Eczema, officially known as atopic dermatitis, is a chronic inflammatory skin condition characterized by intense itching, dry skin, inflammation, and recurring rashes. While often manageable with topical treatments and lifestyle adjustments, severe and chronic forms can be debilitating. These severe cases cause persistent pain, extensive lesions, and functional limitations that interfere with a person’s ability to work.
Eligibility for Social Security Disability (SSD) benefits depends entirely on the condition’s severity and its measurable impact on an individual’s capacity to perform gainful activity for a continuous period of at least 12 months. The Social Security Administration (SSA) assesses whether symptoms, such as extensive lesions, frequent flare-ups, and treatment side effects, prevent the applicant from sustaining full-time employment. Applicants must meet strict medical and non-medical criteria.
The Two Types of Social Security Disability Benefits
Individuals applying for disability benefits typically apply for one of two distinct programs: Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Both programs require the applicant to meet the same medical definition of disability, but they differ based on the applicant’s financial and work history.
Social Security Disability Insurance is an earned benefit that workers pay into over their careers through FICA payroll taxes. To qualify for SSDI, applicants must have accumulated a sufficient number of work credits based on annual income. The number of required credits varies depending on the applicant’s age at the time they become disabled.
Supplemental Security Income is a needs-based program designed for aged, blind, or disabled individuals with limited income and resources. SSI does not require a qualifying work history or earned work credits for eligibility. Applicants must meet strict financial thresholds regarding their assets and monthly income to be considered for the program.
Qualifying for Disability Based on Eczema Severity
The Social Security Administration evaluates chronic eczema under its medical listing criteria for skin disorders. Specifically, the SSA looks at Listing 8.09 for chronic skin lesions. Meeting this listing requires evidence of extensive skin lesions that have persisted for at least three months despite continuing treatment prescribed by a physician.
Extensive skin lesions are defined by their location and the functional limitations they impose, not just the surface area covered. For example, lesions on the palms of both hands that severely limit fine and gross motor movements qualify as extensive. Similarly, lesions on the soles of both feet that prevent walking or standing for extended periods meet the severity requirements. The required three-month duration ensures the SSA is evaluating a condition that is truly chronic and resistant to standard medical intervention.
Another way to meet the listing is if the eczema results in a serious limitation in the ability to use two extremities, such as both hands, both feet, or one hand and one foot. This limitation must significantly impact work-related activities. If the lesions do not perfectly fit the exact location criteria, the SSA will consider if the overall functional impact of the eczema is medically equivalent to the listed requirements. The treatment history is scrutinized to confirm that the applicant has consistently followed prescribed therapy without achieving remission.
Essential Medical Documentation and Evidence
A successful disability claim relies on comprehensive and objective medical evidence detailing the condition’s severity. The most persuasive evidence is provided by a dermatologist or other treating physician who has a long-term relationship with the patient and can attest to the condition’s chronicity. Documentation must include specific clinical findings, such as the exact location and size of the lesions, their appearance, and the frequency and duration of flare-ups.
Treatment notes must show that the eczema has persisted despite adherence to a prescribed medical regimen. This includes records of all medications used, such as topical steroids, calcineurin inhibitors, and systemic drugs, along with the patient’s response to each therapy. Records of hospitalizations or consultations due to secondary skin infections or cellulitis also serve as evidence of severity. The SSA considers the side effects of treatment, such as fatigue or compromised immune function from immunosuppressive drugs, as part of the overall functional limitation.
Physician statements should clearly articulate the patient’s specific functional limitations resulting from the eczema, translating medical findings into practical terms. For example, a statement should explain that hand eczema prevents grasping tools, or that foot lesions limit standing time. Consistent documentation over time is more valuable than a single report, as it demonstrates the condition’s continuous nature.
Evaluating Work Limitations When Eczema is Chronic
If an applicant’s eczema is severe but does not precisely meet the medical listing criteria, the SSA evaluates the claim based on the applicant’s Residual Functional Capacity (RFC). The RFC is an assessment of the most a person can still do in a work setting despite their physical and mental limitations. This assessment is used to determine if the applicant can perform their past work or any other job existing in the national economy.
For chronic eczema, the RFC assessment focuses on non-exertional limitations, which are restrictions not directly related to lifting or standing capacity. These limitations include:
- Inability to perform fine manipulation due to hand lesions.
- Restrictions on exposure to environmental irritants like dust, chemicals, or extreme temperatures.
- A need to frequently change positions or elevate affected limbs.
- Chronic itching (pruritus) and associated sleep disturbance, which impair concentration and the ability to maintain a regular work schedule.
The SSA combines the determined RFC with non-medical factors, such as the applicant’s age, education level, and past work experience, to reach a final decision. For example, a younger applicant with a high school education and only experience in physically demanding labor will face a different standard than an older applicant with a college degree and a history of sedentary office work. If the eczema-related limitations prevent the applicant from performing their previous job and are so severe that they rule out all other forms of work available nationally, the claim will be approved.