Social Security Disability Lawyers: Riverside, San Bernardino and Orange County
What is Hidradenitis Suppurativa?
Hidradenitis suppurativa (HS) is an inflammatory disorder of hair follicles of unknown cause that most commonly occurs in areas where the skin rubs together, such as in the armpits, groin, under the breasts, and in between the buttocks. Skin lesions of HS may resemble pimples, cysts, blackheads, or boils. Sometimes the skin lesions may leak or rupture, extruding pus. Scar tissue formation may occur, which can thicken and interfere with arm motion (armpit) or walking (groin). [Ref: https://www.aad.org/public/diseases/painful-skin-joints/hidradenitis-suppurativa]
While the skin manifestations of HS may resemble pimples or acne, they are not acne, and the location of HS lesions is not where one would typically expect acne to occur (i.e., face, chest and back).
Patients who suffer from HS may also have an increased incidence of other medical conditions, such as inflammatory bowel disease (e.g., ulcerative colitis and Crohn's disease).
HS affects 1 to 4 percent of the population. It is important to recognize that it is not contagious; it is not sexually transmitted; it is not a bacterial infection (e.g., MRSA); and it is not due to poor hygiene.
Typically, the diagnosis of HS is made by a dermatologist on examination of the skin lesions. Sometimes bacterial cultures, laboratory tests, and skin biopsy are used to help confirm the diagnosis. However, the diagnosis is usually made by simply examining the lesions.
Hurley staging of HS lesions categorizes them in accordance with their severity.
Hurley Stage I – is a single lesion without sinus tract (tunnel) formation.
Hurley Stage II – Stage II manifests as more than one lesion or area, but with limited tunneling.
Hurley Stage III – Stage III is defined as multiple lesions, with more extensive sinus tract formations and scarring. It involves an entire area of the body. [Ref: https://www.hs-foundation.org/what-is-hs/]
There are several medications that may help HS patients. Antibiotics are used when there is superimposed infection with the HS, but they are not a treatment for the HS itself. Acne medications may help as supportive therapy, even though HS is not acne. Bleach baths, that you can do in your own bathtub, may be recommended. Corticosteroids and methotrexate are used to reduce the inflammation that occurs with HS. Metformin, a diabetes drug, may help treat HS lesions.
There is a “biologic” drug called Humira (adalimumab), which has been used for many years to treat rheumatoid arthritis and psoriasis, that has been approved by the FDA as a treatment for HS.
Surgery, including laser surgery, is used to help treat lesions that grow deep into the skin.
Lifestyle “treatments,” to help prevent flares of HS, include weight loss, wearing loose fitting clothes, and not smoking.
However, there is no known cure for HS. [Ref: Alikhan, A. “Hidradenitis Suppurativa.” JAMA Dermatol. 2016;152(6): 736.]
Disability Benefits for HS
The criteria that Social Security uses for HS to qualify for long-term disability benefits (SSDI) are listed in the “Blue Book” under subsection 8.06. In order to qualify for disability benefits under a Listing, you must have “extensive skin lesions involving both axillae [underarm], both inguinal areas [both sides of the groin] or the perineum [around the genitals and anus] that persist for at least 3 months despite continuing treatment as prescribed.”
However, you can still qualify for disability even though you don't necessarily meet the criteria set forth in the Listing under 8.06, if your skin lesions are recurrent, persistent, and severe enough to interfere with your ability to work.
HS can cause severe pain from skin inflammation and skin lesions in the axillae, thighs, and inguinal areas that frequently break open and drain pus. The inflammation, if it is recurrent and chronic, may cause scar tissue in affected areas or “sinus tracts” that burrow under the skin.
Affected areas in the armpits, thighs, or groin, can lead to restricted movement of the arms and legs, making walking, sitting, reaching overhead, and other movements with the upper and lower extremities very painful or impossible to perform in a work environment.
At Law Med, we have medical insight and legal expertise to obtain LTD benefits for you under SSDI and/or ERISA.