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