The Social Security Administration (SSA) recognizes hidradenitis suppurativa (HS) as a potentially disabling disease. For HS to be considered a disability, your symptoms must be severe enough to keep you out of work for 12 months or longer.
The conditions for HS to qualify as a disability are listed in the SSA’s Blue Book, which is the manual of conditions that can lead to long-term or permanent disability. If you can continue working, you will not be able to qualify for disability benefits. In addition to being unable to work and proving that you qualify medically, you must not be able to switch jobs to continue working. The SSA will take into consideration your work history and relevant skills that you have. According to the SSA’s eligibility criteria, to qualify for Social Security Disability Insurance (SSDI) benefits with HS, your medical records must show one or combination of the following:
- Extensive skin lesions that involve axillae (both your underarms)
- Inguinal areas (both side of the groin) involved
- Lesions in the perineum (the area around the genitals and anus)
- Skin lesions must last a minimum of three months even while undergoing continuous treatments as prescribed by your physician
In addition to meeting these listed eligibility requirements, your HS must also prevent you from getting and maintaining gainful employment either in your traditional field of work or in any other job for which you’d be qualified based on your skills, education, and work experience and taking into consideration the limitations that your HS places on you.
What is hidradenitis suppurativa (HS)?
Hidradenitis suppurativa (HS) is considered a severe skin disease that produces painful bumps under the skin. These pus-filled bumps occurring in the hair follicles tend to occur near the sweat glands and in areas where the skin frequently rubs against the skin or clothing. The commonest sites are armpits and between the thighs and bums.
- This condition develops due to blockage of the ducts leading to the skin pores.
- When the duct lining cells block the ducts, a plug builds up in those blocked areas and starts expanding the duct, causing oozing, swelling, and irritation.
- The oil duct and hair follicle eventually explode sideways underneath the skin.
- The body develops a strong irritant and allergic reaction to this foreign material under the skin.
- The reaction develops with large, red, hot, painful swellings that eventually break down and drain pus; although this is not an infection, this problem can be hereditary.
- In addition to the family history, this condition is related to hormones. It commonly starts around puberty. It often gets worse each month with the menstrual cycle.
- Stress can be a factor, and sweating can trigger a flare.
- Friction in the areas of involvement is often a problem. The walls of the pores or “follicles” in the sweaty areas of the body seem to be “weaken” and easily rupture. Anything that rubs the areas (tight clothing, menstrual pads, etc.) can cause the plugged and swollen ducts to break down more easily.
- Hurley’s Stage I: There are some boils, one or several, but they do not have small tunnels under the skin, and scarring is fairly minor.
- Hurley’s Stage II: There are recurrent boils with small sinuses under the skin and scarring. There may be one or several of these complexes scattered in different areas or small groups of them.
- Hurley’s Stage III: There are large areas involved with multiple interconnected tunnels and tracks and draining lesions with a lot of scarring.
- Antiseptic wash can be helpful. It does not cure anything but can help in the areas of odor and drainage.
- There is no cure for this lifelong condition. In severe cases, surgery may be appropriate for the management of symptoms.
- There are a few surgical options available for the treatment of HS. Lancing of individual bumps is the simplest and least invasive surgical option, but it only provides short-term relief from painful flare-ups. The recurrence of bumps is likely following this treatment.
- In many people, bumps caused by HS repeatedly appear in the same location. In such instances, a procedure called “unroofing” may be used. It turns bumps and pockets under the skin into painless scar tissue. This procedure is more resistant to relapse than lancing and draining.
- Severe cases of HS may require widespread removal of the problem areas of the skin. During such procedures, the removed skin is replaced with skin from another part of the body in what is known as a skin graft. The new skin will attach and grow in the area just like the original skin.