People who struggle with substance abuse problems are often recommended to enroll in rehabilitation programs. However, doing so can be difficult, as they may not be able to take time off work or risk losing their job. Would Social Security Disability Insurance (SSDI) provide the financial support needed for substance abuse rehabilitation?
Unfortunately, SSDI does not extend benefits for substance abuse disorders; hence, it also does not provide financial support while individuals go through rehabilitation. Luckily, there are a few other options through which individuals can maintain a steady source of income while they get the treatment they need.
This article provides an in-depth guide regarding SSDI and substance abuse rehab.
General Eligibility Criteria for SSDI
Anyone over the age of 18 must meet the Social Security Administration’s (SSA) basic requirements in order to qualify. It says that an individual must “have a medically determinable physical or mental disability.” The following circumstances are listed as prerequisites for eligibility:
- the condition must result in an inability to engage in any substantial gainful activity
- it can be expected to result in death
- it must have lasted or be likely to last for a continuous period of not less than twelve months
You might be eligible for disability payments from the Social Security Administration if they determine that you meet these requirements and that your medical condition meets the criteria for disabilities listed on their website.
Can I get SSDI for Drug Rehab?
The Social Security Administration will attempt to ascertain the impact of your substance abuse or dependence on your present condition when reviewing your case. This is referred to as a drug and alcohol abuse evaluation (DAA).
The purpose of this is to establish whether substance misuse is a contributing factor. To put it another way, does using drugs cause the condition, or does the condition exist by itself?
It is crucial to establish that the ongoing use of the substance does not exacerbate the disabled person’s condition for the claim to be successful. In other words, substance abuse plays no role in the condition.
When a person’s addiction does not lead to permanent health problems, the government will grant the applicant benefits. On the other hand, the government will not grant disability status if addiction is the root cause of the impairment, and the disease could be curable with a cessation of usage.
You should stop using it in order to increase your chances of getting benefits. Ceasing usage will provide you with the opportunity to show that your illness is more than just your drug misuse. As a result, they will have an easier time concluding that your disability is unrelated to drug misuse.
Another strategy that might work to help you reach your goal is to enroll in a treatment program that focuses on helping people quit using substances.
Unfortunately, since the Social Security Administration does not offer benefits for substance abuse disorders, it also does not extend its benefits to people who struggle with substance abuse and are going into rehabilitation.
Why it is Difficult for Disabled People to Get Rehab Access?
Disabled individuals may face obstacles while trying to access addiction treatment programs. There are different types of problems, such as mental, physical, social, financial, or natural. The facilities that offer treatment could also be a barrier. A few instances of this are:
Lack of Accessible Spaces
Building entrances and parking lots that don’t have wheelchair-accessible features, like buildings without lifts or ramps, or things like uneven flooring and too-small hallways, fall into this category.
Lack of Accommodating Material
There are insufficient reading tools in the right format for people who are blind or have low vision, like Braille or large print.
Treatment Approaches
Methods of treatment that are either not appropriate or have not been adequately modified for individuals with intellectual or learning difficulties, for example, programs that do not consider various cognitive capacities or reading levels.
Flawed Policies
Policies that don’t help disabled people, such as a hospital that wants patients to be able to leave on their own in case of an accident.
Lack of Training for Staff
There are problems with staff not knowing sign language or having the right training to use technology to help people who have trouble hearing interact.
Can I Get Medicare and Medicaid For Drug and Alcohol Rehab?
Treatment for addiction may be covered by both Medicaid and Medicare, but it depends on which program you are enrolled in.
Moreover, not every rehab accepts Medicaid or Medicare, so you will need to ensure that the facility you choose does. If you or someone you know is confused about Medicare and Medicaid and needs help deciding which program is best for you, this brief comparison might be of help:
Medicaid
Medicaid is an insurance program for people with very low incomes that was started in 1965 and is paid for by both the federal government and the states. The Affordable Care Act guarantees that all insurers, including Medicaid, must cover substance abuse treatment. Coverage depends on your state and the Medicaid insurance company you have.
There are, however, some treatment centers that do not accept Medicaid or will not let you pay with Medicaid insurance. Before you go, make sure that the center you want to go to supports Medicaid.
Medicare
Medicare is another program started in 1965 by the federal government and the states that covers people over 65 or with severe disabilities, no matter how much money they make. Some individuals can get health coverage through both Medicaid and Medicare. In the following cases, Medicare will pay for drug rehab and addiction treatment:
- When a physician establishes a treatment plan or determines that drug addiction treatment is medically required,
- The provision of treatment by a facility or provider that is a participant in Medicare.
Medicare Part A pays for inpatient addiction treatment, and patients are responsible for the other costs that they would be paying for hospital stays. However, there is a lifetime limit of 190 days that Medicare will pay for psychiatric hospital stays. General hospitals are exempt from this regulation.
Medicare Part B covers outpatient treatment at an 80-20 rate, which means that the program pays 80% and the patient or their additional insurance pays 20%. This includes services like drug and alcohol counseling, in-office pharmacological treatments, and patient education.
Part D provides coverage for prescription drugs. But methadone or buprenorphine, which are used to treat addiction, will not be covered by Part D. Part A may pay for hospital-administered methadone.
What is the Cost of Rehab?
