How Does Drug and Alcohol Use Affect a Disability Claim?

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 continue to 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. Whether the alcohol abuse will harm the claimant’s disability case 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 for these issues 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 theoretically get disability benefits based on that condition, regardless of drug or alcohol use.

Notably, claimants whose disabling conditions are psychiatric or mental 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.

Contact our office today if you or anyone you know would like to learn more about qualifying for Social Security Disability benefits.

Read more: https://www.ssa.gov/OP_Home/cfr20/416/416-0935.htm ; https://www.ssa.gov/OP_Home/rulings/di/01/SSR2013-02-di-01.html 

By: Devon Brady of Premier Disability Services, LLC®

Social Security Disability Benefits for Lupus

Lupus is a chronic disease that can cause inflammation and pain in any part of your body. It is considered an autoimmune disease, which means that your immune system — the body system that usually fights infections — attacks healthy tissue instead. Lupus most commonly affects your skin, joints, and internal organs. Because it can affect many parts of the body, it can cause a variety of different symptoms, such as: fatigue, headaches, joint pain, fever, edema, hair loss, and abnormal blood clotting.

Nobody knows what causes lupus, but it and other autoimmune diseases do tend to run in families. Experts also think it may develop in response to certain hormones or environmental triggers. An environmental trigger is something outside the body that can bring on symptoms of lupus — or make them worse. Lupus is not contagious.

There are two ways you can qualify for Social Security Disability benefits for lupus. You can either (1) meet the requirements of a listing set out in Social Security’s list of qualifying impairments, or (2) show that you are unable to work due to your limitations.

Lupus is one of the diseases specifically notated in Social Security’s listing of impairments. To qualify as disabled under this listing, you must meet the following requirements:

• Your lupus must affect at least two body systems or organs, (such as the kidneys and the lungs, or the heart and the brain), with at least one involved to a moderate level of severity; and
• Your lupus must cause at least two of the following symptoms: severe fatigue, fever, malaise (feelings of physical discomfort or illness resulting in low physical or mental activity), and/or involuntary weight loss.

OR

• You must have repeated symptoms of lupus, with at least two of the symptoms above, resulting in one of the following limitations at the marked level: 
  • Limitations of activities of daily living
  • Limitation in maintaining social functioning
  • Limitation in completing tasks in a timely manner due to lack of focus or ability to work quickly.

You can also qualify for Social Security Disability for lupus if you can prove that you are unable to work due to the health problems caused by lupus. For example, an individual with lupus might have the following physical symptoms: fatigue, chest pain, shortness of breath, headaches, and abnormal heart rhythms. These limitations can make it difficult to stand or walk for a lengthy period of time, which rules out many jobs. Furthermore, those with lupus may suffer personality changes, including anxiety and depression, and may have difficulty concentrating or have increased forgetfulness. Social Security will take these limitations into account when deciding if the applicant can do even simple, routine tasks that don’t require skill. 

Contact our office today if you or anyone you know would like to learn more about qualifying for Social Security Disability benefits.

Learn more about lupus: https://www.lupus.org/resources/what-is-lupus 

Adult Listing for lupus: https://www.ssa.gov/disability/professionals/bluebook/14.00-Immune-Adult.htm#14_02 

By: Joyce Trudeau of Premier Disability Services, LLC®

June is PTSD Awareness Month

This month, the Department of Veterans Affairs (VA) is raising awareness for Post-Traumatic Stress Disorder (PTSD). PTSD is a mental health disorder that begins after a traumatic event, which may involve a real or perceived threat of injury or death. This can include: a natural disaster like an earthquake or tornado, military combat, physical or sexual assault or abuse, or other accidents. The VA estimates that about 8 million people in the United States currently suffer from PTSD.

PTSD used to be called “shell shock” or “battle fatigue” because it often affects war veterans. According to the National Center for PTSD, it’s estimated that about 15 percent of Vietnam War veterans and 12 percent of Gulf War veterans have PTSD.

But PTSD can happen to anyone at any age. It occurs as a response to chemical and neuronal changes in the brain after exposure to threatening events. Having PTSD doesn’t mean you’re flawed or weak.

Symptoms of PTSD fall into four groups: intrusion (flashbacks, unpleasant memories, nightmares, or distress), avoidance, arousal/reactivity (trouble concentrating, startle response, feeling on edge, irritability, or bouts of anger), and cognition/mood (negative thoughts, distorted feelings, trouble remembering the event, or reduced interest in activities). People with PTSD may also suffer from depression and/or panic attacks. There are also differences in how men and women tend to manifest symptoms – everyone is different.

People with PTSD tend to feel a heightened sense of danger. Their natural fight-or-flight response is altered, causing them to feel stressed or fearful, even when they’re safe. PTSD can disrupt your normal activities and your ability to function. Words, sounds, or situations that remind you of trauma can trigger your symptoms.

Treatment for PTSD may include therapy, medication, or a combination of both.

The Social Security Administration (SSA) may consider your PTSD under Listing 12.15. However, even if you do not meet the strict requirements of the listing, you may still qualify for disability benefits if your experience of PTSD prevents you from working full time. The SSA will consider how your PTSD, or any other mental impairments you may have, affect your ability to: understand, remember, or apply information; interact with others; concentrate, persist, or maintain pace; and adapt or manage oneself.

Read more about PTSD: https://www.ptsd.va.gov/understand/awareness/index.asp ; https://www.healthline.com/health/post-traumatic-stress-disorder

See SSA’s mental listings: https://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm#12_15

Contact our office today if you or anyone you know would like to learn more about qualifying for Social Security Disability benefits.

By: Joyce Trudeau of Premier Disability Services, LLC®