Drug & Alcohol Evaluation: Social Security & SSI Disability

Overview

In any Social Security disability case, there are two primary issues with drug and alcohol use. First, whether drugs and alcohol cause you to be disabled. Second, how drug and alcohol use affects your credibility. There are three secondary issues – testing, whether Social Security reports your use to the authorities, and payees.

Tip. Before we get started with all that, Social Security is not concerned with one-time or two-time drug use and social or casual drinking. Social Security is concerned with ongoing drug use and alcohol abuse.

Disability & Social Security’s Drug And Alcohol Evaluation

Six-Step Evaluation

If drugs and alcohol cause you to be disabled, Social Security will find your use “material” or “material to your disability,” and you will not receive disability benefits. Social Security uses a six-step drug and alcohol evaluation process to determine if your use is material.

Tip. Social Security rarely finds drug and alcohol use material.

Step 1 – Is There Evidence Of Drug Or Alcohol Use?

No. Your drug and alcohol use evaluation ends as it is not material. Social Security will continue its evaluation of your case to determine if you are disabled.

Yes. Go to issue 2.

Step 2 – Are You Disabled Considering All Your Medical Conditions And Drug Or Alcohol Use?

No. Your case will be denied as you are not disabled.

Yes. Go to issue 3.

Step 3 – Is Your Drug Or Alcohol Use Your Only Medical Condition?

Yes. Your drug and alcohol use is material. At Step 2, you were found disabled. Here at Step 3, your drug and alcohol use is your only medical condition. Your case will be denied.

No. Go to issue 4.

Step 4 – Is Your Other Impairment(s) Disabling While Your Are Using Drugs Or Alcohol?

No. Your drug and alcohol use is material. At Step 2, you were found disabled. At Step 4, your other impairment(s) is not disabling by itself. Instead at Step 4, you are disabled due to the combination of your other impairment and drug use or alcohol abuse. Your case will be denied.

Yes. Your drug and alcohol use in not material.

If you are disabled due to past or current drug or alcohol use, and your disability would still exist even if you stopped your drug and alcohol use, then your disability would still remain if you stopped using drugs or alcohol, and you will be found disabled. In other words, if the damage is already done from DAA, then DAA is not material. Examples of impairments caused by DAA that will not improve even if you stopped your substance use include the following: brain, liver, or kidney damage; substance-induced persisting dementia; or substance-induced persisting amnestic disorder.

• At Step 4, your drug and alcohol evaluation essentially ends. Social Security found you disabled at Step 2. At Step 4, Social Security found either 1) your other medical impairment disabling “by itself,” or in other words, your drug use and alcohol abuse is not the cause of your disability – your case will be awarded; or 2) you were only disabled due to the combination of your impairment and drug use or alcohol abuse, and hence, your use is material – your case will be denied. Despite resolving the issue of drug use and alcohol abuse at Step 4, Social Security found reason to add two more Steps.

Step 5 – Does Your Drug Or Alcohol Use Affect Your Other Medical Conditions?

No. Your drug and alcohol use is not material. Your case will be allowed.

Yes. Go to issue 6.

Step 6 – Would Your Other Medical Conditions Improve So That You Are Not Disabled If You Stopped Using?

No. Your drug and alcohol use is not material. Your case will be allowed.

Yes. Your drug and alcohol use is material. Your case will be denied.

Drug & Alcohol Use And Credibility

Most claimants are concerned about Social Security learning about their drug use or alcohol abuse. Of course, it is the government. And, if you attend a hearing, there is a judge there. Will Social Security call the police? Will someone show up at my house? Will they take my kids? Will they search my person? My car? Will I get in trouble? These are all legitimate concerns. And many claimants want to therefore deny or minimize their drug and alcohol use. However, the answers to all the above questions are no. Social Security will not do any of those things.

Most claimants are also concerned that Social Security will find their drug use and alcohol abuse material and deny benefits. Again, denials and minimizing seem like the right choice. And yes, your benefits can be denied if your use is material. But, as stated above, it usually is not material. If you have engaged in drug use or alcohol abuse, you really need a lawyer/representative, and their thorough evaluation can address your concerns of materiality.

Your drug use or alcohol abuse is usually noted by your medical providers in your medical file. Social Security will read your file. Social Security will usually already know about your use before it talks to you.

So, most of the time, if you deny or minimize your drug use or alcohol abuse, you will usually get caught in the lie, and your credibility will be shot as Social Security will have a difficult time believing anything else you say. On the contrary, if you use, and you admit it, Social Security will find you more credible. The theory goes that if you are honest about drug and alcohol use, the one thing many people want to lie about, then you are probably honest about everything else – most importantly, your functional limitations that disabled you.

Will Social Security Report Me To The Police Or CPS If I Admit Drug & Alcohol Use?

No. Social Security will not report you to any authority for your drug use or alcohol abuse. This may seem counter-intuitive. Social Security is the government; the prosecutor’s office, the police, and CPS are the government. So why doesn’t Social Security just pick up the phone and make the call? Well, it doesn’t. Social Security’s primary goal in a disability case is to determine if you are disabled, not spearheading a drug and alcohol-related investigation. It would have great difficulty assessing disability if it reported every claimant to the authorities for drug and alcohol abuse.

Will Social Security Test Me For Drugs & Alcohol?

No. Social Security will never perform drug or alcohol testing on you. Social Security will not send you out for drug testing. Social Security will not ask your doctor to drug test you. Social Security will likely schedule you for a physical or psychological medical evaluation with a consultative examiner (CE), but the CE will never test you for drugs or alcohol.

Will Social Security Make Me Have A Payee If I Tell Them I Use Drugs & Alcohol?

Most likely yes. If you are awarded benefits, but you are using illegal drugs, abusing medications, or drinking too much, you will usually be assigned a payee. If you later become sober or you drink alcohol but drink responsibly, Social Security will not require a payee.