SUBSTANCE ABUSE & SSD BENEFITS
Substance abuse could prevent you from winning disability benefits. This is because the SSA has regulations that prevent you from winning SSD benefits if your disability is due to abuse of alcohol or drugs. Abuse of alcohol is not just occasional use, social drinking, or a drink with dinner. It is an unhealthy addiction to alcohol. The same is true for drug abuse. Alcohol and drug abuse can prevent you from winning benefits if your addiction prevents you from working. Addiction is material to your claim if it interferes with your work, activities of daily living, and relationships.
SUBSTANCE ABUSE AND THE SOCIAL SECURITY ACT
The Social Security Act states that a claimant “shall not be considered to be disabled if alcoholism or drug addiction would be a contributing factor material to the Commissioner’s determination that the individual is disabled.” Social Security Act Sections 223(d)(2)(C) and 1614(a)(3)(J) .
Under the law, once the SSA determines you have a disability, they must also determine if substances are “material” to your case. 20 CFR 404.1535 and 416.935. Drugs or alcohol are “material” to your case if you would cease being disabled if you stopped using drugs or alcohol.
WHO DETERMINES MATERIALITY?
If you have a substance addiction, you may wonder who will determine if it is important in your case. There are many levels of the disability review process and a number of people will look at your case. The following adjudicators, at the different levels of review, are responsible for determining materiality:
- A) At the initial and reconsideration levels of the disability review process (except in disability hearings), a State agency disability examiner makes the finding whether DA&A is material to the determination of disability. The State agency is responsible for determining the medical aspects of the DA&A analysis, such as what limitations a claimant would have in the absence of DA&A.
- B) In disability hearings conducted by a disability hearing officer at the reconsideration level, the disability hearing officer determines whether DA&A is material to the determination of disability.
- C) At the ALJ and Appeals Council level, the ALJ or Appeals Council determines whether DA&A is material to the determination of disability.
THE SUBSTANCE ABUSE RULES APPLY DIFFERENTLY DEPENDING ON WHERE YOU LIVE
Since SSA regulations are federal law, you would think the law would be the same in every state. However, that is not the case. Each circuit interprets the substance abuse or drug and alcohol regulations differently.
For example, the Second, Fifth, Ninth, and Eleventh Circuits place the burden of proof of “materiality” on the claimant. Those circuits require the claimant to prove that their addiction is not material to the determination that they are disabled in order to get benefits.
The Eighth and Tenth Circuits take the opposite approach. Those two circuits place the burden of proof of materiality on the government. As the Tenth Circuit states in Drapeau v. Massanari, 255 F.3d 1211 (10th Circuit), what the SSA must examine in determining whether drugs or alcohol are a contributing factor to the claim is whether the the claimant would still be disabled if he or she stopped using drugs or alcohol. 20 C.F.R. § 416.935(b)(1). Therefore, the ALJ must evaluate which of plaintiff’s current physical and mental limitations would remain if plaintiff stopped using substances. Then, the SSA must determine whether any or all of plaintiff’s remaining limitations would be disabling. The SSA also takes the position that the burden of proof is on the SSA.
SUBSTANCE ABUSE ALONG WITH MENTAL AND PHYSICAL DISABILITY
The burden of proof regarding materiality has important implications for “dual-diagnosis” claimants. Dual-diagnosis means the individual has more than one impairment, such as Depression or Anxiety Disorder. These impairments might then couple with drug or alcohol addiction. Those with addiction and a mental or physical disorder may struggle to prove their addiction has nothing to do with their disability. For example, if a person has Depression and also abuses alcohol, it may be difficult to parse the depressive symptoms from symptoms of alcoholism or drug addiction.
CANNON DISABILITY AND DRUG AND ALCOHOL ABUSE
At Cannon Disability Law, we will help you with your Social Security Disability and/or SSI case. We are more likely to accept representation of your case if you have treatment for alcohol or drug addiction. We will be looking in your records for periods of sobriety. If you have issues of addiction, you should be seeking treatment.
When you contact us, explain your disability and your issues with drugs and alcohol. Chances are you have a dual diagnosis, such as mental health impairment and addiction. If you are attempting sobriety and are seeking treatment, we will help you with your disability case. As your legal team, we will want you to seek medical help and treatment for all of your issues. We will submit all of your medical records to the SSA. The SSA will also look to your medical records to see if you are sober. Therefore, if you have not tried to overcome your addictions and that is the main reason you cannot work, then the SSA will not grant your case.
CONTACT CANNON DISABILITY LAW FOR YOUR FREE CONSULTATION
Contact Cannon Disability Law today and take advantage of our free consultation. We understand that addiction is a disease and is not always something that you can control. However, like any impairment, treatment can help. So can your efforts toward a sober lifestyle. Let us help you present your disability case to the SSA, while you seek treatment. We have won over $100 million in ongoing and past-due disability benefits for our clients. The past thirty years of litigation experience gives us the knowledge to help you in your disability case.
Our representatives want to be your disability legal team. We will prepare you for your hearing and appeal your case if you receive a denial. Dianna Cannon has been representing people with disabilities for over thirty years. Brett Bunkall and Andria Summers also have years of litigation experience. Learn more about our legal experience on this website. It is always our goal to win disability benefits for our clients. But it is also our goal to make the disability review process easier for you. Contact our legal team today.