Can I Be Denied Social Security Disability Benefits If My Condition Results From Alcoholism or Drug Addiction?
Can I Be Denied Social Security Disability Benefits If My Condition Results From Alcoholism or Drug Addiction?
Alcoholism or drug addiction are complicated topics when it comes to Social Security Disability benefits.
Largely, the Social Security Disability benefits system has been viewed by the US Congress and the Social Security Administration (“SSA”) as a support system for those rendered incapable of engaging in meaningful gainful employment through no fault of their own.
There are certainly a number of exceptions to this somewhat moralistic underpinning of our Social Security Disability benefits award system. For example, if you voluntarily drive recklessly and slam your car into a phone pole, permanently disabling yourself, you are not barred from Disability benefits even though the ultimate fault is your own.
Not so when it comes to alcoholism or drug addiction.
The general rule with regard to Social Security Disability benefits is that, if you are unable to work because your alcoholism or drug addiction is a material factor, you will not be able to receive Disability benefits.
However, as in all things, there is some nuance here. There are occasions in which the above is less true than it sounds.
This article will discuss the nuance involved in the determination of whether or not Social Security Disability benefits may be awarded when alcoholism or drug addiction is involved, as well as the condition itself.
What Does Alcoholism or Drug Addiction Look Like?
What alcoholism or drug addiction looks like will vary from case to case. It will also vary depending upon one’s stage of progress within the substance abuse spectrum.
Alcoholism has been recognized as a disease by the American Medical Association since 1956. Its effects include a loss of decision-making ability, compulsive behavior, and a continuing cycle of recovery and relapse.
Generally, however, you may have an issue with alcoholism or drug addiction if any of the following are true for you:
- You think about alcohol or drugs constantly.
- You are consistently drunk, intoxicated, or hungover.
- You have attempted to stop drinking or using without success.
- When you do stop, you experience withdrawal.
- Your drinking or drug use is interfering with your normal daily activities—including your ability to work and earn income.
The Diagnosis of Alcoholism or Drug Addiction
A physician will diagnose alcoholism, in particular, using the so-called Diagnostic and Statistical Manual of Mental Disorders (“DSM”). This Manual posits 11 questions for use in establishing whether an individual suffers from a condition of alcoholism.
These questions will help your doctor to zero in on whether or not the symptoms listed above actually apply to you.
Of particular relevance to Social Security Disability benefits determination, the DSM asks whether or not your drinking has interfered with your life responsibilities.
If the answer to this question is “Yes,” you may not only be an alcoholic—but you may also have an issue obtaining Social Security Disability benefits.
First, what exactly is a “disability” as far as the Social Security Administration is concerned?
What Is “Disability”?
The SSA defines as a “disability” entitling someone to Social Security Disability benefits as:
The inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.
That is a mouthful of a definition, but the long and short of it is that, per the SSA, a “disability” is a physical or mental condition that will kill you or, at least, will last for a long time—at least 12 months.
The question with regard to alcoholism or drug addiction and Disability benefits awards then, by statute as opposed to moral judgment, whether or not it meets this bundle of criteria.
Is alcoholism likely to last more than 12 months? Almost certainly without treatment. And even with treatment, according to many authorities.
Will it kill you? This is also likely, through a variety of manifestations, from liver failure to blood poisoning to drunk driving road accidents.
Nevertheless, Congress has decided that alcoholism and drug addiction are, in a large number of cases, not “disabilities” for purposes of Social Security Disability benefits awards.
Why is this?
The 1996 Law Denying Social Security Disability Benefits for Drug & Alcohol Addiction
In 1996, Congress added §416.935 to the Code of Federal Regulations.
This Regulation makes denial of Social Security Disability benefits for the conditions of alcoholism or drug action the SSA’s default position.
Plainly, the statute states that, if the SSA determines that your alcoholism or substance abuse is a “contributing factor” that is “material” to the question of whether or not you are disabled, you will likely be denied benefits.
However, the SSA undertakes, per this rule, an inquiry into the role that alcoholism or substance abuse plays in your inability to work.
First, the SSA will examine whether, once the alcoholism or drug addiction is removed from the calculation, your remaining conditions would or would not be disabling.
If those non-substance abuse-related conditions would not be disabling (and the alcoholism or substance abuse is the only thing interfering with your ability to work), you will be denied Social Security Disability benefits.
If those other problems are in and of themselves disabling, then the SSA will find that alcoholism or substance abuse is not a contributing factor.
A Disability benefits award may then be granted.
What Alcoholism-Related Conditions Would Support a Benefits Award?
The sorts of alcoholism-related medical conditions that may support a Disability benefits claim are those that would support a Disability claim if alcoholism were not involved.
That is, it must be a condition that is either listed in the SSA’s Bluebook listing of adult or childhood impairments or one that otherwise meets a level of severity sufficient to meet the definition of “disability” above.
The adult impairments are divided into differing classes of conditions as follows:
- Musculoskeletal disorders;
- Special senses and speech;
- Respiratory disorders;
- Cardiovascular system;
- Digestive system;
- Genitourinary disorders;
- Hematological disorders;
- Skin disorders;
- Endocrine disorders;
- Congenital disorders that affect multiple body systems;
- Neurological disorders;
- Mental disorders;
- Cancer;
- and immune system disorders.
Physiological conditions that are identifiable in the Bluebook listing, then, that may have been caused by but are now “independent” of alcoholism or substance abuse may support a Disability benefits award.
For example, a condition such as deterioration of the liver may have been caused by or exasperated by alcoholism. However, the damage having been done, if it now renders you unable to work, you may be eligible for Disability benefits.
What Is Substantial Gainful Activity?
A quick word about the question of whether or not you are eligible for benefits due to an inability to “work.”
What does it mean to be able to work for Disability benefits determination?
The question of whether or not you are able to engage in “substantial gainful activity” is actually the first question posed by the SSA when it reviews your Disability benefits application.
“Substantial gainful activity” is what the SSA calls “work.”
In order to be eligible for Disability benefits, you must be unable to engage in substantial gainful activity (“SGA”).
That is, if you are able to earn above a certain level of income on a monthly average basis, you will be unable to obtain Disability benefits regardless of whether your condition is alcoholism or substance abuse or some related condition.
For 2022, the monthly SGA amount is $1350. (For statutorily blind individuals, the amount is $2260.)
Thus, the argument you will be making in the case of alcoholism is:
- That you are unable to engage in substantial gainful due to your condition;
- And that your condition is something other than your alcoholism or drug abuse condition.
How Can You Obtain Social Security Disability Benefits for Alcoholism or Drug Addiction?
If you suffer from alcoholism or a substance abuse condition, your best shot at obtaining Social Security Disability benefits is to consult with an experienced Florida Disability Attorney.
A Florida Disability Lawyer will, first, ensure that your full array of medical conditions is properly assessed by a doctor.
If you have a Bluebook-listed condition that may or may not have arisen as a result of alcoholism that is, itself, now preventing you from engaging in substantial gainful activity, a Social Security Disability Lawyer will ensure that your tests, surgical history, and prescription and other treatment history is properly documented.
Your Orlando Disability Attorney will ensure that your application is properly prepared with the right documentation and submitted within all required statutory timeframes.
If your Disability application is initially denied (as most are), your Disability lawyer will be well-positioned to appeal the denial and, if necessary, to file suit in Federal Court on your behalf.
Orlando, Florida Social Security Disability Attorney Shea Fugate will ensure that your odds of success are properly maximized.
Contact us now to schedule your free, initial consultation.
You may be more eligible for Social Security benefits than you think.