Many factors affect how much money is needed to pay for addiction treatment, including:
- The amount of attention required
- The kind of healthcare center
- Whether you choose an inpatient, outpatient, intensive outpatient, or partial hospitalization mode of therapy
- The duration of your treatment
- The conveniences that the venue provides
- The services required for treatment (dual diagnosis, co-occurring disorders, etc.)
Most of the time, residential treatment (inpatient treatment) costs more than outpatient treatment and partial hospitalization.
This is because you must pay extra to live at the center during treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) says the following rates show how much rehab usually costs based on the type of treatment program:
- 30-day detox: $250 to $800 daily
- Program for outpatient treatment lasting three months: $1,400 to $10,000
- Intensive outpatient program for 30 days: $3,000 to $10,000
- An average of $5,000 to $80,000 for inpatient treatment
Other Options for People in Rehab
Here are some other options for people who want to get into rehab.
Short-term Disability Insurance Benefits
Limited treatment choices are covered by short-term disability. Rehabilitation through substance addiction can be linked to short-term disability.
Since substance addiction may be curable in a relatively short amount of time, it is categorized as a temporary disability. Individuals need to check into a rehabilitation center and start a treatment program if they are addicted to substances like alcohol and narcotics.
Adequate rehab services should be made available to prospective patients who require rehab support through various rehabilitation methods. If you want to know why someone needs therapy and if short-term disability covers it, here is a list of addictive substances that rehabilitation services cover.
Alcohol
Alcohol is one of the short-term disabilities that has been deemed to affect people in a variety of different ways.
A man is considered to be addicted to alcohol if he consumes four glasses of alcohol a day or more than 14 glasses in a single week. A woman is considered to be addicted to alcohol if she consumes more than three drinks a day or more than seven drinks in a single week.
OTC or Prescription Medication
Opioid pain relievers are among the over-the-counter (OTC) medications that are frequently abused. These are medications that are prescribed to patients suffering from anxiety, sleep disorders, and deficit hyperactivity disorder. When consumed in large quantities, these medications have the potential to cause an individual to become drunk or intoxicated.
Tobacco-Related Items
The chemical nicotine found in cigarettes is responsible for the euphoria and energy they provide. Finishing two or three boxes a day is a sign of addiction.
Cocaine
Cocaine is a stimulant drug that allows a particular person to experience an increase in their level of energy. On the other hand, a sudden change in mood is a common side effect of cocaine.
The use of cocaine for an extended period can result in the development of an addiction to the drug. Cocaine often causes euphoria and inflated self-esteem, as well as dilated pupils and hypervigilance.
Marijuana
This is a substance that makes people happy and is often known as the gateway drug. It elevates one’s mood to the point where they feel inexplicable feelings of happiness and excitement.
A common and potentially dangerous side effect of the medication is burnout. Some of the physical symptoms include inflammation of the eyes and mouth, as well as an increase in both blood pressure and heart rate.
Heroin
Heroin is known to cause a surge of feelings, which subside after the initial rush has passed. After becoming addicted to it, the need to use it daily with an increasing dosage becomes a necessity, which is harmful to one’s health.
Stimulants
Stimulants may be prescribed by a doctor. These substances have the potential to produce an addictive “high, euphoric” sensation. There is a major risk of overdose associated with the abuse of this kind of drug. Stimulants, such as those required to treat Attention Deficit Hyperactivity Disorder (ADHD), are some of the most regulated prescription drugs.
Club drugs
Club drugs include substances like Ecstasy, GHB (gamma-hydroxybutyric acid), and ketamine. They can trigger hallucinations, paranoia, and other problems.
All of the aforementioned substances are prohibitive, and addiction to them can be cured with the help of rehabilitation programs. Getting a correct diagnosis from a medical professional and enrolling in a rehabilitation program is the most effective way to fight against these addictions.
Family Medical Leave
Patients requiring long-term medical treatment, such as those in recovery from substance abuse, have a legal safeguard under the Family Medical Leave Act (FMLA).
The Family and Medical Leave Act applies to you if you have been working for your current employer for a minimum of one year and your employer has more than fifty employees.
Through FMLA, you can request unpaid medical leave for a period of up to twelve weeks, which is sufficient time to undergo detoxification from alcohol and drugs, and then enroll in an inpatient rehabilitation program.
FMLA safeguards you from termination throughout this time. On the other hand, your monthly payments will likely stop. If you are denied leave under the Family and Medical Leave Act, you may be able to file a discrimination lawsuit against your employer and take them to court.
Keep in mind that although you are obligated to inform your employer, request medical leave, and frequently attend FMLA meetings, you are not obligated to explain the reason behind your request for medical leave.
If your employer attempts to pressure you into disclosing the information or refuses FMLA leave unless you explain why, you might have grounds to sue for discrimination.
Employee Assistance Programs
You may be able to submit an application for financial assistance for your rehabilitation if your employer has an employee assistance program (EAP).
The majority of EAPs are mandated to assist with substance abuse rehab. Further, unless they can demonstrate a decline in your performance on the job, your employer cannot lawfully fire you due to a substance abuse problem.
Conclusion
People who struggle with substance abuse may require a safety net they can fall back on. And, while you cannot get financial support from SSDI for substance abuse rehab, you still have many other options through which you can stay afloat.
