Drugs Alcohol and Benefits Claims

I Am an Alcoholic. Isn’t That An Illness? So Why Can’t I Get Disability?

Oftentimes, our clients or potential clients are confused. If they have alcoholism or addiction, why can’t they get disability benefits? If the condition is so severe, why are they not entitled to the same kind of assistance as other people with severe conditions?

Unfortunately, many people don’t understand how the law works. The law may be strict, but it was not passed simply to deny people disability benefits because of alcohol and/or drug addiction.

The SSA treats the law very specifically. To receive benefits, the SSA must conclude that a claimant:

  • is disabled, and
  • that drug abuse or alcoholism (DA&A) is not a contributing factor material to a claimant’s disability determination

If the substance abuse is a material factor, the claimant cannot be found disabled and cannot receive benefits.

This is oftentimes very difficult for a claimant to accept. It is also very difficult for an attorney who has examined the evidence and listened to the claimant’s story, and knows that the SSA will deny benefits.

Unfortunately, the SSA must consider a number of legal definitions, procedures and processes before determining disability. These aspects oftentimes do not work in the claimant’s favour.

As attorneys, we understand the struggle. The law views each claimant’s case through formal rules, laws and regulations. Even the most emotional personal addiction case may be denied for benefits if the law does not apply.

To receive benefits, you would have to still be disabled even if you quit alcohol and/or drugs. In other words, if you can end your problems but stopping, then you do not qualify for benefits. That said, many people who suffer from addiction do have other disorders and conditions. In these cases, such problems still persist, and disability continues, even if the individual gets sober.

Finding Other Support Networks

Again, the law does not account for how difficult addiction may be or how long it may take to get sober. The disability process looks at only whether a person is disabled, and how addiction contributes to that disability. Everything else is a secondary issue.

This is why there are programs like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). These organizations help people to stay clean by offering various support structures. If a claimant can get rid of his or her disability by attending AA or NA, disability benefits will not be administered.

When there are other impairments and the claimant’s DA&A problem is a factor, then the SSA’s decision-making gets more complicated. Many people seeking disability have either physical or mental impairments in addition to drug or alcohol abuse. In fact, many people do not follow a doctor’s advice and self-medicate with drugs or alcohol instead.

Other Physical and Mental Impairments

For instance, one claimant may have a severe back impairment. In order to mask the pain, the claimant abuses alcohol. However, even if the claimant stops drinking, that back disability remains. A case like this may be more likely to get approved for benefits.

On the other hand, if you have only mental impairments, you are more likely to lose your case. This is because the principles of modern psychiatric practice make it difficult for doctors to properly diagnose you. After all, if you are consistently under the influence, determining the cause of your mental issues becomes more complex.

Many psychiatrists and psychologists may simply consider your primary problem to be addiction-related. They would have to be able to examine you after a period of sobriety of over a month before they could reach a more informed opinion.

Some cases can still be won based on the doctor’s opinion that whether or not you can stay clean, your mental condition is still disabling. These cases are quite difficult, and typically require a long-standing relationship with your doctor.

The key word to remember in benefits determination is material. For instance, if a person has cirrhosis of the liver, the SSA may deny your benefits because if you were to stop drinking alcohol and/or stop abusing drugs, your liver condition would stabilize. However, if your liver was no longer functioning, quitting alcohol or drugs would not heal it. In other words, alcohol or drug abuse contributed to your failed liver, but is not a material contributing factor.

In such a case, the SSA may quickly approve you for benefits.

Again, there are many types of cases that can be argued one way or the other. Many factors must be considered, in accordance with laws, processes and procedures. If you believe you qualify for benefits due to addiction, do not delay.

Consult the Law Offices of Jason Khattar & Associates for advice.

Contact us HERE for a free consultation.