Can You Get Social Security Disability Benefits if You Have Drug Addiction or Alcoholism?

Many Social Security disability applicants have wrestled with drug or alcohol abuse at one time or another, whether for prescribed medications or illicit ("street") substances. Disability attorneys are frequently asked "Is addiction a disability?" or "Can alcoholics get disability?" The answer can be surprising for applicants worried about how a recent history—or even ongoing struggle—with substance abuse will affect their chances of getting SSDI or SSI benefits.

Is Substance Abuse a Disability for Social Security?

The Social Security Administration (SSA) considers you disabled if you have a "medically determinable" severe impairment that prevents you from working full-time for at least one year. Prior to 1997, that included applicants who were unable to work solely on the basis of drug addiction, alcoholism, or both.

Following the passage of the Contract with America Advancement Act of 1996 (H.R. 3136), however, the SSA is no longer allowed to award disability benefits based only on addiction or alcoholism, or any type of substance use disorder. (So alcoholics and drug addicts can't get disability without another severe physical or mental condition.)

Instead, the agency looks to see if you have any other physical or mental conditions that keep you from working and then determines whether your substance abuse is "material" to your disability. Drug or alcohol abuse (DAA) is material to your disability when your underlying medical condition would get better or go away entirely if you stopped using drugs or alcohol.

If Social Security finds that DAA is material to your condition, your claim will be denied. But it's important to know that "materiality" doesn't mean that the agency can deny a claim for disability solely because the applicant is an alcoholic or has a drug addiction. Even intentional misuse of illicit substances doesn't automatically disqualify you from receiving benefits. However, you must show that you'd be unable to work even if you were clean and sober.

How Does Social Security Assess Whether Drugs or Alcohol Are Material to Disability?

Before considering whether DAA is material to your disability claim, Social Security must see evidence that you're using drugs or alcohol in a dysfunctional way. Generally, this means that a doctor has diagnosed you with substance abuse disorder, but a claims examiner might find evidence elsewhere in the medical records (such as clinic notes or hospital intake forms).

Not every instance (or instances) of alcohol or drug use are addictive—the SSA isn't concerned if you have a glass of wine with dinner. But if your substance abuse disorder is damaging your body or causing disruptions in your work, family life, or social activities, it's likely that Social Security will need to evaluate whether DAA is material in your case.

Materiality evaluations are technically a six-step process, but can be boiled down to two fundamental questions about the nature of your addiction or alcoholism.

Would Your Condition Improve If Your Drug or Alcohol Abuse Ended?

Applicants are often surprised to learn that you can get disability for a medical condition that's caused by substance abuse, as long as the limitations from the condition persist even when abstaining from drugs or alcohol—in other words, the effects aren't "reversible."

For example, say you have greatly reduced liver function from advanced cirrhosis despite years of sobriety. Social Security may find that the liver damage is permanent and can't be repaired. Therefore, your history of alcoholism wouldn't be material in determining disability. On the other hand, if your doctor tells you that your liver enzyme and protein levels would return to normal if you stopped drinking, the agency is very likely to conclude that DAA is material to your claim.

Would You Be Able to Work If You Stopped Using Drugs or Alcohol?

DAA is considered material when it makes the difference between finding you disabled or not disabled. So even if your medical condition would improve with abstinence or sobriety—but not so much that you'd be able to work—the SSA won't deny you benefits based on substance abuse.

Returning to the cirrhosis example above, if your liver enzymes improved slightly but remained abnormal after you stopped drinking—resulting in excessive fatigue that made even sit-down jobs too difficult—Social Security would likely find that DAA isn't material in your case, since you wouldn't be able to work full-time regardless of sobriety.

Showing that disabling symptoms aren't affected by substance abuse is easier for some conditions than others. For example, if severe degenerative disc disease reduces your range of motion to the point that you can't lift anything heavier than five pounds, the agency will probably conclude that your limitations would be the same whether or not DAA was involved.

But many mental disorders can be intertwined with substance use in a way that can make it hard to determine which symptoms, if any, would improve without DAA. For this reason, it's important for people with a mental disorder to establish some period of sobriety so Social Security can get an idea of your mental health symptoms without interference from drugs or alcohol.

Is an Addiction to Prescribed Medication Considered Material?

Under Social Security Ruling SSR 13-2p, "Evaluating Cases Involving Drug Addiction and Alcoholism," if you're taking your prescription medication as prescribed—even highly addictive medications such as opioids or other narcotics—Social Security doesn't find that drug use material, or even DAA. In the agency's eyes, if you're using your prescribed medication the way your doctor wants you to, you're not abusing it, so DAA doesn't come into play. In fact, the SSA takes into consideration any side effects you have from these potent painkillers when deciding whether you could work full-time.

But if you're taking your medication at a higher dosage or greater frequency than your doctor prescribed, or you're using prescription drugs meant for somebody else, Social Security can perform a DAA materiality determination and deny your claim if your prescription drug use is material.

When Is Medication Taken as Prescribed?

Your medication is "taken as prescribed" when you follow the instructions of a licensed medical doctor with whom you have a doctor-patient relationship and who appropriately directs you to take a reasonable amount of medication for legitimate purposes. This means that you can't ask your cousin the nurse to give you a fentanyl patch for a sprained ankle and expect that Social Security will ignore any DAA issues.

When Is Medication Not Taken as Prescribed?

Any medication taken outside the scope of a doctor-patient relationship (or when the doctor-patient relationship has been "broken") isn't considered to be prescribed and is a potential contender for a DAA evaluation. Some examples may include:

• "doctor shopping," referring to someone who visits several medical providers to obtain narcotics, such as oxycodone, in larger amounts than they would otherwise be able to obtain
• getting "leftover" narcotics from a friend or family member
• using prescription medication meant for somebody else
• ordering opioids online without any doctor's knowledge, and
• having a medical professional write you a prescription for opiates when you don't need them.

Keep in mind that the SSA is aware of the addictive properties of these medications, and understands that disability applicants might make an undesirable or ill-advised decision when faced with a lack of availability. But the agency also recognizes the difference between somebody who takes a Vicodin pill from a friend to deal with an unexpected surge of pain and somebody with few doctors' visits who buys large amounts of morphine off the internet. The former is less likely to need a DAA determination than the latter.

How Do I Show Social Security That I'm Disabled Despite Drug Addiction or Alcoholism?

The most difficult, yet effective, method of proving that you're disabled despite substance addiction or abuse is to establish a period of sobriety. If you have several months where you weren't drinking or using, but you still experienced physical or mental symptoms from your underlying condition, that's a strong indicator that DAA isn't a material issue in your case.

Another persuasive method is to get a doctor's note from a physician or psychiatrist who's seen you on a regular basis. Social Security values the opinions of treating doctors, and if your doctor thinks that your drug or alcohol use doesn't contribute to your medical condition and can provide a written letter to that effect, the agency will likely be persuaded that DAA isn't material.

Depending on the specifics of your claim, showing that substance abuse doesn't have an effect on your physical or mental health can be challenging. And even if the SSA doesn't consider drug or alcohol use material to your case, you still need to prove that your medical condition keeps you from working. Consider contacting an experienced disability attorney to get help with your claim and gather the records needed to show the SSA that you're disabled.

_{Updated January 30, 2024}