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Social Security Disability Blog

The Effect Of Drug Addiction Or Alcoholism On A Claim For Social Security Disability

Monday, March 25, 2013

On March 22, 2013 a new Social Security Ruling regarding drug addiction and alcoholism (DAA) went into effect. (SSR 13-2p). While the ruling does not dramatically change the way that SSA evaluates DAA in disability cases, I thought this was a good time to write on the topic.

What is DAA in the Social Security Disability Context?

The SSA considers DAA to be “maladaptive patterns of substance use that lead to clinically significant impairment or distress.”Thus for DAA to be an issue in a case, the claimant must have both a pattern of substance use and impairment as a result. Thus, self reported occasional drug or alcohol use or an arrest for “driving under the influence” are not enough to find DAA as these are not a “pattern.” There needs to be objective medical evidence of DAA before SSA is allowed to consider DAA in its analysis. Second, the substance use must also cause some medical impairment. Typical impairments as a result of chronic use of drugs or alcohol involve the cognitive functioning of the brain such as dementia and memory problems.

Can DAA be the basis of a claim for disability?

The short answer is: no. Although drug addiction and alcoholism are generally considered “diseases” in the medical community, federal law prohibits an award of disability benefits based on drug addiction or alcoholism.

Can someone be found disabled if they suffer from DAA?

Yes, but the DAA cannot be “material” to the finding of disability. In other words, the claimant must suffer from another condition or conditions which would be disabling by themselves, in the absence of DAA. In evaluating these cases, the SSA determines what the claimant’s impairments would be in the absence of DAA. If the claimant is still disabled, then the claimant will be granted disability benefits even though drug addiction or alcoholism is also present.

Specific Examples from My Practice

Drug Addiction. I represented a Vietnam War veteran in his claim for disability benefits based upon his severe post traumatic stress disorder (PTSD). The veteran also was a habitual user of heroin. I argued that the heroin use was simply his way of “self-medicating” and that the PTSD was serious enough to prevent work regardless of the heroin use. We were successful.

Alcoholism. I have represented numerous individuals with alcoholism. Some of them have presented with cirrhosis of the liver as a result of a lifetime of alcohol abuse. Cirrhosis of the liver is a very serious condition which is ultimately fatal. It causes serious fatigue, malaise, illness, loss of energy, and dementia. Advanced cirrhosis typically prevents all work activity. Other individuals have presented with peripheral neuropathy as a result of alcohol abuse. Peripheral neuropathy causes loss of feeling in the hands, arms, feet, and legs. Again, this condition can certainly have a significant impact on the ability to work in any capacity.

These two alcohol-related examples are different than the drug addiction example because the DAA (in this case alcoholism) actually caused the disabling conditions. We have, nevertheless, prevailed in both of these scenarios. The key to the analysis is whether these conditions would be disabling if the claimant stopped drinking. In both of these examples, the alcohol-related damage is already done. While it may be advisable to stop drinking, that will not cause the impairments from the cirrhosis or peripheral neuropathy to stop. Thus the DAA is not material to the finding of disability.

By David Galinis

Liver Disease, Alcoholism & Social Security Disability

Thursday, May 24, 2012

The most common forms of liver disease I see in my disability practice are liver cancer, hepatitis, cirrhosis, and alcoholic liver disease. All of these medical conditions can be severe enough to prevent a person from working. This post describes the most common types of liver disease and how they may be used as a basis for social security disability benefits.

Liver Cancer

Assuming they are not working, a person diagnosed with liver cancer should apply for social security disability benefits. The Social Security Administration (SSA) has promulgated regulations that provide for the expedited evaluation of claimants diagnosed with liver cancer. Liver cancer is one of over 100 medical conditions on this “compassionate allowance” list. Not only should the claim be handled quickly, but the claimant should be granted benefits so long as the diagnosis is clear in the medical records.


A diagnosis of hepatitis means that the liver has become inflamed. The cause is usually a virus (hepatitis A, B, C) although it can be caused other ways, including alcohol consumption. Most of the claimants I have represented with hepatitis generally complain of intense fatigue and weakness. Some have also complained of loss of appetite, jaundice, and being prone to sickness.

If you recall, there are two primary ways to prove disability. (See 5 Step Disability Evaluation Process). One way is to prove that your condition meets the medical criteria as defined in the Listing of Impairments. The other way is to prove that your medical condition creates symptoms which prevent you from being able to work.

Most of the claimants with hepatitis in my practice have not been able to meet the Listing of Impairments for liver disease. Instead we usually prove that the claimant is unable to work because of a decrease in productivity. The argument is that overwhelming fatigue will lead to frequent absences from work and will also impair productivity while at work. If the productivity is decreased by 20% or more, then the worker would not be able to sustain gainful employment.

Some claimant’s may also be disabled due to the treatment for hepatitis. The treatment regimen usually involves being medicated with interferon and ribavirin for 12 months. The side affects of the medications (think chemotherapy type side effects) during those 12 months are usually much worse than the actual symptoms of the hepatitis. During those 12 months of treatment it is often easy to prove disability. The problem is that the impairment must last at least 12 months, so a successful course of treatment may end a claim for social security disability benefits.


Cirrhosis occurs when the liver tissues die and are replaced by fibrous tissues. Cirrhosis can be caused by many things including chronic hepatitis and alcohol use. The symptoms include fatigue, malaise, weakness, nausea, loss of appetite, jaundice and altered mental status (e.g., when the liver function is severely impaired, the person can appear to be intoxicated).

Claimants with cirrhosis can often meet the Listing of Impairments criteria. This can often result in decisions without the need for multiple appeals or hearings. To meet the listing criteria, a claimant must either be awaiting a liver transplant and/or be diagnosed as having “end stage liver disease.” Whether one has end stage liver disease involves the results of lab results measuring creatinine and bilirubin levels. The precise levels and the computations can be found in the Listing.

For claimants who don’t meet these listings, all is not lost. The symptoms associated with cirrhosis are usually more severe than those claimants with hepatitis alone. The symptoms will often be severe enough to decrease productivity enough to prevent all work.

Alcoholic Liver Disease

Over-consumption of alcohol can cause both hepatitis and cirrhosis. It can lead to all the conditions and symptoms described above. Can a claimant who suffers from both liver disease and alcoholism obtain social security disability benefits?

SSA rules provide that if substance use/abuse is material to the finding of disability, then the claimant is not entitled to disability benefits. This might lead you to the conclusion that those with alcohol induced liver failure cannot be granted disability benefits. This is not the case. If the reason for the disability is a poorly functioning liver (as a result of any cause) then the claimant is entitled to disability benefits. If the reason for the disability is alcoholism, the claimant is not entitled to disability.

Let me illustrate. If the person’s productivity has been reduced because they are frequently late and/or absent due to the abuse of alcohol, then they are not considered disabled. Frequent benders cannot be the basis of disability. In this case, alcoholism is “material to the finding of disability.” However, if the alcohol abuse has caused a condition, like cirrhosis, which by itself causes the decrease in productivity – the claimant is entitled to the disability benefits. In the latter case, the use of alcohol is not “material” to the disability.

By David Galinis


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