SUBSTANCE ABUSE & SSD BENEFITS
Substance abuse could prevent you from winning SSDI and SSI benefits. This is because the SSA has rules that prevent you from winning SSD benefits if your disability is due to the abuse of alcohol or drugs. Abuse of alcohol is not having a drink at a party or having a drink with dinner. It is an unhealthy relationship with alcohol that overtakes your life. The same is true for drug abuse.
If you use illegal drugs or drink to excess on a daily basis, then you probably have a substance abuse problem. For example, have you stolen money to buy illegal drugs? Have you taken too many prescription drugs? Do you spend your day thinking about your next drink? Or, do you spend your day drinking, instead of working? If your use of drugs and alcohol is out of control, then you will know it. Because it is the main thing you spend your time doing.
Alcohol and drug abuse can prevent you from winning benefits if that is the main reason you aren’t 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 decision that the individual is disabled.” Social Security Act Section 223(d)(2)(C) .
Under the law, once the SSA determines you have a disability, they must also determine if substance abuse is “material” to your case. 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, then you may wonder who will decide if it is important in your case. There are many levels of the review process. This means a number of people will look at your case. At the different levels of review, the following agencies are responsible for making a decision about whether drugs or alcohol are material to your case:
- THE STATE AGENCY: At the appeal levels of the Social Security review process, a State agency claims worker makes the finding whether DA&A is material to your claim for benefits. The State agency is responsible for the medical aspects of the DA&A analysis. For example, they will decide what limits you would have in the absence of DA&A.
- THE HEARING OFFICER: In hearings at the lower appeal level, the hearing officer determines whether DA&A is material to your claim for benefits.
- THE JUDGE: At your Social Security hearing, it is the judge who will make the decision as to whether or not your drug or alcohol use is material to your claim for benefits.
- THE APPEALS COUNCIL: At the Appeals Council level, the Appeals Council will examine the decision of the judge. They will decide if the judge properly applied the DA&A rules to your case.
SUBSTANCE ABUSE RULES DEPEND ON WHERE YOU LIVE
Since SSA rules are federal law, you would think the law would be the same in every state. However, that is not the case. Each circuit court interprets the substance abuse or drug and alcohol rules differently.
For example, the Second, Fifth, Ninth, and Eleventh Circuits place the burden of proof of “materiality” on the claimant. In order to get benefits, those courts require that you prove your addiction is not material to your case.
The Eighth and Tenth Circuits take the opposite approach. Those two courts place the burden of proof 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.
Therefore, the ALJ must look at which of your current physical and mental symptoms would remain if you stopped using substances. Then, the SSA must determine whether any or all of your remaining symptoms would keep you from working. The SSA also takes the position that the burden of proof is on the SSA.
SUBSTANCE ABUSE ALONG WITH MENTAL & PHYSICAL CONDITIONS
The burden of proof regarding materiality is important for people who have a dual diagnosis. Dual diagnosis means you have more than one medical condition, such as Depression or Anxiety Disorder. These mental conditions might couple with drug or alcohol abuse.
Those with substance abuse and a mental or physical condition may struggle to prove it has nothing to do with their other severe health issues. For example, if a person has anxiety and also abuses alcohol, it may be difficult to parse the anxiety symptoms from the symptoms of alcoholism or drug use.
TREATMENT FOR DRUG AND ALCOHOL ABUSE
At our law firm, we will help you with your SSDI and SSI case. We are more likely to accept your case if you have treatment for alcohol or drugs. We will be looking in your records for periods of sobriety. If you have issues of abuse, then you should seek treatment.
When you contact us, explain your issues with drugs and alcohol. Chances are you have a dual diagnosis, such as mental health condition and addiction. If you are sober and seeking treatment, then we will help you with your SSD 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. If you don’t have a doctor, then the SSA may send you to one of theirs for a free medical exam. You can learn about how to prepare for SSA’s mental exam.
Therefore, if you have not tried to conquer your abuse of drugs and alcohol. And, that is the main reason you cannot work. Then, the SSA will not grant your case. You must do what you can to stop abuse of drugs and alcohol before you file an application for SSD benefits.
WHAT WE DO TO HELP YOU WIN SSD BENEFITS
You do not need to try to win benefits by yourself. We can help file your SSD application. Also, we can help you appeal every SSA denial. For example, our attorneys and staff can:
- Send you the paperwork you need to become our client
- Help you file your application for SSD and SSI benefits
- Inform the SSA that they should pay your benefits under the Compassionate Allowance Rules
- Request an appeal if you receive a denial from DDS
- Help you confirm your free SSA doctor exam
- Request a Hearing with an Administrative Law Judge (ALJ)
- Prepare you to testify at your ALJ hearing
- Represent you at your SSA hearing and question the expert witnesses
- Read more about the job expert
- Learn more about medical expert testimony
- Request review of an SSA decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your application for benefits online at Social Security’s website, then you have 6 months to complete the application. Try not to take that long to finish it. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back. If you need help to file your application, then we will help you.
CONTACT US FOR A FREE REVIEW OF YOUR SOCIAL SECURITY BENEFITS
Contact our law firm today. Take advantage of our free review of your benefits. We understand that substance abuse is a disease. And, because it is a disease, it is not always something that you can control. However, like any medical condition, treatment can help. So can your efforts toward a sober life.
Let us help you present your case for benefits to the SSA while you seek treatment. We have won over $100 million in ongoing and back due SSD benefits for our clients. The past 30 years of legal experience gives us the knowledge to help you win your SSD case.
Our lawyers and staff want to be your Social Security legal team. We will prepare you for your hearing and appeal your case if you receive a denial. Dianna Cannon has been helping clients win SSD benefits for over thirty years. Brett Bunkall and Andria Summers also have years of legal experience winning benefits. Learn more about our legal experience on our About Us page. It is always our goal to win SSD benefits for our clients. But it is also our goal to make the Social Security review process easier for you. Contact our legal team today.
