How Does Drug and Alcohol Use Affect a Disability Claim?

Posted February 15, 2019 by Premier Disability Services, LLC®

Sometimes the Social Security Administration (SSA) can use the fact that you drink or use drugs as a reason to ignore your disabling symptoms and limitations and deny your claim. In other cases, however, it is possible to get disability benefits even if you drink or use drugs.

Whether drug or alcohol use will affect your eligibility for disability benefits hinges on whether it contributes to your disabling medical condition. If your drug or alcohol abuse is deemed a material contributing factor to a medical impairment, you will not be awarded disability benefits based on that impairment. Materiality is determined by asking these questions: Is the medical condition for which the claimant alleges disability exacerbated – or caused – by alcohol or drug use? Would the medical condition improve enough not to be disabling if the claimant stopped using drugs or alcohol? If the answer to these questions is yes, your drug or alcohol use will be considered material to the alleged impairment, and you may be found ineligible to receive disability benefits.

For example, if a claimant has seizures, and the records indicate substance abuse, a claims examiner or judge (depending on the level the claim is at) will question what role is played by the claimant’s use of substances. If the SSA thinks that a claimant’s seizure condition would medically improve if the substance use came to an end, then the substance use would be labeled as material to the seizure condition. As a result, the claimant could not be awarded benefits on the basis of seizure disorder. If, however, the conclusion was made that the claimant’s frequency of seizures would continue regardless of whether or not the alcohol or drug use was discontinued, such use would be considered immaterial.

It does not matter whether past alcohol or drug abuse caused the medical condition. Another example: a claimant applies for Social Security disability based on liver dysfunction and alcoholic hepatitis. The claimant has a history of alcohol abuse, some of it recent. Will the alcohol abuse harm the claimant’s disability case? It depends on whether or not it is currently material to his condition. It doesn’t matter whether the alcohol abuse caused the liver damage in the first place. What matters is whether the disabling condition would disappear if the claimant stopped drinking. If the claimant’s liver damage is so pronounced that ceasing alcohol use completely would make no difference to the claimant’s medical condition, then alcohol abuse would be considered immaterial, or irrelevant, to the case. If, however, ceasing the use of alcohol would result in medical improvement, alcohol abuse would be deemed material to the disability case, and the claim would be denied.

This evaluation process is called a drug and alcohol abuse (DAA) determination. Of course, if the claimant has another medical condition, one that’s severely debilitating and completely unrelated to the one caused by or exacerbated by drugs or alcohol, he or she could get disability benefits based on that condition, regardless of drug or alcohol use.

Claimants whose disabling conditions are psychiatric or emotional in nature (for example, depression or anxiety) will have a harder time proving that their alcohol or drug use is not a contributing factor to their mental impairment. Most psychologists and psychiatrists believe that even moderate alcohol use contributes to depression.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your claim!

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By: Joyce Trudeau of Premier Disability Services, LLC®