adults. Children must have a medically determinable physical or mental impairment or impairments (including emotional or learning problems) which result in marked and severe functional limitations, and the impairment(s) has lasted or can be expected to last for a continuous period of at least 12 months or be expected to result in death. Child SSI terminates when the child turns 18. The claimant will then have to reapply and be evaluated under the above adult sequential evaluation.
You must be found disabled under SSA's Five Step Sequential Evaluation before you are entitled to either type of benefit.
Five Step Sequential Evaluation
At every step of the Disability Process, SSA uses the Five Step Sequential Evaluation to determine if you are disabled.
- Step 1 – Are You Working? The Social Security Administration defines work as “Substantial Gainful Activity” (SGA). SGA is roughly defined as work from earnings that average more than $1,550 (2024) a month. If you are making that amount you generally will not qualify for disability.
- Step 2 – Is Your Condition “Severe”? Severity is key when it comes to what qualifies as a disability. Severe is defined by the Social Security Administration as: your condition must interfere with basic work-related activities for your claim to be considered.
- Step 3 – Is Your Condition on the List of Disabling Conditions? The Listings are very hard to meet in most cases and not always interpreted as a common reading would suggest. If you meet a listing you are gravely ill. The listings are found here.
- Step 4 – Can You Do the Work You Did Previously? The Social Security Administration will look at your past work and determine if it was sedentary, light, medium, or heavy. They also will evaluate the skill level: unskilled, semi-skilled and skilled. For instance, an attorney would be sedentary skilled work. The Dictionary of Occupational Titles is found here.
- Step 5 – Can You Do Any Other Type of Work? If the Social Security Administration finds that you cannot do what you used to do, they then look to see if you can do anything else. This is where the “grids” come into play. The grids are the Medical-Vocational Guidelines. The grids are only for exertional impairments. Non-exertional impairments are not considered by the grids. If you are found to be capable of any other work, you will be found not disabled. Read The Grids and Your Social Security Disability Case.
Also read North Carolina Social Security Disability Lawyer
What is Hidradenitis Suppurativa ?
Hidradenitis Suppurativa or Acne inversa is a skin condition that causes small painful lesions under the skin in places where the skin rubs together (armpits, thighs, groin and anus - apocrine or sweat glands ).
Many times, HS can be confused with pimples or acne cysts. However, acne is common to the face, neck, back, chest and shoulders while HS often shows up in skin folds (WebMD).
These recurrent abscesses can break open and cause pus-filled tunnels (sinus tracks) under the skin in the affected area (AADA). The result can be odorous, itching, painful and inflamed pustules.
Fortunately, Hidradenitis Suppurativa is rarely life threatening but it can cause disability, chronic pain, scarring and depression in a patient. "According to a study conducted in Canada, some people return to the ER 10 or more times before getting diagnosed with HS (via AAD.org)."
Hidradenitis Suppurativa usually starts between the ages of 20 and 29 and in some individuals it worsens with age. Being a woman, an African American or having a relative with Hidradenitis Suppurativa increases your chances of having it. Infection and thick scars resulting in range of motion restrictions are frequent complications (Via Mayo Clinic ).
Treatment for Severe Hidradenitis Suppurativa
Treatment depends on the severity of the flare of HS lesions. A warm compress, NSAIDS, steroids, hormone therapy and topicals can be used. Accutane can also be prescribed but there is conflicting information about its usage.
If these methods fail, biologic injections (like Humira or Adalimumab and Remicade) can be given. Surgery may also be needed but even with surgery the skin lesions may come back again (Via WebMD ). Deroofing (including of the sinus tract ), excision and liquid nitrogen are all surgical options.
Is HS a disability?
The most important factor in receiving disability benefits is the severity of your illness. Simply being diagnosed with Hidradenitis Suppurativa (or any other condition ) is not enough to be found disabled. You must show that your severe HS is preventing you from engaging in substantial gainful activity.
