Eczema is a draining disorder. Even mild cases can deprive sufferers of sleep and distract them from important tasks. Severe cases are often extremely painful and require immune-suppressing therapies. Regardless of the severity of the disorder, eczema forces many sufferers to modify their daily activities.
The symptoms are frequently debilitating. But is eczema a disability?
It’s a simple question to ask, but a complicated question to answer. It depends largely upon who is asking and why the question is being raised in the first place. Regardless of the context, though, any real answer depends upon knowing what eczema is.
What is Eczema?
Eczema is not one individual disease–rather, it’s an umbrella term for several different types of dermatitis, or inflammatory skin disorders. The most common type of eczema is atopic dermatitis. The term can also refer to contact dermatitis, seborrheic dermatitis, and nummular dermatitis, to name just a few.
These conditions are all characterized by inflammation of the skin, with symptoms such as redness, dryness, rash, and itch. Eczema can have different triggers; for some, it is triggered by stress. For others, it is triggered by pet dander or other allergens in the environment. It can also be triggered by contact with irritants in plants or cleaning supplies.
The severity of the disorder varies widely from one patient to another. Some people experience it as an infrequent and relatively mild annoyance. Others will experience frequent recurrences of severe symptoms.
Eczema and its Tolls
Eczema can exact a heavy toll. The incidence of depression is 14% greater among eczema patients; the incidence of anxiety is 17.5% higher. Eczema flares interfere with sleep in many cases, which brings its own risks. It adversely affects academic and professional performance. Eczema causes enormous stress–which in turn exacerbates eczema symptoms, creating an excruciating spiral.
Depending on the triggers, eczema may cause a person to limit activities they once loved and excelled at. This can negatively impact social and professional life. It can even lead to problems in relationships.
Eczema can profoundly affect a person’s ability to enjoy life and to work. It is the overall burden of these effects that determine whether your eczema can be determined a disability.
Eczema on the job
Discussions about disability primarily center around employment and schooling. As we mentioned before, eczema can limit or negatively affect a person’s professional performance. Whether those limitations rise to the level of a disability depends upon several factors.
Does the condition impact your work or your studies significantly enough that you require special accommodations? Does it prevent you from working altogether? Do you expect it to permanently impair your ability to work or go to school?
All of these questions are pertinent when determining whether a health condition is a disability. In the United States, different laws and agencies determine disability in their own ways for their own purposes. We’ll compare the ways in which disability is determined by the Americans With Disabilities Act (ADA) as well as the Social Security Administration (SSA) and how those criteria apply to workers with eczema.
The ADA and “reasonable accommodations” for Disability
Enacted in 1990, the ADA prohibits disability-based discrimination in workplaces, schools, and businesses. The act makes it illegal to deny employment to qualified people on the basis of disability, and it also demands that employers make “reasonable accommodations” for employees’ disabilities.
Under the ADA, “disability” is defined as “a physical or mental impairment that substantially limits one or more major life activities.” A person may be considered disabled when they have “a history or record of such an impairment” or if they are “perceived by others as having such an impairment.”
The ADA enumerates a few conditions that can be considered disabilities, including cancer, diabetes, visual impairments, and motor impairments. This is not an exhaustive list, however, and the law is purposely left vague on this point to allow for broader application.
When determining whether a person is disabled, the ADA is more concerned about whether their condition “substantially limits” their activity than they are with a specific diagnosis. The word “substantially” is key; mild, seasonal hay fever is not considered a disability. A serious allergy that causes asthma attacks and anaphylaxis may be.
At the same time, the ADA stipulates that a person may be considered disabled if they are “perceived by others as having…an impairment.” The ADA website provides the example of a person with visible scarring from burns.
The ADA is not a benefits program. It has no eligibility guidelines. It is a law meant to guarantee disabled people a fair chance at social participation–including a chance to work. The ADA makes it illegal for an employer to deny employment to a qualified candidate simply because they have visible eczema lesions, and it gives workers the right to demand “reasonable accommodations” in the workplace.
“Reasonable accommodation” might mean providing nitrile gloves to a person whose eczema is triggered by latex. Another example would be an employer removing air fresheners from a workplace to avoid triggering dermatitis for workers sensitive to fragrances.
In more severe cases, reasonable accommodations could involve being allowed to work from home during severe flares or during treatments that suppress the immune system.
How the SSA defines disability
The Social Security Administration (SSA) is a benefits program that provides living assistance to retired people and those with disabilities that prevent them from working gainfully. Its eligibility criteria are far stricter than the ADA’s broad definitions of disability.
The SSA describes disability as “the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”
The SSA’s guiding “bible,” the Blue Book, lists 14 different categories of “disabling conditions,” including immune system disorders and skin disorders. The blue book does not specifically list eczema, but it does list dermatitis.
Simply having a diagnosis of dermatitis is not enough, though, to qualify you for Social Security Disability Insurance (SSDI) benefits. The guidelines state clearly that a person seeking SSDI benefits for dermatitis must have “extensive” lesions over their body, they must have them over a sustained period of time (at least three months), and they must persist in spite of medical treatment.
The SSA will demand verification of your disorder from licensed physicians, either your own or one that works for the SSA. The physician’s report will contain the extent of the eczema, results from pertinent tests (such as allergy tests and biopsies), and a questionnaire about how the condition has impaired your ability to work.
The SSA will consider all of these factors to determine whether you can sustainably work to support yourself. They will want to know if any accommodations are available for your condition in your current career, and if not, they will investigate whether or not you could find gainful employment in another field in spite of your dermatitis.
Applying for SSDI benefits is typically a long and detailed process that demands a lot of supporting evidence–from you, from your physician, and possibly from a vocational specialist. Even with this evidence, you may find your claim rejected when you first apply. You can appeal decisions you disagree with; many SSDI applicants find that they are awarded benefits after doing so.
An attorney who specializes in SSDI cases can tell you whether you have a strong possibility of earning benefits. They often collect no fees unless you are awarded SSDI benefits, in which case they will claim a percentage of any lump sum payment from the SSA.
In The Meantime
While you're looking at Eczema and whether it's a disability - it's worth using a quality eczema cream as recommended by a dermatologist to try and deal with the flare. The key is to use one that isn't too high in hydrocortisone - leaving far less chance of topical steroid withdrawal.
We have many more articles on our blog regarding eczema and dermatological conditions for you to check out for further reading.