Drug addiction and alcoholism (DAA) are serious conditions that can take a toll on a person’s mental and physical health. However, anyone who has been officially diagnosed with these conditions and is also disabled may have an added layer of difficulty in getting approved when they apply for benefits.
The Social Security Administration (SSA) has many doctors that work for it, who spend all day reviewing medical claims and making disability determinations. It is always possible that the one doctor who reviews your file may determine that your disability symptoms are not necessarily a medical condition, but instead, that they are related to your substance abuse. If that determination is made, you will be denied, because you cannot receive Social Security disability benefits if your disability is due to your substance abuse.
The easiest way around that problem is to prove that it is not true – for example, if you have evidence of sobriety in your medical records. Such a record may show that you are still suffering from disabling conditions, even though you are no longer dependent on drugs and/or alcohol.
SSA has issued a ruling, or additional guidance, for adjudicators to review if they are presented with a file that indicates DAA. The guidance allows for a six-step process:
- Is DAA involved? If there’s evidence that you previously or currently suffer from DAA, the second question will be asked.
- Do your impairments including DAA qualify you as disabled? If you don’t meet the Social Security Administration’s requirements for and definition of disability, your Social Security disability claim will be denied. However, if the organization does find you disabled, your claim can proceed.
- Is the only impairment DAA? If you are only considered disabled because of your substance abuse, your claim will be denied because it can’t be the sole basis for your application.
- Are your impairments disabling themselves or because of DAA? If you’re only unable to work because of drug addiction or alcoholism, it doesn’t meet the requirements for Social Security disability benefits.
- Are your medical impairments caused or affected by DAA? If the answer is no, then DAA is not considered material.
- If you didn’t have DAA, would your impairments leave you disabled? If the answer is no, then you won’t meet SSA requirements.
If you have a record of DAA, it is best to consult with a Social Security attorney who can help you make sure the best case is presented on your behalf before SSA.