Disability Benefits for Drug or Alcohol Addiction: Possible?

Before a claimant can receive disability benefits from the Social Security Administration (SSA), the disability must be evaluated to determine the claimant's eligibility. The disability must be severe enough to prevent a claimant from working. On the issue of whether drug addiction or alcoholism is a disability, SSA regulations provide that if either is a contributing factor to the determination of disability, the claimant is not eligible for benefits.

Policy

42 U.S.C. §423(d)(2)(C) provide  that "an individual shall not be considered to be disabled for purposes of this title if alcoholism or drug addiction would (but for this subparagraph) be a contributing factor material to the Commissioner’s determination that the individual is disabled."

Evaluation

The SSA has a five-step sequential evaluation process to determine a claimant's disability. During each step, the evaluator considers the claimant's limitations to see if they meet the criteria for eligibility. If the claimant does meet the five-step criteria, the evaluator then must determine if drug or alcohol addiction is a material contributing factor in the determination of disability.

The SSA then looks at two issues:

1. Is drug or alcohol addiction involved in the case? The SSA does not rely solely on the claimant's admission that he or she is an addict or alcoholic. Medical evidence is used to establish an addiction impairment.
2. Would the claimant be able to work if he or she stopped using? If the answer is no, then the evaluator looks at the remaining limitations to determine if they are still disabling. If those remaining limitations are determined not to be disabling, then the addiction will be found to be a material contributing factor. Conversely, if the remaining limitations are still disabling without the addiction, then the addiction is not a material contributing factor in the determination of disability. It does not matter whether the addiction brought on the initial impairment; the issue is whether the impairment will remain once the addiction ends.

If drug abuse or alcoholism is found not to be a material contributing factor in the determination of disability, the claimant will be ordered to name a representative payee if he or she is unable to manage their benefits and/or is referred for treatment.

SSR 82-60 - Titles II and XVI: Evaluation of Drug Addiction and Alcoholism

Social Security Regulations provide:

Drug addicts or alcoholics cannot be considered "disabled" on the basis of that diagnosis alone; on the other hand, a diagnosis of drug addiction or alcoholism should not have an effect on a disability evaluation that is adverse to the applicant. Drug addicts and alcoholics are subject to all the ills that may affect any other applicant. Drug addiction and alcoholism are diagnostic terms; they do not denote impairment value or severity. It is necessary to evaluate the severity of the impairment which may be associated with, manifested by, result from, or coexist with these diagnoses.

It must be recognized also that the issue of whether the individual has lost the ability to control the use of drugs or alcohol affects the matter of diagnosis. The loss of ability to control these substances identifies the individual as a drug addict or alcoholic diagnostically, but does not provide a conclusive basis for evaluating the severity of the impairment.

Consult an Attorney

If you are disabled and have an addiction, you may or may not be eligible for SSA disability benefits depending on whether your addiction can be found to be a contributing factor material in the determination of disability. Consult an attorney to discuss disability benefits for drug or alcohol addiction.