We generally base our assessment of severity on the extent of your skin lesions, the
frequency of flare ups of your skin lesions, how your symptoms (including pain) limit
you, the extent of your treatment, and how your treatment affects you.
1. Extensive skin lesions. Extensive skin lesions are those that involve multiple body sites or critical body
areas, and result in a very serious limitation. Examples of extensive skin lesions
that result in a very serious limitation include but are not limited to:
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. If you have skin lesions, but they do not meet the requirements of any of the listings
in this body system, you may still have an impairment that prevents you from doing
any gainful activity when we consider your condition over time, especially if your
flare ups result in extensive skin lesions, as defined in DI 34128.007C.1. in this section. Therefore, if you have frequent flare ups, we may find that your
impairment(s) is medically equal to one of these listings even though you have some
periods during which your condition is in remission. We will consider how frequent
and serious your flare ups are, how quickly they resolve, and how you function between
flare ups to determine whether you have been unable to do any gainful activity for
a continuous period of at least 12 months or can be expected to be unable to do any
gainful activity for a continuous period of at least 12 months. We will also consider
the frequency of your flare ups when we determine whether you have a severe impairment
and when we need to assess your residual functional capacity.
3. Symptoms (including pain). Symptoms (including pain) may be important factors contributing to the severity
of your skin disorder(s). We assess the impact of symptoms as explained in §§ 404.1528,
404.1529, 416.928, and 416.929 of this chapter.
4. Treatment. We assess the effects of medication, therapy, surgery, and any other form of treatment
you receive when we determine the severity and duration of your impairment(s). Skin
disorders frequently respond to treatment; however, response to treatment can vary
widely, with some impairments becoming resistant to treatment. Some treatments can
have side effects that can in themselves result in limitations.
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:
i. The treatment you have been prescribed (for example, the type, dosage, method,
and frequency of administration of medication or therapy);
ii. Your response to the treatment;
iii. Any adverse effects of the treatment; and
iv. The expected duration of the treatment.
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. (If you are not
undergoing treatment or did not have treatment for 3 months, see 8.00H.) We consider
your specific response to treatment when we evaluate the overall severity of your