How Drug or Alcohol Abuse Affects a Mental Disability Claim

Many people with mental health disorders also struggle with drug addiction or alcohol use disorder (a current medical term for alcoholism), especially before they've received a formal diagnosis or during times when they lack insurance or access to health care. While Social Security doesn't look too fondly on periods of "self-medication," the agency understands that the relationship between substance abuse and mental health can be complex, and you won't automatically be denied benefits if you have a history of drug or alcohol abuse.

Is Alcoholism or Drug Addiction Considered a Disability?

The Social Security Administration (SSA) won't award disability benefits solely on the basis of alcohol or drug abuse. You'll need to establish that you have a medically determinable severe impairment, such as depression or anxiety, that is disabling despite the effects of substance abuse. In Social Security lingo, this is known as showing that your addiction isn't "material" to a finding of disability.

If the agency determines that alcohol or drug use is material to your claim, you'll receive a denial letter. To decide whether substance addiction is a material factor, the SSA looks at your medical records for evidence of functional limitations that persist during periods of sobriety or abstinence.

For example, people with bipolar disorder can experience periods of mania and hyperactivity that often mimic symptoms of methamphetamine use. If you were a regular user of meth before you were diagnosed with bipolar disorder and got clean after receiving treatment—but still experience manic episodes where you're unable to think linearly and finish tasks—the SSA will likely find that meth use isn't material to a disability finding, since the bipolar symptoms continued after the substance use stopped.

How Social Security Views Drug and Alcohol Use in Mental Claims for Disability

Separating the effects of drug addiction from those of mental health impairments can be challenging. Stimulants like methamphetamine and cocaine can increase feelings of anxiety and paranoia, while depressants such as alcohol and opiates can amplify mood disorders. When reviewing a disability claim for mental illness that includes a history of addiction or substance abuse, the SSA will consider several factors when determining materiality.

Can You Abstain From Drugs or Alcohol?

The strongest argument against drugs or alcohol being material to your claim is having a period of sobriety where your mental health symptoms didn't improve or go away entirely. This doesn't mean that you have to be completely abstinent for the period at issue—the SSA is aware that relapses occur, and won't penalize you for making honest attempts at sobriety.

Even if you don't have an extended period of abstinence, the SSA shouldn't automatically find that drug abuse is material to your disability claim. People with disorders such as schizophrenia, major depression, autism, bipolar disorder, traumatic brain injury, and markedly impaired intellectual functioning often try multiple substances (both prescribed medications and "street" drugs) in an attempt to control symptoms. Unless your treating psychiatrist's records state both that you could refrain from drug use and that your condition would improve significantly if you did, it's unlikely that the SSA will deny your claim based on drug and alcohol abuse.

Attending a Consultative Examination

If your medical record isn't conclusive as to whether substance addiction is material to a finding of disability, the SSA may ask you to attend a mental consultative examination to get more information. While the consultative exam is one data point in a (hopefully) more robust disability application, the examiner can review the notes from your treating psychiatrist or psychologist to help form an opinion about whether your mental health would improve with drugs and alcohol out of the picture.

Your Doctor's Opinion About Addiction or Alcoholism

Social Security values letters from doctors who've treated you regularly and therefore have special insight into how substance abuse affects your mental well-being. If your psychologist or psychiatrist is willing to write a medical source statement saying that your mental health symptoms would remain even if you stopped using drugs or alcohol, the SSA is likely to take their opinion seriously.

Having an opinion from a therapist or licensed mental health counselor can be useful as well, but generally in addition to, rather than a substitute for, a psychologist or psychiatrist. Keep in mind that general "lifestyle recommendations," such as advice to drink less or avoid illicit substances, aren't sufficient for the SSA to find that drug and alcohol abuse is material to your claim.

How "Reversible" Is the Damage from Drug or Alcohol Addiction?

Even if your mental health would get better without substance abuse in the picture, you can still qualify for disability benefits if your symptoms don't improve to the point where you'd be able to work full-time. For example, if your baseline mood is elevated when you stop drinking, but you still experience severe agoraphobia and panic attacks, the SSA probably won't deny your claim based on alcohol use disorder.

Alcoholism and ADA Accommodations

The Americans With Disabilities Act (ADA) requires most employers of 15 people or more to provide reasonable accommodations for employees with disabilities. For employees with alcohol use disorder, this could mean offering a flexible work schedule that allows the employee to attend an outpatient rehabilitation program. The ADA does not provide protections for people who show up to work intoxicated, however, nor does it allow you to drink on the job.

If you're a recovering alcoholic with ongoing limitations from a mental health impairment, you're also entitled to accommodations under the ADA. You'll need to request accommodations from your employer, preferably in writing, with reference to the specific modifications you're seeking. For example, if you have an attention deficit disorder, you may want to ask your supervisor to provide feedback in a more controlled manner, or for a quieter office more conducive to maintaining focus.

Getting Legal Representation for Your Disability Claim

It's difficult to predict how symptoms of mental disorders would manifest without the compounding effect of drugs or alcohol, yet this kind of judgment is the cornerstone of many disability claims. Claims examiners and administrative law judges often need to make an educated guess based on your medical record and hearing testimony, but not many applicants are savvy enough about disability law to make this guess work in their favor.

For this reason (and many more), it's a good idea to hire an experienced disability attorney to help you with your claim. Most disability lawyers offer free consultations, so you can get an idea about the strengths and weaknesses of your case. The consultation is also an opportunity to ask the attorney questions to make sure they're a good match for your needs. And because disability lawyers work on contingency—meaning they're only paid if they win your case—you're unlikely to have any up-front costs.