Does Alcohol or Drug Abuse Qualify as Eligible for Disability Benefits?

When it comes to qualifying for disability benefits, some applicants are concerned about prior, or current, use of certain drugs and/or alcohol. They typically ask themselves, “Does alcohol or drug abuse impact an individual’s eligibility to obtain disability benefits?” Unfortunately, there is no simple “yes or no” answer to this important question. The issue of whether or not the Social Security Administration (SSA) will decide to deny your benefits claim on the basis of alcohol and/or drug use depends primarily on the nature of your particular medical condition that has left you disabled. If, for example, your disabling condition has the potential to improve if you quit drinking or cease taking drugs, then you likely will not qualify for disability benefits or Supplemental Security Income through the SSA.

Impact of on Benefits Eligibility When Alcohol or Drug Use is a Contributing Factor to the Impairment

Your eligibility for disability benefits when you have a record of alcohol or drug use will depend on whether your use of drugs or alcohol contributes to your disabling medical condition. If your use of drugs and/or alcohol is determined to be a “material contributing factor” to your disability, then the SSA will most likely deny your claim.

SSA will conduct an assessment on material contributing factors by asking the following questions:

  1. Is your medical condition or impairment made worse, or even caused, by your chronic use of alcohol and/or drugs?
  2. Would your medical condition improve enough not to be disabling if you halted using drugs and/or alcohol? If you respond affirmatively, then your drug and/or alcohol use will most likely be considered material to the impairment. Once a material contributing connection is established, the SSA will promptly deny your claim for disability benefits.

In order to answer these questions, the SSA engages in an evaluation known as a “drug and alcohol abuse” (DAA) determination. This means if there is evidence that a claimant has another medical condition or impairment and that condition/impairment is the cause of your disability AND wholly unrelated to any condition caused by drug or alcohol abuse, you could still be eligible for disability benefits.

Drug Testing and Eligibility for Disability Benefits

The SSA has no formal drug testing policy for individuals applying for disability benefits. Nevertheless, use or abuse of controlled substances could potentially result in your benefits application being denied. Though, in other circumstances, the SSA may actually consider a history of substance use as a symptom of a mental or psychological disability that may enable you to obtain disability benefits.

Disclosing Drug and/or Alcohol Use

It is important to be transparent and honest when completing a disability benefits application. In fact, the disability application includes specific questions regarding any prior or current use of drugs and/or alcohol. If you fail to disclose any substance use, the SSA could very well wind up discovering it while reviewing your medical records and related materials. If they determine you were not honest while completing your disability benefits application, the SSA will likely deny your claim on that basis alone.

SSA Will Assess Whether Your Impairment Could Improve By Ceasing Use of Alcohol or Drugs

As mentioned earlier, during the SSA’s material contributing factor assessment, the agency will ask whether simply quitting drinking or using drugs would materially improve your disabling condition. For example, let’s say an applicant is struggling with chronic seizures and is unable to maintain employment as a result. In addition, their medical records reflect a history of substance abuse. In this scenario, a claims examiner will typically question whether the substance abuse played a material role in causing the applicant’s chronic seizures. If the SSA concludes that the applicant’s seizure condition would medically improve if the substance use or abuse was halted, then the substance use or abuse will likely be labeled as material to the seizure condition. As a result, the claimant’s application will likely be denied.

If, on the other hand, the SSA determines that the claimant’s chronic seizures will continue regardless of whether or not the alcohol or drug use is discontinued, such use could be considered immaterial and they could remain eligible for disability benefits.

The Decision Process for Determining Whether the Condition Would Improve By Quitting Alcohol or Drug Use

When someone applies for disability benefits at the initial level, the process for determining whether your condition will improve by halting use of drugs or alcohol will be determined by a medical consultant (i.e., a doctor). This medical consultant will work for Disability Determination Services (DDS). In most instances, they write an opinion giving their best assessment on whether stopping the use of drugs or alcohol would have a positive effect on the person’s medical condition and functional ability.

The SSA may also ask your treating physician whether your drug or alcohol use is materially impacting your health and functional capacity.

If your initial claim is denied and you file an appeal, a judge will be empowered to decide the issue of how your drug or alcohol use is impacting your functional capacity. In fact, the judge will likely schedule a hearing and is not obligated to follow the opinion of a medical consultant. The judge has the option to make a decision based on the regulations regarding DAA.

Challenges for Claimants with Mental Conditions in Proving Immateriality

When an applicant has a disabling condition that is psychiatric or emotional in nature (e.g., depression or anxiety) then there is a good chance they will have a more difficult time in proving their alcohol or drug use is not a contributing factor to their mental impairment. For example, many psychologists and psychiatrists agree that even moderate intake alcohol could contribute to depression.

When a claimant for disability benefits has a history of alcohol or drug abuse but who is not currently using substances needs to carefully review their medical records before they file an application seeking disability benefits. In many instances, medical doctors and mental health professionals will indicate “suspected use” in their treatment notes, and these indications, proven or otherwise, could negatively impact their disability benefits claim.

When the SSA May Require a Representative Payee

If you prevail in your claim for disability benefits, but the SSA has reason to believe you are still abusing alcohol or drugs, then the agency could require you to have a representative payee and will refer you to a substance abuse treatment program.

If you find yourself in this situation, it means the SSA will send your disability check to the representative payee and not you directly. The payee would then be empowered to disperse the money to you and pay bills on your behalf. Basically, the payee would serve as a proverbial stopgap to reduce the risk that you use the disability payments to purchase illegal drugs or an excess of alcohol. It is worth noting that the representative payee can be a friend, relative, or even an organization.

Ready to Take Action? Fill Out a Free Evaluation Form on this Page

If you are interested in applying for disability benefits through the Social Security Administration, now is the time for action. If you qualify, disability benefits can be used to help pay for essential living expenses such as food, housing, medical bills, and so forth. This is why it makes sense to fill out the free evaluation form on this page. Once you fill out the form, you’ll be connected with an experienced disability benefits attorney to discuss your options and the best path forward.

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