Proving disability for HS will require medical records demonstrating a diagnosis, what medical treatments have been attempted, and if undergoing continuous treatments has been helpful/unhelpful.
SSA will look at your medical evidence during the Five Step Sequential Evaluation to determine if you meet a listing (Step 3) and again when they assess your residual functional capacity (before proceeding to Step 4).
The Social Security Administration can evaluate your Hidradenitis Suppurativa in a few different ways: Listing 8.09, the Grids (Medical Vocational Guidelines) or on the combination of your impairments.
Listing 8.09 requires extensive skin lesions that last for at least 3 months despite following medical treatment. Unfortunately, an outbreak for HS patients can last for years or a few months. If your HS lesions have lasted more than 3 months even though you are following medical treatment, you may meet this listing:
8.09 Chronic conditions of the skin or mucous membranes resulting in:
A. Chronic skin lesions or contractures causing chronic pain or other physical limitation(s) that persist despite adherence to prescribed medical treatment for 3 months.
AND
B. Impairment-related functional limitations demonstrated by 1, 2, 3, or 4:
1. Inability to use both upper extremities...or
2. Inability to use one upper extremity and a documented medical need for an assistive device that requires the use of the other upper extremity....or
3. Inability to stand up from a seated position and maintain an upright position to the extent needed to independently initiate, sustain, and complete work-related activities....or
4. Inability to maintain an upright position while standing or walking affecting both lower extremities
SSA Listing 8.09
As discussed elsewhere on this site, most listings are difficult to meet and working has long stopped being an option prior to meeting most listings. This listing requires severe complications.
The Medical Vocational Guidelines (SSA Grid Rules) may offer help for those over 50 years of age with lesions that affect their ability to walk or stand. Apocrine glands occur in parts of the body that feel friction when the body moves. Friction can cause lesions and may prevent you from moving without pain.
According to the Hidradenitis Suppurativa Foundation , metabolic syndrome, cardiovascular disease , and thyroid disease can occur with Hidradenitis . In addition, there seems to be a relationship between Inflammatory Bowel Disease (IBD), especially Crohn's Disease , and Hidradenitis Suppurativa . Pyoderma gangrenosum can also co-occur with HS. The combination of your HS symptoms and your other impairments may prevent you from engaging in substantial gainful activity.
Plainly speaking, you need to have skin lesions that are not responding to medication or that are recurring at a rate that is making your daily life difficult to be approved for disability. Unfortunately, in my clients with this skin disorder , even surgery on the affected area does not always work and can make the disorder worse. But for others, their lesions are controlled with continuing treatment.
Do you need a Social Security Disability Attorney?
A disability attorney who knows the process can help you show the SSA why you cannot work from your HS. A hearing before an Administrative Law Judge (ALJ) is your only chance of speaking to a decision maker directly. This time should not be wasted.
During the hearing and at every stage of the disability process, an attorney can point out the medical documentation that support your disability claim.
In my hearings with a HS patient, I may ask:
- Where do you have skin lesions? Tracks? What percentage of your body is covered by lesions currently? Is this normal for you?
- Do you have pain, odor, and itching? Can your loved ones smell the lesions?
- Anything that makes lesions better? Worse? Does your clothing make your HS worse? Do you have to change clothing frequently?
- What medications and therapies have you and your doctor's tried? Did any of those therapies work?
- Have you had any surgery for your HS? Was this surgery effective?
If burning, pain , itching, odor, other symptoms, or treatment side effects are stopping you from working, apply for Social Security Disability for Hidradenitis Suppurativa as soon as possible. Delay may cause you to lose benefits!
The Bishop Law Firm represents Social Security Disability clients in Raleigh, Durham, Fayetteville, Cary, Rocky Mount, Wilson, Smithfield, Louisburg, Chapel Hill, Roanoke Rapids , Winston Salem, Garner, Greensboro, Greenville and surrounding areas in North Carolina. Call us today for a free case review, (919) 615-3095 or start online now.
