Millions of Americans suffer from substance abuse issues involving drugs and/or alcohol. While substance abuse can certainly be highly detrimental to a person’s health, it’s also possible to have a medical condition or disability that is unrelated to that problem. So can a person who is dealing with substance abuse qualify for Social Security Disability Insurance (SSDI)?
A person can’t get Social Security benefits – either SSDI or Supplemental Security Income (SSI) — based solely on their substance abuse of alcohol and/or drugs because addiction is not a qualifying condition. However, if they have a qualifying condition, they can’t be denied benefits based on their abuse of alcohol or drugs if they otherwise qualify. That’s where “materiality” comes in.
The role of materiality in the decision
What if – as is often the case – a person’s substance abuse caused or contributes to their medical condition? That’s what the Social Security Administration (SSA) will need to determine before approving an application. Disability examiners and medical professionals will determine whether the addiction is “material” to the condition that prevents someone from working.
If the substances are causing or making the condition worse and the condition would improve enough that a person could resume working if they stopped using, it’s considered “material.” If neither is the case, it’s not material and shouldn’t affect a person’s qualification for benefits.
Even if you are approved, the SSA may require you to get substance abuse treatment as a condition for receiving benefits. They may also require someone else (known as a representative payee) to manage the benefits so they aren’t misused.
If a person has a condition caused by substance abuse that is no longer reversible even if they stopped using, they may be able to qualify for benefits. Another exception involves addiction to prescription drugs. As long as a person is taking the drugs as prescribed by their physician, the materiality test isn’t used. Of course, most people with prescription drug addictions take far more than a responsible doctor would prescribe.
It’s important to know the facts rather than assume that a substance abuse issue automatically disqualifies you from SSDI benefits. If you’re having difficulty getting the benefits to which you’re entitled, it’s wise to seek legal guidance.