Approximately 20.3 million people in the US have a substance use disorder, which can cause a range of severe physical and mental health problems. Unlike in the past, since 1997, substance abuse or addiction is not considered a disabling medical condition.
Does that mean a person with a substance use disorder can not obtain SSDI or SSI benefits? Not necessarily, although it does make the case much more complicated and the likelihood of winning the case much less likely.
Social Security Disability: General Requirements
Anyone over the age of 18 can apply for Social Security disability benefits if they have a medically determinable physical or mental impairment that also meets any of the following:
- The condition results in their inability to engage in substantial gainful activity
- The medical condition either has lasted or can be expected to last for at least 12 consecutive months or is considered to be terminal
How would drug or alcohol addiction affect Social Security disability benefit requirements?
When the SSA considers a case, they will try to determine the level of impact substance use and or addiction has on a person’s health and ability to work. They will conduct an evaluation to determine if substance abuse is a contributing factor in a person’s impairments and if yes, they will consider whether substance abuse caused the condition, or if the disabling condition exists separately from substance abuse.
The claim for Social Security disability benefits may be successful if a claimant can prove that substance abuse did not contribute to the disabling limitations that they experience. So, in essence, substance abuse has to be determined to be an immaterial factor to the finding of disability.
But what if substance abuse caused irreversible medical problems? In that case, the SSA may grant disability benefits. But if the addiction is causing the person’s disability and it can also be reversed by ceasing substance use, then the claim will likely be denied.
What Conditions Related to Substance Abuse Qualify for Disability Benefits?
If a claimant can prove beyond a reasonable doubt that substance abuse caused a permanent and irreversible health condition, then they may qualify for benefits. Such conditions include:
- Peripheral neuropathies
- Seizures disorders
- Organic brain syndrome
- Liver damage
Mental health impairments can also be considered, but unless a claimant can prove a long history of disabling mental health impairments in the absence of substance abuse (of at least six to twelve months duration), the benefits are unlikely to be granted.
Medical Documentation is Critical
Accurate, in-depth documentation from physicians is critical to proving a disability case regardless of whether substance abuse is involved. Social Security disability claimants need to seek routine medical care and treatment to ensure the appropriate documentation is available.
Here is what you can do:
- Prepare thorough documentation of appointment and treatment dates, places, and details related to the disabling condition.
- Document and list your physician’s prescriptions, tests, and test results.
- Examine your medical records and physician notes for anything inaccurate or erroneous that could harm your case, and those things that help your case.
Substance Abuse and Social Security Disability: The Bottom Line
Abstaining from drugs and alcohol when applying for SSDI will have many health benefits. But quitting drugs and alcohol will also give you the chance to demonstrate that your disability exists outside of addiction and its impacts.
Obtaining and keeping track of the appropriate documentation will also help you illustrate exactly how your health conditions (separate from substance abuse) impact your ability to engage in substantial gainful activity and how your condition or conditions are separate from substance abuse.
Are you applying for Social Security disability benefits? Then you need an experienced disability attorney at your side. Attorney Sara J. Frankel is a former staff attorney at the Social Security Administration and has decades of experience representing clients before the Social Security Administration. Contact the Law Offices of Sara J. Frankel & Associates today at 508-730-1451 for a free consultation on your disability claim.