Substance Abuse and SSDI Benefits

Although it is widely acknowledged that drug or alcohol dependency can be a debilitating condition, an applicant will not be approved for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits if substance abuse (alcohol and or drugs) “substantially contributes to one’s disabling condition.” While for many years, substance addiction was a recognized medical impairment or condition for which one could be provided benefits, Congress determined in 1996 that such benefits would no longer be made available to those whose drug addiction was at the root of their disabling condition, passing Public Law 104-121 in March, 1996. The Social Security Administration (SSA) will not provide SSDI and SSI benefits to those with disabilities that have been caused or worsened by substance abuse. Social Security attorney Russell J. Goldsmith has over 35 years of experience helping people struggling with addiction seek SSDI benefits. At the Law Offices of Russell J. Goldsmith, our legal team offers honest and individualized evaluations to each client, and we can explain your rights and benefits under the applicable law.

SSDI benefits are available to qualified workers who meet the federal definition of disabled. In other words, they must be unable to engage in any substantial gainful activity as a result of a severe medically determinable physical or mental impairment expected to last for one year or longer, or result in death. The SSA recognizes that heavy and prolonged abuse of drugs or alcohol can cause severe and long-lasting mental and physical impairments. While you cannot receive SSDI benefits based on a diagnosis of alcoholism or drug addiction alone, you may still be eligible for benefits if you have another mental or physical impairment that was caused by or associated with alcoholism or drug use, such as liver damage, mental disorders, depression, pancreatitis, and other conditions which condition is no longer being made disabling by the continued substance abuse of a claimant. That is to say, tt does not matter that your impairment was caused by drug or alcohol abuse. Rather, as long as the continued use of drinking and/or using drugs is no longer causing your medical condition to be disabling. This may mean 1) you have discontinued the use of alcohol and/or drugs altogether, 2) that even if you were to discontinue the use of alcohol and/or drugs, your condition would continue to remain severe or disabling, or 3) that your use or alcohol and/or drugs remains a byproduct of the severe medical condition from which you suffer (rather than the other way around). In each example, the Social Security Administration will look at whether your condition either meets the criteria for one of the medical impairments set forth in the SSA’s Listing of Impairments: assuming that is the case, and you are able to make one of the three (3) arguments above, substance abuse may not end up being a hindrance to the receipt of benefits. As is always the case when SSA is reviewing a claim for disability, if your condition is not one of the listed impairments, SSA will next assess your residual functional capacity to see if you might be capable of performing other jobs.

Whether or not current alcohol or drug use will affect your SSDI benefits depends on if it is deemed to be a material contributing factor to a medical impairment. Even if your condition was not caused by alcohol or drug consumption, you may be denied SSDI benefits if the SSA finds that your use of such substances contributes to your unrelated qualifying physical or mental impairment. This could include conditions such as anxiety, insomnia, seizures, and a wide range of other disabilities. In determining whether your substance use is material to your medical impairment, the SSA will conduct a drug/alcohol addiction evaluation. In most situations, as long as your impairment would still meet the listing criteria or would still remain severe and disabling (from the standpoint of significantly impairing one’s residual functional capacity) even if you were to stop using alcohol and/or drugs, the SSA would still consider you disabled if you nonetheless continued to consume these substances. However, if the SSA believes that your impairment would improve if you stopped using drugs and alcohol to the extent that it would no longer meet the listing criteria (or would no longer cause you to be significantly impaired in terms of your residual functional capacity and ability to return to work), the SSA generally will not provide you benefits. Thus, for example, the continued use of even a moderate amount of alcohol and a corresponding showing of an increased frequency of seizures or a worsening of one’s depression, would likely result in denial of one’s claim.

It is important to note that the SSA will consider all of the medical evidence when making a disability determination, including a doctor’s notations of your substance use in your medical records. Furthermore, it is difficult to prove that even moderate drug and alcohol use does not materially contribute to many medical conditions. Therefore, those who have a history of substance abuse and those who are currently consuming drugs or using alcohol often benefit from a review of their case circumstances prior to presenting a claim.

If the SSA approves your SSDI benefits application but believes that you continue to abuse alcohol or drugs, it may refer you to a substance abuse treatment program. The SSA may also require that you obtain a representative payee, to whom the SSA will mail your SSDI payments. A representative payee can oversee the spending of your SSDI benefit payments and ensure that any money from the government is not being used to support a drug or alcohol addiction.

You have the right to obtain legal representation throughout the Social Security claims process. If you have substance abuse issues, a qualified and experienced SSDI lawyer can present your application in the most advantageous way possible. To schedule a free evaluation, contact the Law Offices of Russell J. Goldsmith at (800) 773-8622 or online .