If you are considering filing for disability for your HS and live in the US, this article will help guide you through the process.
Understanding the difference between Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) Disability Insurance
The Social Security Administration operates two disability benefits programs and there is a large difference between the two benefits packages. When applying for disability it is important to be aware of the difference between Social Security Disability Insurance(SSDI) and Supplemental Security Income(SSI). SSDI requires a certain amount of work credits while SSI is based on financial needs.
What is SSDI?
Social Security Disability Insurance (SSDI) allows workers who become disabled to receive their Social Security retirement benefits early. In order for you to apply for SSDI, you need to have enough work credits based on taxable employment to be covered for Social Security purposes.
SSDI is based on FICA (Federal Insurance Contributions Act) taxes you paid throughout your working career, it is not based on how much money you have or do not have.
If you become disabled before you reach the age of 24, you need to have at least 6 work credits to qualify for SSDI and 12 credits if your age is between 24 and 31. If you are over 31, you need to have earned 20 work credits in the past 10 years before you became disabled to be eligible for SSDI.
To file for SSDI disability benefits you must either be:
A blind or disabled worker
An adult who has been disabled since childhood
Or otherwise eligible to apply according to SSA's rules
The amount of your monthly disability benefits will be based on your Social Security income record.
What is SSI?
Supplemental Security Income (SSI) benefits are awarded on the basis of financial need to adults and children who are disabled, blind, or have limited income and resources. When you file an SSI disability claim, make sure you can demonstrate to the case reviewer that you have very few financial resources or assets and a low income.
Eligibility Requirements for SSDI and SSI
The SSI disability program has different eligibility requirements than Social Security Disability Insurance (SSDI). To be entitled to SSI benefits you must be a U.S. citizen who meets the requirements set by the Social Security Administration (SSA).
To qualify for SSI benefits you need to present medical evidence that your disability will last for at least one year. Your total countable income should also be below listed Supplemental Security Income levels. The SSI amount differs from state to state.
In both SSDI and SSI cases a claimant's medical records will be checked periodically to be sure the individual is still disabled.
The Social Security Administration will review your condition every 3 to 7 years, depending on the nature of your disability. Once you’re awarded SSI disability benefits your financial records will be reviewed every year.
Other Facts You Should Know
When you apply for Social Security Disability benefits you should be screened for both SSDI disability and SSI. If you are awarded SSDI benefits of less than a thousand dollars per month it would be wise to consult with a representative to check if you qualify for SSI as well.
When you make a disability claim for SSI you may also be required by the Social Security Administration to provide financial records which include bank statements, mortgage and lease agreements, savings and other financial data that will help them assess your financial status.
SSA’s Eligibility Criteria
Hidradenitis Suppurativa appears in the SSA's Blue Book under Section 8: Skin Conditions, and has a dedicated listing under subsection 8.06.
It is imperative to list HS properly on your application. You can also label your condition as a chronic, debilitating inflammatory skin condition. Using any other language can put your case at risk for being overlooked, hold up paperwork, or even be denied.
It is important to note that HS has never been classified as an autoimmune illness, so there is no reason to list HS as an autoimmune on your application and doing so may risk HS as not being recognized or not matching the category as it is not categorized as autoimmune. If the agency with whom you are filing has HS listed under skin condition, you must list it as the same on your application.
Qualifying Under a Medical Listing:
In order to qualify for disability under the SSA’s medical listing for Hidradenitis Suppurativa, your medical records must include a diagnosis of hidradenitis suppurativa with skin lesions on either:
both sides of the groin
or on the perineum
The lesions must be extensive and must persist for at least three months.
In addition to meeting these listed eligibility requirements, your Hidradenitis Suppurativa must prevent you from obtaining and maintaining gainful employment based on your skills, education, and work experience.
If you don't meet the SSA’s listing for Hidradenitis Suppurativa, you may be found disabled under a related impairment, such as cellulitis or Crohn’s disease. If you have chronic skin infections such as cellulitis, you could qualify for disability under listing 8.04. The listing requires you to suffer from extensive festering or ulcerating sores that don't respond to a doctor's prescribed treatment for at least three months. Unless you have severe ulcerating lesions that make it hard for you to walk or use your hands, you are unlikely to qualify under this listing.
Alternately, if your Hidradenitis Suppurativa or related infections like cellulitis have caused you to be hospitalized numerous times in the past year, this is a good argument that you would be unable to hold down a full-time job with as many absences from work as your skin condition causes.
Tips & Resources
Some people elect to retain the services of a disability lawyer. Most of the time there is no cost for a disability lawyer unless you win your case. If/when you win your case they take a certain percentage of what you’re awarded. You may not need a lawyer the first time around, but if you are re- applying for disability or appealing a disability case, you may want to consider seeking the services of a disability lawyer. If you’ve hired an attorney or have an advocate, you should stay in contact with them during the claim process.
It can be difficult to get approved for hidradenitis alone depending on your severity. If you have any other illnesses make sure to list them all.
Be organized, document everything, and keep all your records and documentation handy. If you have any visible abscesses, take photos and include them.
When you receive your packet, fill it out completely.
Ensure you have a doctor(s) in agreement with your filing for disability and who agrees to assist. It is crucial that your doctor(s) get the paperwork into your disability caseworker on time. If you do not stay on top of your doctor and make sure they get this done in a timely manner it could put your case at risk. Lack of response or paperwork not being turned in on time represents a high percentage of denied cases.
Always follow up with your caseworker to ensure they have everything they need from your doctor(s). Stay in touch with your caseworker; they're there to help you.
Being asked to see a doctor at the request of disability is normal, no need to be alarmed.
Keeping track of your application: https://www.disabilitybenefitscenter.org/how-to/track-your-ssdi-application
SSDI/SSI Helpful Information Link: https://www.ssa.gov/disability/disability.html
Applying for Benefits
How to Apply
Disability Starter Kits
Getting Benefits Now
Social Security Number & Card
Change Your Name
Social Security Statement
My Social Security
Frequently Asked Questions
All services section/link: https://www.ssa.gov/site/menu/en/
Office of Disability Employment Policy: https://www.dol.gov/odep/topics/disability.htm
Frequently asked questions: https://faq.ssa.gov/en-US/
SOAR Outreach - Free training to assist with filing disability benefits
What is SOAR: https://soarworks.prainc.com/content/what-soar
SSI/SSDI Outreach, Access, and Recovery (SOAR) link: https://www.samhsa.gov/soar
This information has been researched, compiled, and put together to help navigate disability as well as for educational purposes.
Written by Denise Panter Fixsen
Edited by Brindley Kons