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Can a substance use disorder keep you from getting SSDI?

On Behalf of | Jun 9, 2023 | Social Security Disability (SSD)

Millions of Americans have a substance use disorder, sometimes known as substance abuse, involving alcohol and/or drugs. Some will develop a serious illness or suffer a disabling injury that prevents them from being able to support themselves and their families. In some cases, people develop an addiction to pain medication only after suffering an injury and being prescribed drugs that are meant to help them but are also highly addictive.

People often assume that their substance use disorder will disqualify them from being able to get or continue receiving Social Security Disability Insurance even if they have a qualifying medical condition. Therefore, they may try to hide it from their doctors and from those who approve or deny their SSDI benefits. Let’s look at some facts and some factors that determine if or how an addiction can affect your ability to receive SSDI.

The materiality of the substance abuse to the disabling condition

First, a substance use disorder isn’t a qualifying condition for SSDI. If someone has a substance use disorder in addition to a qualifying condition, doctors and disability examiners will determine whether the substance abuse is “material” to that condition. In other words, did it play a role in causing it or is it worsening it?

The key question is whether stopping or cutting back on alcohol and/or drugs would improve the person’s qualifying condition enough that they could work and not need SSDI. If so, they would likely be denied benefits. If a person’s substance use disorder didn’t cause their qualifying condition and getting treatment for that disorder wouldn’t have much, if any, effect on their qualifying condition, then it would be less likely to affect their chance of approval.

There might be some conditions on that approval

The person may be required to get substance abuse treatment. They may also not be able to get the benefits directly. They might have to be paid to a representative payee like a family member or care facility or guardian and then used on behalf of the beneficiary.

Every case is unique. However, it’s important never to lie to your medical provider about your alcohol and/or drug use. If you’re concerned about whether you can still be approved for SSDI benefits or if you believe you or a loved one has been wrongfully denied benefits, it may be wise to get legal guidance on your claim.