The Social Security Administration (SSA) has clarified a new policy regarding drug and alcohol addiction. There is no doubt that Social Security generally does not grant benefits to individuals who are disabled due to substance abuse. To be more precise, in 1996, the federal government eliminated alcohol and other addictions as qualifying reasons for getting Social Security disability benefits. 

You can be legally denied SSDI benefits due to a drinking or drug problem even if your medical condition renders you unfit to work and support yourself. There are some exceptions; however, you may need to be well-versed in the law to truly understand how alcohol and drug addiction are treated by SSA when deciding claims for disability benefits. 

Know what substance addiction is 

Before you delve into the complications of the SSDI application process, it is helpful for you to know how SSA treats substance addiction. This might help you understand and prepare your case better. According to Psychology Today, substance addiction is when a person becomes physically and mentally dependent on alcohol and/or drug consumption to function normally. Broadly speaking, there are two types of substance abuse:

  • Physical addiction: physical addiction is typically characterized by severe physical symptoms in reaction to the drug or alcohol,  such as withdrawal symptoms. 
  • Psychological addiction: Psychological addiction is when an individual becomes mentally addicted causing psychological symptoms, like anxiety, depression, or agitation. 

Attitudes towards substance addiction 

Substance Abuse in SSDI Benefits

You should know that SSDI, which is Social Security Disability Insurance, is a program that has been designed to provide monthly financial and other support to applicants who have a physical disability. Everyone knows that the SSDI program denies benefits to individuals who have become disabled due to substance addiction alone. But a more difficult question is how SSA evaluates those with a legitimate disability that is worsened or impacted by substance abuse. 

In that regard, you should know SSA’s approach towards substance addiction is rather complex. That is, the impact of your addiction will not be factored into whether you are disabled. 

Prior to the 1996 change in federal law, SSDI applicants would have been eligible for benefits for disabilities even if they were entirely based on addiction. After the new law was passed, however, applicants should provide valid and reliable medical evidence showing that their physical or mental impairments would persist in spite of their addictions. There are also relatively relaxed rules for SSDI Over 50 applicants. So if you are 50 years of age or older, make sure you know the law before taking any steps.

The rules of SSA

The new SSA rules cover addiction and substance abuse cases that contribute to one’s disability. In accordance with current rules and regulations, state Disability Determination Services will evaluate an applicant’s disability and determine whether or not the drug and alcohol abuse contributes materially to the applicant’s disability. 

You might need to know about how drug and alcohol abuse is evaluated. For instance, a person’s combination of physical impairments that are the result of medicinal drugs may not be factored against a favorable disability decision if the medicine is described for legitimate medical purposes. 

Moreover, in cases where a disability is caused by a medically prescribed high-dose of medication that is necessary to treat a valid medical condition, the applicant can still qualify for disability benefits. If an individual is paralyzed and also has substance abuse problems that hinders them from working, the SSA will need to determine to what extent the disability or the substance abuse contributes to an inability to work.  It is best to consult with an experienced attorney before initiating the SSDI Application Process. An attorney can help you at every step of the process.

Acknowledge a few key considerations 

When it comes to the matter of determining benefits eligibility in these circumstances, two questions are:

  • Are drugs or alcohol worsening the physical or mental impairment? 
  • If you are able to refrain from taking substances, would your physical and mental impairments still prevent you from going to work? 

If your answer is no to both of the questions, you may be able to sufficiently carry out normal duties. Therefore, you may not be covered by benefits. However, if the answer is yes to both of the questions, you must know you may be considered disabled.

On the off chance your substance abuse has resulted in disability that is irreversible, you may be entitled to draw the benefit. You should know that in a few cases, people with advanced liver disease due to alcoholism that is irreversible may be able to get benefits that have been designed for the disabled person. There are a few things to keep in mind, such as:

  • If Social Security approves your disability benefit application, you may have to follow other mandates. For example, the disabled individual might have a representative payee or fiduciary who will manage the payment of benefits. 
  • The beneficiary may also be subject to occasional check-ups to check on their well-being. They will be evaluating whether the alcohol or drug addiction has worsened the disabling medical condition. You as a beneficiary should never hinder these periodic visits, as that might encumber your benefit payments as well. 

If your appeal has been denied several times, it is important to hire a San Antonio Social Security Disability Attorney. Our attorneys have years of experience in disability claims and are well-versed in the technicalities of the SSDI program. Experienced attorneys will know precisely how to troubleshoot issues. They also have the ability to present your case with a gravitas that will surely grab attention.