Substance abuse can be grounds for disability benefits, but the eligibility for such benefits will depend on the specific circumstances and the rules of the disability program in question.
In general, for a person to be eligible for disability benefits due to substance abuse, their substance abuse must be so severe that it makes them unable to work. The disability must be expected to last for a year or more or result in death.
In most cases, disability benefits are not provided for substance abuse alone but rather for the resulting health condition that causes disability. For example, chronic alcoholism can cause conditions such as liver disease, pancreatitis, and peripheral neuropathy which can make a person disabled and unable to work, then they can be eligible to claim disability benefits.
Most people wouldn’t think that substance abuse problems would lead to disabilities. However, a new study highlights the issue and reports that some substance abuse issues can actually lead to disabilities that may warrant Social Security Disability (SSD) and Medicaid / Medicare benefits. Here’s a look at both:
Many substance addiction disorders may indeed qualify for SSD, Medicaid, and Medicare benefits. According to a study published in Addiction Treatment Magazine, many substance abusers eventually suffer from some type of permanent damage that may entitle them to benefits. The Social Security Administration (SSA) defines “substance addiction disorders” as:
“…behavioral or physical changes associated with the regular use of substances that affect a person’s central nervous system (CNS). These types of issues include organic mental disorders, depressive syndrome, anxiety disorders, personality disorders, peripheral neuropathies, liver damage, gastritis, pancreatitis and seizures.”
The SSA cannot refuse to pay benefits to someone with a substance addiction disorder if they are actively abusing drugs or alcohol – as long as the qualifying condition will remain. In order to determine this, a drug and alcohol addiction (DAA) evaluation is conducted to gauge the permanency of the disability.
However, it is often difficult to identify the severity of depression and anxiety, especially if they can be treated with drugs or therapy and the abuser gets sober. However, anyone who is actively using drugs or alcohol, but qualifies for benefits, cannot receive those benefits directly. A third-party “representative payee” will be designated to manage the benefits.
Substance abusers can also be eligible for Medicaid or Medicare benefits if they have suffered a permanent disability as a result of drug or alcohol abuse. Those who are approved for needs-based SSI disability benefits will automatically be eligible to receive Medicaid. Those who are approved for work-based SSD benefits may be eligible for Medicare benefits after two years.
Additionally, some countries and state-funded programs may require that the individual seeking disability benefits for substance abuse demonstrate that they are receiving treatment for their addiction and are making a good-faith effort to overcome their addiction before they will be considered for benefits.
It’s important to note that the specific rules and requirements for receiving disability benefits due to substance abuse can vary depending on the country or program, so it’s recommended to check with the relevant authorities for more information and guidance.
There are two types of Social Security Disability benefits available – SSI (Social Security Income) and SSDI (Social Security Disability Income). While each has different basic eligibility requirements, both have the same definition of disabled. To be considered disabled, your condition must have lasted 12 months, be expected to last 12 more months, or must be a condition that will result in death. Your disability must prevent you from working and earning a living and must have a severe impact on your life.
Unfortunately, the SSA has started to crack down on those seeking SSD benefits after discovering that many applicants obtained benefits through fraudulent means. Although some say the government’s approach has been overly aggressive, the bottom line is that those who need SSD benefits may have to jump through more hoops to obtain them.
Having an experienced Social Security Disability Attorney on your side can make that process easier because they understand how the process works, the qualifying standards needed for the application, how the SSA narrowly defines the definition of a “disability,” what triggers the SSA to reject benefits and, most importantly, how to appeal. It’s the latter issue that’s the most important, as more than half of all SSD benefits are denied.