ESA for Hidradenitis Suppurativa: How to Describe Your Limitations on the WCA
Updated May 2026 - Based on current WCA descriptor framework
Hidradenitis suppurativa (HS) causes painful, recurring abscesses and boils in the armpits, groin, buttocks, and under the breasts. Severe HS causes chronic pain, scarring, wound drainage, and significant limitations on sitting, standing, and movement.
The Work Capability Assessment does not ask "do you have hidradenitis suppurativa?" It asks how your condition affects your ability to perform 17 specific work-related activities. You need 15 points across all activities for Limited Capability for Work (LCW), or you must meet a Support Group (LCWRA) descriptor.
Which WCA Activities Does Hidradenitis Suppurativa Affect?
- Standing and sitting - Directly affected by hidradenitis suppurativa
- Mobilising - Directly affected by hidradenitis suppurativa
- Reaching - Directly affected by hidradenitis suppurativa
- Manual dexterity - Directly affected by hidradenitis suppurativa
- Continence - Directly affected by hidradenitis suppurativa
- Social engagement - Directly affected by hidradenitis suppurativa
- Personal action - Directly affected by hidradenitis suppurativa
Points from all 17 activities are combined. Even moderate scores across several activities can reach the 15-point threshold.
HS and Sitting/Standing
HS lesions in the groin and buttocks make sitting extremely painful. Lesions in the armpits make arm movement painful. This directly affects Activity 2 (Standing and sitting) and Activity 3 (Reaching). Describe the locations of your lesions and how they specifically limit your ability to remain at a work station: "Active HS lesions in my groin and buttocks mean I cannot sit in any chair without severe pain. The lesions are open and draining, requiring frequent dressing changes throughout the day."
Wound Management
Active HS requires wound dressing, pain management, and hygiene care multiple times per day. This takes significant time and is difficult to manage in a workplace setting. The drainage from lesions can soak through clothing, causing embarrassment and hygiene concerns that affect social engagement (Activity 16).
How to Describe Hidradenitis Suppurativa on Your ESA50/UC50 Form
The biggest mistake claimants make is describing their condition in medical terms rather than work-related terms. The WCA does not care about your diagnosis - it cares about what you cannot do reliably, repeatedly, and safely in a workplace context over an 8-hour working day, 5 days a week.
For each activity, describe your worst typical day (not your best), explain how often limitations occur, mention medication side effects, and always frame your answer in terms of workplace capability.
Evidence to Support Your Claim
- GP or specialist letters confirming diagnosis and work impact
- Prescription records showing medication and side effects
- Fit notes or med3 certificates
- Hospital or clinic appointment records
- A personal diary showing day-to-day variation
Support Group for Hidradenitis Suppurativa
You may qualify for the Support Group if your condition means that work-related activity would pose a substantial risk to your health. Ask your GP to write a letter specifically stating: "Requiring [your name] to engage in work-related activity would pose a substantial risk to their health." This mirrors the legal test and carries significant weight with decision makers.
Get Personalised WCA Guidance for Hidradenitis Suppurativa
ESAexpert generates tailored guidance for all 17 WCA activities based on your specific conditions. See exactly which descriptors apply and get ready-to-use language for your ESA50/UC50 form.
Get Your Personalised ReportWhat if You Are Rejected?
Around 2 in 3 ESA mandatory reconsiderations result in a changed decision. If you are scored too low, challenge the decision - the odds are in your favour. Read our mandatory reconsideration guide for step-by-step instructions.