Disability Benefits & Substance Abuse

In 1996, Newt Gingrich and the Republican’s released the “Contract with America,” which included amendments to the Social Security Act. One change was precluding claimants from being eligible for Social Security Disability (“SSD”) benefits or Supplemental Security Income (“SSI”) benefits if drug or alcohol addiction was a “material factor” preventing the claimant from working. In other words, a claimant was not entitled to disability benefits unless his mental or physical limitations would remain disabling even in the absence of drugs or alcohol.

A woman diagnosed with bipolar disorder retained me after her SSD application was denied. At the 1996 U.S. Psychiatric & Mental Health Congress, Kathleen Brady, M.D., Ph.D., an associate professor of psychiatry at the Medical University of South Carolina, reported that "substance abuse occurs in 30% to 60% of patients with bipolar disorder and is more likely to coexist with bipolar illness than with any other Axis I psychiatric disorder." Some of the claimant’s medical records indicated that she had a history of alcoholism.

I was notified today that the claimant’s application was approved based upon the on the record (“OTR”) request I submitted for a fully favorable decision. As a result, the claimant will not have to wait for a hearing to be scheduled. Along with additional medical records and reports, I obtained a drug and alcohol (“DAA”) statement from the claimant’s psychiatrist, all of which were included with the OTR. The OTR decision highlighted that the DAA statement confirmed that the claimant remained disabled notwithstanding any history of alcoholism.

Whenever any disability involves records reflecting some type of substance abuse, it is advisable to get the treating sources to provide a DAA statement explaining how the substance abuse is not a material factor contributing to the claimant’s disability.