People seeking Social Security Disability benefits must meet stringent medical criteria. Given this requirement, many people may believe complicating medical issues, such as drug addiction, preclude a person from receiving benefits. As any Illinois SSD attorney knows, substance abuse or reliance can complicate an SSD claim. However, drug use does not automatically prevent a person from receiving benefits.
Basic eligibility guidelines
To qualify for benefits, a person must first meet non-medical criteria. The person cannot engage in work with monthly income greater than $1,090. The person also must have enough of an earnings record to qualify as “insured.” If these requirements are satisfied, the person must additionally meet medical criteria. The person must suffer from a medical condition that prevents gainful work. This condition must be expected to last at least one year.
As any Illinois SSD attorney can explain, drug use is not considered a disabling medical condition. However, the Social Security Administration recognizes numerous substance addiction disorders. These include depression, anxiety, liver damage and pancreatitis. Someone who suffers from one of these conditions or a condition unrelated to the addiction may qualify for benefits. First, though, the SSA must determine that the drug use is not a “material factor.”
Effects of addiction
To make this determination, the SSA evaluates how the drug addiction interacts with the disabling condition. If the condition would not be disabling without the drug use, the addiction is a material factor. Similarly, drug use may be material if it exacerbates the medical condition. If the SSA determines that the condition would improve in the absence of drug use, benefits aren’t awarded.
Sometimes, though, a person may receive benefits despite drug addiction. Drug use does not affect eligibility in the following situations:
- The addiction is not a material factor. If a condition is disabling regardless of drug use, a person may receive benefits.
- Previous drug use contributed to the medical condition. The SSA can only consider the way ongoing drug use affects the disability.
- Drug use indirectly caused the condition. For instance, a person could become disabled after suffering an accident while under the influence. The circumstances do not prevent the person from receiving benefits.
Unfortunately, as any Illinois SSD attorney knows, determining whether drug use is a material factor is not always simple. For example, drug use and mental illness are often correlated. People with mental illnesses may use drugs to self-medicate. In turn, drug use can worsen existing mental health conditions. Establishing that a mental illness is independently disabling may prove challenging.
Other cases involving less readily visible or obvious disabilities may present similar issues. This makes preparing a strong, well-documented claim essential for anyone seeking benefits while living with a drug addiction.