The Possible Effect of Drug or Alcohol Abuse on a Disability Claim

Whenever a claim for Social Security Benefits under Title II or Title XVI is being evaluated, the Administrative Law Judge must be aware of possible “DAA” materiality on the claim. DAA stands for drug and alcohol abuse. Prior to 1996, a claimant could receive benefits based upon “DAA” (Drug Addiction or Alcoholism) with the conditions that benefits would be paid to a “representative payee” who would manage the funds, that the claimant enter a mandatory treatment program, and that their benefits would be limited to threes.


In 1996, however, Congress enacted the “Contract with America Advancement Act of 1996”, Public Law 104-121. Section 105 provides that "an individual shall not be considered to be disabled ... if alcoholism or drug addiction would ... be a contributing factor material to the Commissioner's determination that the individual is disabled."


The Social Security Administration has acknowledged that there are no exact criteria for when drug addiction and alcoholism are present. However, some courts have concluded that an actual diagnosis of a substance abuse disorder is not required, only that there is some evidence to support a finding of DAA.


The key factor Judges look to in determining whether drug addiction or alcoholism is a contributing factor material to the disability is whether the claimant would still be disabled if he or she stopped using drugs or alcohol. In making that determination, the Judge evaluates whether the claimant’s current physical or mental impairments would remain if the claimant stopped using drugs or alcohol and whether any of the remaining conditions would be disabling. If the impairments would still remain and would be disabling, then the DAA is not a contributing factor.


In order to be a contributing factor to the disability, however, the claimant must be currently abusing drugs or alcohol. The law does not apply to claimants who have stopped using drugs or alcohol. The Social Security Administration considers a one-month period of abstinence to be a sufficient period of time to observe whether the absence of drugs or alcohol has affected the claimant’s condition.


Credibility is always of major importance in disability cases, but it is especially important when a claimant states that the disability is independent of the drug or alcohol abuse. Judges often give great weight to the opinions of the claimant’s treating physicians in their determinations. Thus it is very important for claimants to be truthful about their drug or alcohol abuse. If a doctor feels that their patient is not being truthful, that opinion may appear in their treatment notes. And Judges will review those notes before the hearing. If a Judge suspects that the claimant has not been truthful in the past, the chances of being awarded disability benefits will be severely damaged.

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Social Security Administration Improvements: 2010 Update

Michelle Nevarez, Esq.


The Obama Administration has committed to helping our fellow Americans in need by allocating more of the Nation’s budget to the preservation and improvement of the Social Security disability insurance approval process. In response to increased application in addition to existing backlog of claims, SSA has committed to increasing their processing capacities in a number of ways.


Extended Service Team(EST) are new centralized units that tasked to assist in with hearing backlog in flood areas that experienced increased applications. The purpose of these teams is explained by SSA Commisioner Astrue, “These centralized units have reduced the hearings backlog and improved processing times at some of the hardest-hit hearing offices....”

In FY 2010, SSA plans to place 280 new employees in four States (Virginia, Arkansas, Oklahoma , and Mississippi ) to help staff the teams that will be able to quickly take cases from the hardest hit States.
DDS Federal Units in each of the ten regions are tasked with assisting the DDSs in processing cases. In FY 2010, we plan to provide 237 additional hires in these units. The increases at the DDA level also include more medical consultants in order to prevent expensive and much dreaded consultative examination.

Virtual Screening Units have been erected with senior attorneys tasked to review the disability hearing backlog for potential awards.SSA believes that the screening methodology and the electronic folder to move work to the members of the virtual unit will identify about 14,600 on-the-record, fully favorable awards this year without a hearing.

SSA eligibility and processing requirements are in constant flux, for this reason you should take a moment to update yourself on the changes in 2010 eligibility requirements.

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Does My Family Receive Any SSDI Benefits?

Once you are approved for SSDI benefits, certain members of your family may also be entitled to payments. SSDI benefits, based on your earnings record, may be available for your spouse, your former spouse, and your children.

Your spouse may be eligible for payments upon your award of SSDI benefits, if the spouse is (i) caring for your child, or (ii) age 62 or older. To receive benefits for caring for your child, the child must either be under age 16, or disabled and receiving Social Security benefits. Benefits for a spouse caring for your child under age 16 will end once that child reaches age 16. Similarly, when your spouse reaches age 62, he/she will be eligible for benefits based on your earnings record. However, the monthly amount your spouse will receive at age 62 will be less than if he/she waits until full retirement age to receive the benefit. If your spouse is eligible for SSDI benefits based on his/her own earnings record, your spouse will receive either that amount or the amount based on your record, whichever is higher.

A spouse you have divorced will be eligible for SSDI benefits based on your earnings if he/she is (i) at least 62 years old; (ii) unmarried; (iii) was married to you for at least 10 years; and (iv) is not eligible for a higher benefit amount on his/her own.

Finally, your child will be eligible for SSDI benefits if the child is unmarried and (i) under age 18; or (ii) 18 or 19 and a full-time elementary or high school student; or (iii) 18 or older wtih a disability that began before age 22. For the child under age 18, the benefit will stop when he/she reaches age 18. For the full-time student, the benefit ends upon graduation or 2 months after the child's 19th birthday, whichever comes first. For the disabled child, the benefit will last for the duration of the disability. An eligible child may be biological, a step-child, adoptee, or dependent grandchild.

As far as the amount of SSDI benefits your family members are entitled to, each may receive up to half of your benefit amount, but there is a limit on the amount SSA will pay family members in total. The limit depends on your benefit amount and the number of family members who qualify based on your record, but the total is generally around 50 to 80 percent of your benefit amount.


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