How Does the SSA Decide Cases in which There is Drug and Alcohol Involvement

The Social Security Administration will not award a claim in which drug or alcohol use is material to the disability. This means that if the claimant would not be disabled were they to stop abusing drugs or alcohol, the claim cannot be awarded. The agency assesses whether the claimant would be disabled in a condition of sobriety, or free of illegal substance abuse.

This does not mean, for example, the claimant who became a double amputee after crashing his car into a tree while driving drunk could not be awarded. In a state of sobriety, this person would still be disabled. Similarly, individuals with organic brain conditions, which are a product of a long history of alcohol abuse, can be awarded, if the condition has advanced so far that abstinence from alcohol would not reverse the condition.

There is a sequential evaluation process which the agency uses in assessing claims in which drug or alcohol abuse are involved. First, there must be some medical diagnosis of a drug or alcohol problem, based upon objective signs, or laboratory findings, such as urine drug screens. If the individual does not have drug or alcohol abuse, the inquiry ends. If he does, the inquiry proceeds.

At the second step, it is determined whether the claimant would be disabled considering all of his impairments, including drug or alcohol abuse. If not, the inquiry ends, and the claim is denied. If so, we proceed to step three.

At step three, the inquiry is whether drug and alcohol abuse is the only impairment. If it is, the claim is denied, and the inquiry ends. Otherwise, we proceed to step four.

In step four, we ask whether the other impairment is disabling by itself while the individual is abusing drugs or alcohol. If the answer is no, the claim is denied. The answer is yes, we proceed to step five.

At step five, we ask whether drug or alcohol abuse causes or aggravates the claimant’s other conditions. If not, drug and alcohol is not material in the claim is awarded. If yes, but the other condition is irreversible, or would not improve in a condition of sobriety or abstinence, the claim is awarded. Otherwise, we go to step six.

At step six, we ask whether the other conditions would improve to the point of non-disability in the absence of drug or alcohol abuse. If so, the claim is denied, and drug or alcohol abuse is considered material to the disability. If not, drug or alcohol abuse is not considered to be material, and the claim is awarded.

All disability applicants should be forewarned that use of alcohol or street drugs, including marijuana, will be very damaging to a claim for disability based on a mental condition. Furthermore, it damages the claimant’s credibility, regardless of the medical condition in issue.