Can You Win a Social Security Disability Claim if Your Medical Records Contains Evidence of Alcoholism or Drug Abuse?

alcoholism and SSDISocial Security law has long included a provision which disallows a finding of disability if a claimant’s drug or alcohol addition is a contributing factor material to the determination of disability.  As a practical matter this means that a Social Security decision-maker (adjudicator or judge) has to decide whether you would meet Social Security’s definition of disability if the drug or alcohol addition did not exist.

Obviously it will be very difficult to untangle your medical record to make this type of determination because the limitations on your capacity to work reflect the totality of your overall body health.  However, Social Security has attempted to offer its decision makers a little more guidance with a new policy interpretation ruling that took effect in March 22, 2013 and rescinded SSA’s prior ruling which dated back to 1980.

The new ruling, which is called SSR 13-2p 1 sets out in a question and answer format the Agency’s policy about substance abuse and disability claims.  Click here to read SSR 13-2p.

My sense is that this new ruling will not change much in the State Agency adjudication offices or in the Administrative Law Judge hearing rooms.   The SSA decision maker will still be faced with the burden of trying to untangle job reliability issues arising from drug or alcohol abuse from the rest of your medical record.  The burden to show that your disability exists independently of any abuse falls on you, the claimant.

In my experience, I have successfully represented claimants with substance abuse issues when:

  • the alcohol or drug use has caused permanent organ damage, such as liver or heart disease that would not go away if my client became completely sober
  • my client alleges a mental health issue such as depression or bi-polar disorder that clearly existed long before intoxicating substances were being used and a treating physician is willing to go on record to verify that these mental health issues would not improve if the intoxicant use was to cease
  • an independent medical issue arises after substance abuse begins – such as a situation where a claimant who is an alcoholic becomes paralyzed in a car accident

The new ruling does suggest that SSA will consider the impact of periods of sobriety to determine the impact that drug or liquor use has on employment reliability.  A documented long period of sobriety during which a claimant’s other symptoms precluded work would be helpful evidence.  Further, sobriety counseling should be undertaken formally and under medical supervision.

I am also certain that cases where alcohol overuse or drug addition permeates the medical record will be reviewed by the Appeals Council so hearing judges will be very reluctant to approve these cases in the absence of compelling medical evidence.

So, if you are self medicating with liquor or drugs, and you are also dealing with a disabling physical or mental health issue, I would make every effort to seek rehab treatment from a medically supervised center to make your judge’s life easier.

  1. SSR 13-2p rescinds and replaces SSR 82-60 and goes into much more detail about how SSA adjudicators and judges should evaluate claims with DAA and how to explain their rationale in decisions.

Jonathan Ginsberg

Jonathan Ginsberg represents Social Security disability clients in Atlanta and throughout north Georgia

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