When filing a claim for disability benefits, claimants should be aware that drug addiction and/or alcoholism may be a factor in Social Security’s determination. If the claimant has drug or alcohol use that has caused or aggravated a current disability, his claim may be denied by Social Security.
The test used by Social Security is whether the drug addiction or alcoholism is a “contributing factor material to the determination of disability.” Meaning, if Social Security finds the drug addiction or alcoholism materially contributes to the claimant’s inability to work, the claim will be denied.
First, Social Security determines whether drugs or alcohol play a factor in the claimant’s case. This should be established by medical evidence in claimant’s file. Second, Social Security must determine whether the individual would be able to work if they stopped using drugs or alcohol.
To determine whether one would be able to work if not using drugs or alcohol, Social Security evaluates current physical and mental limitations, which the claimant’s case is based on, and then determines which limitations would remain if the claimant stopped using drugs or alcohol. Finally, a determination of disability is made based only on the conditions that remain after the claimant stopped using drugs or alcohol.
The cause of claimant’s disabilities is irrelevant, even if drug addiction or alcoholism played a role in creating the condition. The test is whether the claimant would be disabled if he quit using drugs or alcohol and not whether the use caused his conditions.
The burden of proof is on the claimant to show they would remain unable to work if they stopped using drugs or alcohol. The Eleventh Circuit held that the claimant bears the burden of proving that his alcoholism or drug addiction is not a contributing factor material to his or her disability determination. Doughty v. Apfel, 245 F.3d 1274, 1275 (11th Cir. 2001)
The most difficult claims for social security to make determinations on may involve claims for mental impairments combined with substance abuse disorders. Social security will be required to determine which mental health impairments would remain if the claimant discontinued use of drugs and/or alcohol.
Although drug addiction and alcoholism should not automatically have a negative effect on the applicant’s disability claim, it can be very problematic to overcome the prejudice of such findings. If you have filed a claim for disability benefits or plan to file a claim in the future, you should stop drinking or using drugs. You should also consider stopping for a significant period of time to show continued inability to work after drug and alcohol use has stopped.
In Davis v. Apfel, a Florida district court noted that the Commissioner’s instructions regarding handling the “materiality” determination of drug and alcohol addiction state that the “[m]ost useful evidence that might be obtained in such cases is that relating to a period when the individual was not using drugs/alcohol.” Davis v. Apfel, 93 F. Supp.2d 1313, 1318 (M.D. Fla. 2000). In that case, the court found that since medical records showed mental stability during periods of sobriety, the claimant’s drug addiction was material to a determination of disability.