Is Hidradenitis Suppurativa a Disability? ADA, FMLA and SSDI

Yes, hidradenitis suppurativa can be a disability, in two separate legal senses. In the United States, HS can count as a disability under the Americans with Disabilities Act, which protects you at work and gives you the right to ask for reasonable accommodations. Separately, severe HS can qualify for Social Security disability benefits, where it is evaluated under the SSA's skin disorders listings. Neither recognition is automatic. Both depend on how much the condition limits what you can do, and on how well you can document it. This article walks through both systems in plain language, plus the practical middle ground most of us actually live in: not too sick to work, not well enough to pretend nothing is happening.

One thing before we start. I have lived with HS for more than a decade and I write as a patient, not as a lawyer or a doctor. The numbers say this topic is anything but niche: a 2025 review on cumulative life course impairment in HS collected study after study showing that people with HS miss more work, lose more productivity and are unemployed far more often than the general population. In one Danish study in that review, unemployment among people with HS was 25.1 percent against 6.2 percent in the general population. If HS is interfering with your job, you are not imagining it, and you are not alone in it.

Is HS a disability under the ADA?

It can be, and more easily than many people assume. The ADA's definition covers anyone with a physical or mental impairment that substantially limits one or more major life activities, anyone with a history of such an impairment, and anyone perceived as having one. There is no list of approved diagnoses, so HS is not named anywhere, but it does not need to be. What matters is the effect on your life: walking, sitting, lifting, sleeping, concentrating, working.

Two details in the EEOC's ADA regulations matter enormously for a condition like ours. First, the rules state that "substantially limits" is not meant to be a demanding standard. Second, and this is the part every person with HS should know, an impairment that is episodic or in remission is a disability if it would substantially limit a major life activity when active. HS is the textbook episodic condition. The fact that you were fine last month does not erase what a flare does to you this week. The law looks at you during the flare, not at your best day.

The ADA's employment rules apply to employers with 15 or more employees, according to the EEOC's fact sheet on disability discrimination. If your HS substantially limits major life activities when it is active, you are protected against discrimination and you can request accommodations. You do not need a government card, an approval letter or a minimum Hurley stage. As the Department of Justice puts it, the ADA is a law, not a benefit program you apply for.

What workplace accommodations can you ask for with HS?

A reasonable accommodation is a change to how or where you work that lets you do your job, and under the EEOC's rules an employer must provide one for a known disability unless it causes undue hardship to the business. The examples the EEOC gives include scheduled breaks and leave for treatment. For HS specifically, the requests I see most often in the community, and the ones that would have helped me most in my own working years, are unglamorous and cheap:

Flexibility for appointments. Dermatology visits, wound care and procedures do not schedule themselves around shift work.
Permission to step away briefly. A draining lesion sometimes needs a dressing changed now, not at the next official break, and a private restroom beats a crowded one.
Seating and movement changes. A cushion, a different chair, or alternating sitting and standing when lesions in the groin or buttocks make a hard chair feel like a punishment.
Uniform or dress code adjustments. Looser or more breathable clothing where friction and sweat hit the worst areas.
Temperature and sweat control. A fan, a cooler workstation, or a role rotation away from the hottest tasks during a flare.
Telework or schedule shifts during bad flares. Some days the work is fine but the commute, the uniform and the chair are not.

The process is supposed to be a conversation, not a court case. You tell your employer you have a medical condition and need an adjustment, they can ask for reasonable documentation from your clinician describing your limits, and you work out something that functions for both sides. A doctor's note describing functional limits is usually enough. It does not have to name HS or hand over your medical history.

Can you take medical leave for HS flares?

Often yes, through the FMLA, the Family and Medical Leave Act. According to the Department of Labor's fact sheet on FMLA qualifying reasons, eligible employees can take up to 12 workweeks of job-protected leave in a 12-month period for a serious health condition that makes them unable to perform their job. The fact sheet's own example of a chronic condition is an employee whose ongoing illness flares from time to time and who takes leave for those episodes and for periodic medical visits. Swap in HS and the example reads like our lives.

Two features make FMLA genuinely useful for HS. Leave can be taken intermittently when medically necessary, in separate blocks or as reduced hours, which fits a disease that attacks in flares rather than in one neat stretch. And it is job-protected, so a bad quarter of flares does not have to mean quietly losing your position. The eligibility rules are specific: 12 months with the employer, at least 1,250 hours worked in the previous 12 months, and a work site with 50 or more employees within 75 miles. FMLA leave itself may be unpaid, which is a real limitation, but it can run alongside employer-provided paid leave.

Does HS qualify for Social Security disability benefits?

It can, but this is the hardest door on this page, reserved for severe disease that keeps you from working at all. Since a rule change that took effect in October 2023, the SSA no longer has a dedicated hidradenitis suppurativa listing. The old listing 8.06 was folded into listing 8.09 for chronic conditions of the skin or mucous membranes, which now covers HS alongside conditions like severe dermatitis and bullous diseases.

