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Can someone with a substance abuse problem get Social Security disability benefits?


In some circumstances, yes.

Social Security does not consider someone to be disabled solely on the basis of a substance abuse problem. It used to, but a 1996 federal law eliminated alcoholism and addiction as grounds for benefit claims. At the same time, you cannot legally be denied Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) because of drinking or drug use if your medical condition otherwise meets the benefit criteria.

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However, the Social Security Administration (SSA) can reject a benefit claim if it determines that drug or alcohol use causes or contributes to the physical or functional limitations that render you disabled — unable to work for a year or more.

If your medical record has evidence of a substance use disorder, only then can SSA officials consider its effect on your condition. Disability examiners, in consultation with medical experts, assess whether drug or alcohol dependency is, in Social Security parlance, “material” to determining if you are disabled.

Key considerations

Two questions are key to this determination:

  • Are drugs or alcohol causing or worsening your physical or mental impairment?
  • Would your condition improve to the point where you could return to work if you stopped using?

If the answer to both is no, the SSA deems the substance abuse “not material,” meaning you still would be sufficiently impaired minus any limitations related to drinking or drugs, and it can allow your claim. If the answer to both is yes, you will not be considered disabled, and your claim will be denied.

You still may be able to draw benefits for a disability in which substance abuse played a part if Social Security finds that your condition is irreversible and abstinence now would not affect it.

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For example, if you have advanced liver disease or chronic pancreatitis because of alcoholism, you can get disability benefits if Social Security concludes, in effect, that the damage has been done and you could not go back to work even if you quit drinking.

Prescriptions treated differently

The rules are a bit different for prescription drugs. You still cannot get disability benefits on the basis of an addiction to painkillers or other prescription narcotics. But Social Security does not apply the “material"/"not material” test to prescription drugs as long as you are taking them at the frequency and quantity your doctor ordered.

That means Social Security can consider the effects of prescription drugs on your ability to work in a way it cannot with other substances. Social Security will ignore any such limitations directly related to drinking or illicit drug use. But if the side effects of prescription painkillers, such as fatigue or inability to focus, are part of what prevents you from working, the SSA can factor that into determining whether you are disabled, provided you are taking the drugs strictly as prescribed.

Keep in mind

  • If Social Security approves a disability claim for someone with a substance abuse problem, it can mandate treatment as a condition for receiving benefits and require that the person have a representative payee manage their benefit payments.
  • Social Security also may consider the effect of drug or alcohol use on a beneficiary's condition when doing disability reviews — periodic evaluations to assess whether someone getting SSDI or SSI remains unable to work.

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