Many people with substance abuse disorders often end up disabled either due to substance abuse or another medical condition that resulted from substance abuse. But does the Social Security Administration (SSA) consider such conditions disabling?
The SSA does not provide benefits to people due to substance abuse alone. In cases where the condition accompanies substance abuse, the substance abuse must be immaterial to the primary disabling condition.
Read below to find out whether you can apply for Social Security Disability Insurance (SSDI) based on substance abuse disorders.
Is Substance Abuse a Qualifying Disability?
The Social Security Administration does not consider substance abuse to be a disability in and of itself. The SSA removed the listing for substance abuse disorders from its Blue Book in 2017. This means that if you apply for Social Security Disability Insurance or Supplemental Security Income (SSI) benefits and the only reason you are unable to work is because of substance abuse, Social Security will reject your claim.
On the other hand, many people with substance abuse disorders also deal with other health problems. In the previous listing of substance abuse, for instance, several commonly linked illnesses that were triggered by substantial and ongoing drug use were also listed. These disorders included:
- Neurocognitive disorders (brain damage)
- Liver damage
- Gastritis
- Pancreatitis
- Peripheral neuropathy
- Seizures
- Mental health issues like anxiety and depression
Materiality of Substance Abuse
Once the Social Security Administration has established that you are disabled, they are required by law to assess whether or not your substance abuse is a “material” factor in your case. Drugs and alcohol are considered “material” in your case if your disability would go away if you stopped consuming them.
If you can prove that you’re disabled from another unrelated condition, Social Security will usually not consider substance abuse or drug addiction. However, the Social Security Administration will reject your claim if they conclude that your substance abuse is the primary cause of your functional limitations.
Determining whether substance abuse becomes a significant issue is easy in some cases. If you are seeking disability benefits for a completely unrelated diagnosis, such as thyroid cancer or degenerative disc disease, your drug use will not be deemed relevant.
Even if you have disabilities caused by drug abuse, like hepatitis, substance abuse won’t be a disqualifying factor if the damage has already been done.
However, there are some conditions that are a little more difficult to examine.
Many people who suffer from mental health issues have self-medicated with drugs in an effort to alleviate their symptoms, which can be confusing because the signs of both substance abuse and mental illness are similar. Some signs of mental illness or substance abuse include:
- Hallucinations (both visual and auditory)
- Thought disorders
- Problems concentrating or focusing
- Memory loss
- Speech problems,
- Abnormal motor movements (such as fidgeting or a slowed reaction time)
If you have a history of drug addiction and are seeking disability benefits for a mental disorder, the Social Security Administration will need proof of sobriety to assess your capacity to operate without the influence of drugs.
What About Prescription Drugs?
Prescription medications are subject to somewhat different regulations. It is still not possible to receive disability benefits on the grounds of an addiction to painkillers or other prescription medications. However, as long as you follow your doctor’s orders about how often and how many prescription drugs you take, Social Security will not apply the “material” or “not material” test to them.
This means that, unlike with other drugs, Social Security can take into account the impact of prescription medications on your capacity to work. The SSA will not consider limitations that are directly linked to drinking or using illegal drugs.
This means that the SSA can take into account the fact that you are unable to work due in part to side effects like fatigue or lack of concentration caused by prescription medicines when deciding whether you are actually disabled.
How to Apply for SSDI with Substance Abuse
Social Security does not offer disability payments for substance abuse in and of itself, so applicants will need to provide proof from a doctor that they have an additional mental or physical condition that makes them unable to work. Either way, the agency will be looking for evidence that you’ve made an effort to get sober.
The SSA will not ask for paperwork from support organizations like Narcotics Anonymous, but they will want to know whether you have participated in any kind of formal rehabilitation program so they can, with your consent, look over your records.
Providing Evidence for Mental Illness Disability
It could be difficult to get disability benefits for mental illness if you have a history of drug abuse. You should tell your doctor everything there is to know about your substance abuse problems. Since the Social Security Administration understands how difficult recovery may be, they will not punish you for relapses as long as you are forthright with your medical professionals.
The SSA will want to see the following things in your medical records when determining your disability:
- Progress notes, ideally from psychiatrists or psychologists who see you on a regular basis, detailing their assessments of your behavior and emotions during your appointment;
- Mental status exams detailing any abnormalities in your thought processes;
- Medication dosages and side effect reports; and
- Records of your hospitalizations, including admission and discharge information.
Providing Evidence for Physical Disability
Along with proof of mental health treatment, Social Security will also consider limitations caused by physical impairments that could limit your ability to work. Like in cases with mental disabilities, the Social Security Administration will go over your medical records, including notes from doctor visits, hospital stays, and medications. The SSA will also be looking for:
- X-rays, MRIs, or CT scans of the affected organs or joints;
- Physical exams revealing mobility issues, and
- Laboratory results, including those from blood tests and other diagnostics
Conclusion
In conclusion, if you have a substance abuse disorder, you can apply for SSDI benefits as long as you have another disabling medical condition. The SSA does not provide benefits for substance abuse alone.
