SSDI and SSI Benefits for Drug Addiction

The Social Security Administration (SSA) awards disability benefits to people who have medical conditions that keep them from working full-time for at least one year. Often, the agency receives applications that list substance abuse disorder as a disabling condition or that contain medical records indicating a drug addiction. When that happens, the SSA must evaluate the application ("claim") a bit differently to determine whether the claimant can receive benefits.

Is Drug Addiction a Disability for Social Security?

As the sole basis for receiving benefits, drug addiction is no longer considered a disability. In the past, Social Security used to award disability for substance use disorders. But today, if you file for disability benefits and the only reason you can't work is because you have a drug addiction, the SSA will deny your claim.

Instead, you'll need to show that you have another medically determinable severe impairment that keeps you from working. Severe impairments are any health issues you're receiving treatment for that have a significant impact on your daily activities. Many people who struggle with substance abuse have other severe impairments, such as liver damage, depression, or bipolar disorder. You may qualify for Social Security disability benefits based on those impairments as long as they would still keep you from working even if you stopped using drugs.

Do Addicts Get Paid Social Security When Substance Abuse is Material to Disability?

Social Security generally won't hold substance abuse or drug addiction against you if you can show that you're disabled from another condition. But if the agency determines that your drug addiction is material to your disability—meaning that if you stopped using drugs your health would improve to the point where you could work—you won't be paid disability benefits. See SSR-13-2p, Evaluating Cases Involving Drug Addiction and Alcoholism.

For some conditions, deciding whether substance abuse is material isn't very difficult. It's unlikely that drug use will be considered material if you're applying for disability because of an unrelated condition, such as thyroid cancer or degenerative disc disease. Even with impairments that were caused by drug addiction, like hepatitis, substance use isn't disqualifying if the damage is already done.

But other conditions are a little trickier to analyze. Mental illnesses often have symptoms that overlap or mimic those of substance abuse, and many people with mental disorders have "self-medicated" with drugs to reduce their symptoms. Examples of symptoms that could indicate either mental illness or substance addiction include:

• incoherent, delusional, or grandiose thinking
• visual or auditory hallucinations
• difficulty with focus or concentration
• loss of memory
• rapid or pressured speech, and
• abnormal motor movements (fidgeting or delayed reaction time).

Claimants who are applying for disability due to a mental disorder and have a history of drug addiction should establish a period of abstinence first so that Social Security can see how they function without interference from substance use. If your mental health symptoms dramatically improve when you're not using drugs, the SSA is likely to be skeptical that addiction isn't material, but if your symptoms persist through sobriety, your case for disability is stronger.

What Medical Evidence Do I Need to Get Disability With Drug Addiction?

Remember that because you can't get disability benefits for substance abuse alone, you'll need to provide medical records showing that you have another disabling mental or physical condition. Social Security will also want to see that you've sought treatment for your addiction. The agency doesn't request documentation from support groups such as Narcotics Anonymous, but if you've been through any formal rehabilitation services, you should let the agency know so they can—with your permission—review those records.

Providing Evidence of a Mental Disorder With Drug Addiction

Winning a claim for disability benefits based on a mental impairment when you also have a history of substance abuse can be challenging. Make sure that you're upfront with your doctor about your struggles with addiction. The SSA is aware that recovery isn't easy, and won't penalize you for any relapses so long as you're honest with your medical providers.

Social Security will look for the following evidence of the following in your medical records:

• progress notes, preferably from psychiatrists or psychologists who see you regularly, that contain their observations on how you're acting and feeling during your visit
• mental status examinations that document any abnormalities in your thinking
• dosages of any medications that you've been prescribed and whether you experience any side effects, and
• admission and discharge records from any hospitalizations.

If you have a doctor, counselor, or therapist who's been treating you consistently for over a year and has insight into your struggles with drug addiction, ask if they'll fill out a medical source statement. Your doctor's opinion can help the SSA determine what functional limitations you have that aren't a result of substance abuse.

Providing Evidence of a Physical Disorder With Drug Addiction

In addition to evidence showing treatment for a mental disorder, the SSA will look for potentially disabling limitations from any physical impairments. As with mental impairments, the agency will review your doctors' notes, hospitalization records, and prescribed medications for evidence of functional limitations.

Because physical impairments can typically be documented with objective evidence, your record should also contain medical imaging (like an X-ray, MRI, or CT scan), results of any lab work (such as blood tests), and physical examinations showing any signs of abnormal movements or sensations.

How Do I Apply for Disability Benefits With a Drug Addiction?

When you apply for Social Security benefits with a history of substance abuse, you'll go through the same disability determination process as everybody else—just with the added step of having the SSA decide whether drug addiction is material to your claim. Provided that your substance abuse isn't material, you can qualify for benefits by meeting a listed impairment or with a residual functional capacity that rules out all full-time employment.

You don't need to do anything special when you file your application for disability benefits (SSDI or SSI) such as stating that you have a problem with substance abuse. But you'll likely need to appeal a denial at least once. Few claimants are approved on their first try, and the agency is often reluctant to approve cases involving drug addiction until they've had a disability hearing with an administrative law judge.

If you win your disability claim but the SSA believes you're still struggling with substance abuse, the agency might require that you have a representative payee. Back due benefits and ongoing monthly payments will be sent to your representative, who is expected to manage the money on your behalf. You can find out more about representative payees and other issues involving addiction in our article on how Social Security evaluates alcohol or drug use.