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How substance use can affect a Social Security Disability claim

SSD claims may be denied if substance use is a “material factor” in the claim, but substance use is not an automatic reason for claim denial.

As many people in Jonesboro know, substance use is not an uncommon problem in America. National Institutes of Health resources indicate that in 2012, about 17 million adults suffered from an alcohol use disorder, and at least 6 million abused or relied on substances such as marijuana and prescription drugs. Sadly, many people who struggle with drug and alcohol use also live with disabling conditions that prevent gainful employment or even self-care.

Social Security Disability benefits can help disabled people who meet medical and financial criteria. However, many people may think it is impossible for people with substance use issues to qualify for these benefits. In truth, suffering from a substance use disorder does not necessarily prevent a person from receiving benefits, though it can complicate the disability evaluation process.

Substance use as a ‘material factor’

A Social Security claims examiner may deny benefits if a claimant’s drug or alcohol use is a “material factor” in the disability claim. To determine whether this is the case, the claims examiner considers a series of questions:

  • Does the claimant qualify as disabled under Social Security standards? The disabling condition must prevent gainful employment and be expected to either last 12 months or result in death.
  • Is the claimant’s drug or alcohol use the only reason the claimant qualifies as disabled? If so, Social Security cannot award benefits.
  • Do the claimant’s other impairments prove independently disabling, regardless of the claimant’s substance use? If the claimant’s medical conditions would be manageable under other conditions, the claim will be denied.
  • Does substance use interact with the claimant’s other impairments? If substance use worsens existing impairments, it may be a material factor, but this depends on how serious the impairments are in the absence of substance use.
  • Would the disabling conditions improve if the claimant did not use drugs or alcohol? If a condition would improve enough to be considered non-disabling, the substance use is a material factor.

Social Security may award benefits if a person’s use of drug or alcohol is not a material factor in the disability claim.

Other considerations

There are a few special cases when substance use cannot be considered a material factor. First, past habits cannot count against an applicant. If a person who uses alcohol develops a related health problem, such as liver disease, Social Security cannot consider the person’s history of drinking; only the effects of ongoing alcohol use are material. Substance use is also not a material factor if it indirectly contributes to a person’s disability. For example, if a person drives intoxicated and suffers a crippling injury, the role of drugs or alcohol in the accident is irrelevant.

Unfortunately, in many cases, evaluating whether substance use is a material factor can be challenging. For example, mental health impairments and alcohol use are often associated. The American Psychological Association notes that people with mental illnesses such as depression may use alcohol to self-medicate. At the same time, alcohol can worsen existing conditions or give rise to new disorders, such as anxiety. In these cases, documenting periods of sobriety in which the impairments remain disabling is essential.

Seek assistance applying

Anyone who intends to apply for SSD benefits while living with issues that may complicate the claim, such as substance use, should consider meeting with an SSD attorney for advice before filing the claim. People who suffer from complex or less readily apparent disabilities, such as mental disorders, may also benefit from seeking guidance during the claim process.

Keywords: Social Security, disability, SSD