Comments Solicited by SSA on Substance Abuse as a Disability

Charles Hall’s excellent blog today posts a note about a request for comments on drug and alcohol addiction as a disability. SSA’s attitudes have veered back and forth on this over the years. In the early 90’s it was a disability, with the hope that people would get treatment if they got benefits. Though treatment was required it was not widely avaialble, so in the mid 90’s that avenue to disability was slammed closed, though sometimes people had mental illness which ould otherwise qualify them.

SO now: from a Request for Comments to be published in the Federal Register tomorrow:

We are requesting your comments about our operating procedures for determining disability for persons whose drug addiction or alcoholism (DAA) may be a contributing factor material to our determination of disability. …

To provide guidance on how we interpret the DAA provisions of the Act, we issued instructions to our employees in an Emergency Message on August 30, 1996.

We are asking for your comments on the procedures we follow when evaluating DAA. In particular, we would like your opinion about what, if any, changes you think we should make to our instructions. For example, do you have any suggestions about:

What evidence we should consider to be medical evidence of DAA?
How we should evalua te claims of people who have a combination of DAA and at least one other physical impairment?
How we should evaluate the claims of people who have a combination of DAA and at least one other mental impairment?
Whether we should include using cigarettes and other tobacco products in our instructions?
How long a period of abstinence or nonuse we should consider to determine whether DAA is material to our determination of disability?
Whether there is any special guidance we can provide for people with DAA who are homeless?
Social Security’s position has been that if it is impossible to separate the effects of DAA from the effects of other psychiatric illness that the combined effect of both may be considered disabling. This situation is frequently present in individuals suffering from bipolar disorder, a psychiatric illness which has a high degree of association with DAA. A change in this policy would be of considerable importance.

Here are the links: Drug Addiction and Alcoholism; Request for Comments ,
4900 [2010-1834]

Charles says: The talk of whether a period of abstinence should be required before a person could be found disabled is worrisome. The statute does not forbid disability payments to alcoholics and drug addicts. It merely prohibits consideration of alcoholism and drug addiction in determining disability. A person may have a raging substance abuse disorder but be found disabled due to other health problems. This has always bothered some people. They find drug abuse and alcoholism so loathsome that they believe that no one alcoholics or drug addicts should be on Social Security disability benefits even though the statute says otherwise. One interpretation of this notice is that Social Security has a desire to move towards forbidding benefits to anyone with a substance abuse problem.

Our experience is the same as that of Charles. The main thing we look for is whether, absent addiction, the person would still be disabled. In other words, getting clean and sober doesn’t cure AIDS. But it might go a long way toward aleviating depression.