Many people who have suffered a serious injury or illness are dealing with constant and/or excruciating pain. When their prescribed medications no longer provide the relief they need, they often start to “self medicate.” This might include excessive drinking or use of illicit substances, seeking pain medication (sometimes in the form of illegal drugs) from non-medical sources or some combination of these things. All of this can lead to substance abuse and addiction.
Oftentimes, people assume that if they have a substance use disorder (SUD), whether it started before or after their disabling condition, they can’t qualify for Social Security Disability Insurance (SSDI) benefits. They may try to hide it from their doctors, which is never wise.
Why “materiality” matters
In some cases, a person with an SUD can be denied SSDI. In others, it may not affect their ability to get or continue benefits. It largely depends on the “materiality” of the substance abuse to the underlying disabling condition. (SUD alone is not a qualifying condition for SSDI.)
If a person admits to or is discovered to have an SUD in addition to their qualifying condition, disability examiners and doctors will assess whether it caused or worsened the condition. (Note that it’s important not to lie or intentionally leave out pertinent information on any documentation submitted to the Social Security Administration when seeking benefits.)
If a person has an SUD, doctors and examiners need to determine whether stopping or reducing the use of alcohol and/or drugs would improve the condition for which they’re seeking benefits enough that they wouldn’t need them. If that’s found to be the case, their application would probably be denied.
There may be conditions on benefits
If a person’s SUD is irrelevant to their qualifying condition, they should still be able to get benefits if they otherwise qualify. Those benefits, however, might be conditional. The applicant might need to participate in an addiction treatment program, for example. Their benefits might be required to go through a “representative payee” if there’s concern that the recipient could misuse the funds.
Each situation is highly unique. That’s just one reason why it’s important to get the facts and to seek legal guidance to help improve the chances of SSDI approval.