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Even if the 0.1% damage reduction bonus per rank doesn't seem worth it at first, Hard to Kill becomes a somewhat good skill in the long run, but unless the player knows he/she won't be able to take too many hits or is able to take down hordes of enemies very quickly, most players should avoid this skill as it's uses are very situational. However, it is a very good skill to use during The Invincible Empyrean Sentinel fight, as the boss' singularity pull acts as a non-damaging attack. This will in turn give the player multiple stacks, granting him/her a significant damage reduction bonus.
If the player intends to use this skill all the time, careful management of his/her health and how much time is left until the stacks disappear is essential. Deliberately hurting oneself to keep his/her stacks and/or resetting the timer should also be considered depending on the amount the player currently has (again, such a strategy should be considered during The Invincible Empyrean Sentinel fight, such as when it is changing phases and no enemies are nearby).