Chronic Skin Diseases and Social Security Disability

Skin diseases are one of the most common types of disorders, with various conditions affecting 100 million Americans, according to the American Skin Association. Millions of those cases are chronic diseases, which means they’re long-term, recurrent, or possibly life-long conditions.

If you’ve has been affected by a long-term skin disease that’s interfering with your ability to work, there may be help. The Social Security Administration (SSA) provides financial support to those unable to work because of a disabling condition.

The Financial Costs of a Chronic Skin Disease

There are many different kinds of long-term skin disorders that affect people in different ways. In 2004, the National Institutes of Health estimated that almost $30 billion is spent in treating skin disorders each year for expenses like outpatient and inpatient hospital fees, prescribed medication, and over-the-counter drugs. Another $10 billion is lost due to lost productivity costs, such as missed work.

However, those costs have risen exponentially in the last ten years. Though the expenses for each disease vary greatly, some conditions have direct costs of over a trillion dollars nationwide and indirect costs of $2 trillion, according the American Academy of Dermatology and Society for Investigative Dermatology.

Added to the cost of the actual disorders are the psychological expenses of skin diseases. Dr. Ted Grossbart told Psychology Today that major depression is one of the main symptoms of chronic skin diseases, and at least five percent of sufferers have considered suicide. He said a number of those with a skin condition, including 26 percent of people with moderate to severe psoriasis, have been forced to change their daily activities due to their disease.

Medically Qualifying for Benefits with the Blue Book

Once the SSA receives any application for disability benefits, they will first evaluate the claims based on medical requirements. All of these requirements are listed in the Blue Book, the SSA’s official list of impairments.

Chronic skin diseases can be found under section 8.00—Skin Diseases.

In order to qualify for benefits via the Blue Book, you need medical proof that any of these apply to you:

  • Chronic infections of the skin or lining of the skin, with extensive skin lesions that cause breakage in the skin’s surface, death of skin tissue, and often a bad smell. The lesions should persist for at least 3 months despite continuing treatment as prescribed
  • Ichthyosis, with extensive skin lesions that persist for at least 3 months despite continuing treatment as prescribed
  • A form of bullous disease, with extensive skin lesions that persist for at least 3 months despite continuing treatment as prescribed.
  • Dermatitis (for example, psoriasis or atopic dermatitis), with extensive skin lesions that persist for at least 3 months despite continuing treatment as prescribed.
  • Genetic photosensitivity disorders, with extensive skin lesions that have lasted or can be expected to last for a continuous period of at least 12 months or the inability to function outside of a highly protective environment for a continuous period of at least 12 months.

The SSA also offers definitions to further explain their qualifications:

  • Extensive skin lesions involve multiple body sites or critical body areas, and result in a very serious limitation. For example, lesions that interfere with the motion of your joints and limit the use of more than one extremity, lesions on the palms of both hands that very seriously limit your ability to do fine and gross motor movements, and lesions on the soles of both feet limit your ability to walk normally.
  • Frequency of flare-ups will be considered, even if you don’t meet one the above listing, especially if they result in extensive skin legions.
  • Other symptoms, such as disfigurement, will be evaluated under the effected body system.
  • Treatment must be attempted for at least three months so the SSA can see the effect of the treatment on your condition. They will look at your response to any medication, therapy, surgery, and any other form of treatment, any limiting side effects, and the expected length of the treatment.

There are thousands of different skin disorders, so talk to your doctor if you feel your condition is too debilitating to allow you to work.

Qualifying Without Meeting a Medical Listing

Because there are so many different skin conditions with varying severities, your disease may not meet any of the SSA’s Blue Book listings. If you find your type of skin disease doesn’t, there is another way for you to be approved for disability benefits, a Residual Functioning Capacity (RFC).

In order to be considered able to work by the SSA, you need to do some level of work (sedentary, light, medium, heavy, and very heavy) that earns you the minimum amount of monthly income, called substantial gainful activity (SGA). In 2016, the SGA minimum is $1,130 per month for an individual.

RFC approvals happen often because they are based on the workplace limitations caused by your conditions instead of strict medical requirements. As with all disability applications, if you’re applying with an RFC, you need to be expected to be out of work for at least 12 months.

The SSA uses a set of rules, called grid rules, when determining what jobs are available to you, depending on your level of work ability, work history, education and skills, and age. If you are under 45, these rules don’t apply to you, but you may still be approved if you can show the SSA you’re too disabled to perform sedentary work or your applying with non-exertional limitations, such as mental illnesses.

In an RFC, the SSA will consider how frequent and serious your flare-ups are, how quickly they resolve, and how you function between flare-ups. Though you may be in remission part of the time, severe episodes may be enough to qualify, especially if these flare-ups often require hospitalizations or sick days from work.

The SSA also will look at how your condition affects you and the limitations described by your doctor. Chronic skin conditions may cause restrictions in fine motor skills, walking, and joint movements, as well as problems with depression and other body systems caused by your skin disease.

Americans with a chronic skin disease applying for disability have a higher chance of being found unable to work if they did not go to college or they had non-sedentary jobs. For example, if you’ve only worked in physically demanding fields such that require standing, walking, lifting, or constant switching between them, on a regular basis, such as labor, construction, or delivery, you may be approved.

How to Apply for Social Security Disability Benefits

Before you apply for disability benefits, talk to your doctor for his or her advice. The application process can be long and grueling, leaving you without an income for two years. If your doctor doesn’t think your likelihood of getting approved for benefits, either through the Blue Book or an RFC, then it may not be worth your time to apply.

If you meet a medical listing in the Blue Book, you may be eligible for approval in the initial claim stage. However, more than half of applicants are denied because they are missing medical evidence. Make sure you have all of the necessary information to apply so they SSA won’t have to deny or delay your decision.

The SSA needs to know about the onset, duration, frequency of flare-ups, and prognosis of your skin disorder. Important medical evidence will include:

  • Skin biopsy results
  • Patch testing results, which is a test observed over multiple days to determine if your skin reacts to certain substances
  • Blood test results
  • Tests or physician reports describing the location, size, and appearance of lesions
  • Doctor’s reports detailing history of exposure to toxins, allergens, or irritants, familial incidence, seasonal variation, stress factors, and your ability to function outside of a highly protective environment
  • Records of all hospitalizations and doctor’s visits due to your skin condition
  • History, length, outcomes, and side effects of all prescribed treatments
  • Reports for your doctor any other doctor that’s treated you explaining the severity of your symptoms and your physical limitations if not described above

The SSA has an easy and convenient online application, but if you don’t feel comfortable, you can apply at your local SSA office. When filling out your forms, be sure to check your application to make sure there are no mistakes or unanswered questions, as these can delay your application as well. The SSA offers a full list of necessary materials, including tax and personal information, on their website.

If you’re prescribed a new course of treatment, you’re hospitalized, or there are any changes in your condition, you must notify the SSA as soon as possible. The new evidence may strengthen your case, as the more evidence you have to show your symptoms and limitations, the higher your chance of being approved.