In broad strokes, the listing requires chronic skin lesions or contractures that cause chronic pain or other physical limitations and that persist for at least three months despite adherence to prescribed medical treatment, together with serious documented functional limits, such as being unable to use the arms for work tasks or to stay upright when standing or walking. The three-month treatment requirement is central: flares that settle between episodes, however miserable, generally do not meet the listing on their own.

Not meeting the listing is not the end of a claim. The SSA also evaluates what work you can still realistically do given your condition, age, education and work history, the so-called medical vocational route. Severe HS can win there when the combination of pain, restricted movement, drainage and unpredictable absences rules out sustained work. It is a slower and more demanding path, decisions often take months and denials at the first stage are common, which is why documentation matters so much, and why many people only succeed on appeal. If your HS is at that level of severity, this is one of the rare moments where I think talking to a disability lawyer or advocate early is worth it, and the HS Foundation keeps a resource page for exactly this situation.

How do you document HS for a claim or an accommodation request?

Every path above runs on paper, and HS is notoriously badly documented because we often avoid doctors for years. If work is becoming difficult, start building the record now, before you need it.

A consistent dermatology record. Regular visits, even when things are calm, establish that the disease is chronic and that you follow prescribed treatment. That adherence is literally written into the SSA listing.
Your Hurley stage in writing. Severity staging carries weight in every system. If you do not know yours, I explain how staging works in my guide to the Hurley stages, and your dermatologist can record it at the next visit.
Photos with dates. Flares have terrible timing and tend to look better by appointment day. Dated photos close that gap.
A flare and work log. Dates, locations, drainage, pain, what you could not do, days missed. A year of entries tells a story no single appointment can.
Treatment history. Everything tried and the result, including procedures and surgeries. It shows persistence of disease despite treatment, which is exactly what adjudicators look for.

Working with HS: what helped me

I spent my worst HS years employed, and most of what I know about this subject I learned the uncomfortable way. In my book I tell the story of my first job, when I worried about crushing tiredness after lunch, because as a student I could nap and at work I no longer could. Members of my community, whose words open the book, put it more sharply than I ever could: one described playing down the disease at work as just cysts, while privately being unable to raise an arm, carry water up the stairs or demonstrate an exercise to a class. Another, at 25, wrote about the problems HS caused at work while hoping a new job would go better. None of this shows up on a pay slip, but it is work impairment all the same, and the research on HS and employment now says it out loud: more absence, more lost productivity, fewer promotions, lower income.

Three things made the biggest difference for me. First, separating shame from logistics: a dressing change is a task, not a confession, and treating it that way at work made it smaller. Second, taking stress seriously as a trigger instead of a weakness, because for me pressure and flares fed each other, something I have written about in how stress and HS interact. Third, getting my health onto a steadier footing. There is no cure for HS, and nobody should promise you one. In my case, an elimination and reintroduction approach in the AIP tradition changed my disease, and I have been in remission for years; the full story, including the reintroduction part that people skip at their peril, is in my book. Your path may look different. The point is that the legal tools in this article buy you time and space to find it.

Frequently asked questions

Is HS automatically a disability?

No. In both systems it is case by case. Under the ADA the question is whether your HS substantially limits major life activities when active, which many flares plainly do. For Social Security benefits the bar is much higher: lesions persisting at least three months despite treatment, or limitations severe enough to rule out sustained work.

Do I have to tell my employer I have HS?

No. Disclosure is your decision, and you only need to share enough to get what you need. Asking for an accommodation requires saying you have a medical condition with certain limits, usually backed by a short note from your clinician. It does not require your diagnosis history. If you do explain HS, the American Academy of Dermatology's overview covers the three facts that matter socially: it is not contagious, not an STD and not caused by poor hygiene.

Can I be fired because of HS?

Under the ADA, an employer covered by the law cannot discriminate against a qualified employee because of a disability, and retaliating against someone for requesting an accommodation is also prohibited, per the EEOC. You still have to be able to do the essential parts of your job, with or without accommodation. If you believe HS played a role in a firing or a demotion, that is a conversation for an employment lawyer, and timelines for complaints are short.

Is HS a disability in the UK?

It can be. The Equality Act 2010 defines disability as a physical or mental impairment with a substantial and long-term negative effect on normal daily activities, and it has special rules for recurring and fluctuating conditions, which is precisely what HS is. The practical logic is the same as under the ADA: what counts is the effect during the bad periods, not the average of good and bad days.

A last word. Everything here describes how the systems are designed to work, not legal advice for your situation, and the medical side of HS belongs with your dermatologist: if your disease is severe enough that you are reading about disability law, it is severe enough to deserve a treatment plan that is actually being reviewed. Talk to your dermatologist about your case, and bring the flare log with you.

Is Hidradenitis Suppurativa a Disability? A Guide for Work and Benefits