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Can a SSDI claim be denied due to a substance abuse problem?

On Behalf of | Feb 16, 2024 | Social Security Disability

Millions of people in the U.S. of all ages and walks of life suffer from substance abuse. Some of them also develop debilitating injuries or illnesses that prevent them from working. These circumstances may or may not be related.

A person’s addiction to alcohol and/or drugs may have nothing to do with their disabling condition. However, they may be concerned about whether their substance use disorder (SUD), as it’s often called by those in the addiction and recovery communities, will prevent them from qualifying for Social Security Disability Insurance (SSDI) benefits.

People often assume that their SUD will disqualify them from being able to get or continue receiving SSDI even if they have a qualifying medical condition. Everyone’s situation is unique. Nonetheless, there are some general ground rules that can shed some light on whether a person’s SUD will prevent them from obtaining SSDI. (Note that an SUD is not a qualifying condition.)

Is the SUD material to the disabling condition?

Did a person’s abuse of alcohol and/or drugs cause or worsen the condition? Would stopping or even cutting back on the substance(s) improve the qualifying condition enough that an applicant would again be able to work? That’s what disability examiners will need to determine. If the answers to those questions are yes, an SSDI application is likely to be denied.

If the SUD didn’t cause their disabling condition and stopping or minimizing the use of the addictive substances would have little or no effect on it, it’s likely not going to affect an applicant’s chances of getting benefits. Examiners look at medical histories when making their determinations, so it’s important for applicants to be upfront about what they’ve been through and what they’re still grappling with.

Some exceptions to note

If a person’s addiction is to prescription medications that they need to manage their disabling condition, that likely won’t be grounds for denial of benefits as long as they’re taking the amount prescribed. Unfortunately, that’s typically not how addiction works. Further, if the Social Security Administration (SSA) approves benefits for someone with a qualifying condition and an SUD, it has the right to require them to get substance abuse treatment.

If you or a loved one has been denied benefits because of an SUD (or any other reason) or you just have questions or concerns, seeking experienced legal guidance is always an option.


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