Is there such a thing as an automatically disabling drug for Social Security disability purposes? To be an automatic allowance (approval for disability benefits) implies that a drug, or some combination of drugs, would be disabling in every case.
Any Social Security claims examiner or administrative law judge (ALJ) would have to be able to assume the the drug is disabling simply because a disability applicant is taking it. The drug would have to always result in side effects of the same medical severity that would cause a mental or physical disorder to satisfy the most stringent requirement of the disability listings, or the drug’s side effects would need to prevent the ability to perform anywork, even work requiring minimal mental skills or physical strength. In Social Security lingo, that means the drug's side effects would have to prevent a person from doing sedentary work physically or unskilled work mentally for the applicant to be granted a medical-vocational allowance. These are extreme limitations to be imposed by medication alone.
To answer the question about disabling drugs, we need to first rule out the drugs that the Social Security Administration (SSA) would never consider to be disabling alone, no matter how severe their effects are on a person’s ability to function in the world of work. Most such drugs are those substances falling into the abuse category that have no federally recognized medicinal use. These are the Drug Enforcement Administration (DEA) Schedule I drugs like cocaine, marijuana, hallucinogens such LSD and psilocybin, methamphetamine, PCP, and many others as defined in 21 CFR § 13.08.11. Since the Social Security Act prohibits giving disability benefits for drug abuse or alcoholism, all of these drugs are ruled out for disability purposes.
In addition, the side-effects of legal drugs, even if given by prescription, are also generally excluded from being a legal basis for claiming disability benefits, to the extent they are taken in great excess of medical need. (For an explanation, see Nolo’s article Can Addiction to Prescribed Narcotics Keep You From Getting Disability Benefits?).
There is one important exception in which Social Security could consider that the side effects from the intentional abuse of alcohol or any drug are disabling. In this exception, mental function is so impaired that the person could not do even the simplest of jobs on a regular basis. Such a person’s thinking can be so disturbed that they cannot be held responsible for abusing any legal or illegal substance, or the limitations it produces. In such disorders, like schizophrenia, the clinical severity of the mental disorder cannot be clearly distinguished from drug side-effects, and so such effects must be considered legitimate and potentially disabling limitations. (See Nolo's article on how Social Security treats drug or alcohol use in a mental disability claim). However, this situation still involves an illness in addition to drug abuse or alcoholism. Therefore, taking drugs alone still does not automatically result in a finding of disability; the severity of the individual’s mental disorder must also be taken into account.
Are there any drugs that would be considered automatically disabling when legitimately prescribed by a doctor for a physical disorder? A common example seen by the SSA involves a claimant who is receiving chemotherapy for some type of cancer. Depending on the drug, side-effects can sometimes be quite severe, such as causing heart failure, peripheral neuropathy, weakness from anemia, general malaise, infection, nausea, depression, and even death from complications of chemotherapy.
However, there are two reasons that such drugs are not automatically sufficient for a disability determination. First, there is no particular drug to which everyone can be assumed to react unfavorably or to what degree, so no assumption can be made that any drug given for cancer will be disabling in itself. Second, there is the question of duration. In the great majority of cases, cycles of chemotherapy don’t go on for a year; in fact, extremely severe side effects of prolonged duration would be a reason for the treating doctor to decrease the doses of the chemotherapy to alleviate toxicity. In some forms of cancer, such as most types of lymphoma, there could still be enough drug toxicity and associated complications over a period of a year—with relapses—to be disabling when considered along with the cancer itself. However, there is nothing automatic about it—no assumptions can be made about how severe an individual's side effects may be, so evaluations must be done on a case by case basis. Therefore, even in cancer cases where very toxic drugs may be given with potentially severe side effects, one cannot say that consumption of a particular drug will necessarily be disabling.
What about chronic disorders like epilepsy in which prescribed medications may have significant side effects like lethargy, impaired coordination, and sleepiness? Seizure activity might be under control, but the drugs may decrease the ability to function optimally. The SSA adjudicator should of course take the side effects into account when evaluating the claim, but there is nothing predictable about the severity of such drug problems, and so no automatic assumption can be made about an applicant's ability to work.
Limitations caused by drug side effects are less likely to raise an impairment's severity to meet the requirements of one of Social Security's listings. It is more likely for one or more medications given chronically to be disabling on a "medical-vocational" basis (see our section on RFCs and the medical-vocational rules). Even so, a medical-vocational allowance must be determined case-by-case, taking into account the particular person’s age, education, work experience, and medical limitations. For example, it is possible that a person with epilepsy can have so much drowsiness from medications that they cannot return to their prior work, or do other work compatible with their education and experience. Social Security would allow this claim by an individualized medical-vocational decision. Similarly, there are other types of chronic disorders that could be found disabling in particular instances solely because the side effects of medication lower the applicant's residual functional capacity (RFC), but this analysis would always be done on a medical-vocational basis and only for a specific claimant.
In conclusion, there is no drug or combination of drugs used to treat patients that predictably prevents a disability applicant from doing either unskilled mental work or sedentary physical work. No such “automatic allowance” medication exists -- in fact, drugs that toxic probably wouldn’t be approved by the FDA or used by treating doctors. And if such drugs did exist, the SSA would probably have a listing for drugs falling into that class.