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Portnoy Disability Practice

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How Does Social Security Consider Drug Addiction and Alcoholism?

It used to be that people could be awarded Social Security Disability benefits on the basis of drug addiction or alcoholism (DAA). In 1995, when I was doing work for legal aid, Social Security regulations changed. Everyone who was receiving Social Security benefits because they had a drug or alcohol addiction had to reapply based on a different disability. As the law currently stands, Social Security does not recognize drug addiction or alcoholism as a disability.

How does Social Security evaluate cases involving DAA? First, they determine whether you are disabled using the same standards they use for cases where DAA is not a factor. If they determine that you are disabled, they will evaluate whether you have a “substance use disorder.” Drinking or using drugs is only considered a “substance use disorder” when it leads to significant impairment or distress.

If Social Security determines that you have a substance use disorder they will then evaluate whether that disorder is a “contributing factor material to your disability determination.” DAA is material if, without the drug or alcohol use, you would not be considered disabled. In other words, if you were clean and sober would you still be disabled? If the answer is yes, then you are eligible for benefits. If you are not disabled when clean and sober then DAA is material and you would not be disabled under Social Security standards.

Let me give you an example; John P was in a car accident and injured his back. He had surgery which, rather than helping, made his pain worse. He had a second surgery which also did not improve his pain. His doctor diagnosed him with failed back syndrome. The pain is so severe that John is unable to sit or stand for longer than a few minutes at a time. He is on heavy doses of narcotics to control the pain and has a TENS unit. His doctor has stated that, as a result of his back condition, he is unable to work on a full time basis. Turns out, John is also an alcoholic. He drinks to the point of intoxication four times a week as he has for most of his adult life. John would still be disabled under Social Security standards. If he were sober, he would still be disabled because his back condition is so severe. Therefore, DAA is not a contributing factor material to the disability determination.

The most difficult DAA cases are what I refer to as “combination cases.” In addition to being DAA, these individuals are suffering from a mental impairment such as Bipolar Disorder. It can be very difficult to tease out whether you are limited as a result of your mental impairment or as a result of the drug or alcohol abuse. It is important to consider your ability to function during periods of sobriety. Does your mental impairment severely limit you during these periods? Are you actually more functional while drinking or using? Were you able to work while using but unable while clean and sober? Statements from your doctor documenting your limitations both when you are using as well as when you are clean and sober are imperative to winning a combination DAA case.

In sum, being drug or alcohol addicted does not mean that you cannot win your Social Security case. An experienced Social Security attorney can evaluate your case, and significantly improve your odds of winning the benefits you need and deserve.

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