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Disability Evaluation Under Social Security
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Section | 8.00 Skin Disorders |
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1. Extensive skin lesions.
a. Skin lesions that interfere with the motion of your joints and that very seriously limit your use of more than one extremity; that is, two upper extremities, two lower extremities, or one upper and one lower extremity. b. Skin lesions on the palms of both hands that very seriously limit your ability to do fine and gross motor movements. c. Skin lesions on the soles
of both feet, the perineum, or both inguinal areas that very seriously
limit your ability to ambulate. 2. Frequency of flare-ups.
4. Treatment. a. We assess the effects of continuing treatment as prescribed by determining if there is improvement in the symptoms, signs, and laboratory findings of your disorder, and if you experience side effects that result in functional limitations. To assess the effects of your treatment, we may need information about:
b. Because treatment itself or the effects of treatment may be temporary, in most cases sufficient time must elapse to allow us to evaluate the impact and expected duration of treatment and its side effects. Except under 8.07 and 8.08, you must follow continuing treatment as prescribed for at least 3 months before your impairment can be determined to meet the requirements of a skin disorder listing. (See 8.00H if you are not undergoing treatment or did not have treatment for 3 months.) We consider your specific response to treatment when we evaluate the overall severity of your impairment. D. How do we assess impairments
that may affect the skin and other body systems? 1. Tuberous sclerosis primarily affects the brain. The predominant features are seizures, which we evaluate under the neurological listings in 11.00, and developmental delays or other mental disorders, which we evaluate under the mental disorders listings in 12.00. 2. Malignant tumors of the skin (for example, malignant melanomas) are cancers, or neoplastic diseases, which we evaluate under the listings in 13.00. 3. Autoimmune disorders and other immune system disorders (for example, systemic lupus erythematosus (SLE), scleroderma, human immunodeficiency virus (HIV) infection, and Sjögren's syndrome) often involve more than one body system. We first evaluate these disorders under the immune system disorders listings in 14.00. We evaluate SLE under 14.02, scleroderma under 14.04, HIV infection under 14.08, and Sjögren's syndrome under 14.10. 4. Disfigurement or deformity resulting from skin lesions may result in loss of sight, hearing, speech, and the ability to chew (mastication). We evaluate these impairments and their effects under the special senses and speech listings in 2.00 and the digestive system listings in 5.00. Facial disfigurement or other physical deformities may also have effects we evaluate under the mental disorders listings in 12.00, such as when they affect mood or social functioning. E. How do we evaluate genetic photosensitivity disorders? 1. Xeroderma pigmentosum (XP). When you have XP, your impairment meets the requirements of 8.07A if you have clinical and laboratory findings showing that you have the disorder. (See 8.00E3.) People who have XP have a lifelong hypersensitivity to all forms of ultraviolet light and generally lead extremely restricted lives in highly protective environments in order to prevent skin cancers from developing. Some people with XP also experience problems with their eyes, neurological problems, mental disorders, and problems in other body systems. 2. Other genetic photosensitivity
disorders. 3. Clinical and laboratory
findings. b. What we will accept as medical evidence instead of the actual laboratory report. When we do not have the actual laboratory report, we need evidence from an acceptable medical source that includes appropriate clinical findings for your impairment and that is persuasive that a positive diagnosis has been confirmed by appropriate laboratory testing at some time prior to our evaluation. To be persuasive, the report must state that the appropriate definitive genetic laboratory study was conducted and that the results confirmed the diagnosis. The report must be consistent with other evidence in your case record. F. How do we evaluate burns?
G. How do we determine if
your skin disorder(s) will continue at a disabling level of severity
in order to meet the duration requirement? H. How do we assess your skin disorder(s) if your impairment does not meet the requirements of one of these listings? 1. These listings are only examples
of common skin disorders that we consider severe enough to prevent
you from engaging in any gainful activity. For most of these listings,
if you do not have continuing treatment as prescribed, if your treatment
has not lasted for at least 3 months, or if you do not have extensive
skin lesions that have persisted for at least 3 months, your impairment
cannot meet the requirements of these skin disorder listings. (This
provision does not apply to 8.07 and 8.08.) However, we may still
find that you are disabled because your impairment(s) meets the
requirements of a listing in another body system or medically equals
the severity of a listing. (See §§ 404.1526 and 416.926
of this chapter.) We may also find you disabled at the last step
of the sequential evaluation process. 8.01 Category of Impairments, Skin Disorders 8.02 Ichthyosis, with extensive skin lesions that persist for at least 3 months despite continuing treatment as prescribed. 8.03 Bullous disease (for example, pemphigus, erythema multiforme bullosum, epidermolysis bullosa, bullous pemphigoid, dermatitis herpetiformis), with extensive skin lesions that persist for at least 3 months despite continuing treatment as prescribed. . 8.04 Chronic infections of the skin or mucous membranes, with extensive fungating or extensive ulcerating skin lesions that persist for at least 3 months despite continuing treatment as prescribed. 8.05 Dermatitis (for example, psoriasis, dyshidrosis, atopic dermatitis, exfoliative dermatitis, allergic contact dermatitis), with extensive skin lesions that persist for at least 3 months despite continuing treatment as prescribed.
8.06
Hidradenitis suppurativa, with extensive skin lesions
involving both axillae, both inguinal areas or the perineum that
persist for at least 3 months despite continuing treatment as prescribed.
8.07 Genetic photosensitivity disorders, established
as described in 8.00E. B. Other genetic photosensitivity disorders, with: 1. Extensive skin lesions that have lasted or can be expected to last for a continuous period of at least 12 months, OR 2. Inability to function outside of a highly protective environment for a continuous period of at least 12 months (see 8.00E2). 8.08 Burns, with extensive skin lesions that have lasted or can be expected to last for a continuous period of at least 12 months (see 8.00F).
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Last reviewed or modified Tuesday Jun 17, 2008 |