By Scott G. Sanford
Personal Injury Lawyers
Maryland/District of Columbia/Virginia

     Many individuals who apply for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits fall into an unfortunate cycle of drug use.  Sometimes this is an attempt to deal with physical and psychological symptoms.  Other times it is a response to the Claimant’s depressed financial circumstances.  While use of drugs can often detrimentally affect a claim, it is not a bar to the recovery of Social Security Disability Insurance or Supplemental Security Income benefits.

     When evaluating drug use, the administration looks to determine whether the use of prescription or illegal drugs or alcohol is “material” to the Claimant’s disability.  In other words, the administration must consider whether the Claimant’s condition would still be disabling if not for the use of such substances.  As an example, consider an individual who is unable to work because he is paralyzed from the neck down, but also happens to use marijuana.  While the administrative law judges will not look favorably on the drug use, it is clear that it is irrelevant to the question of whether the person is disabled, and therefore should not adversely affect his claim.

     In contrast, consider an individual who is disabled due to psychological factors such as paranoia and hallucinations, but who exacerbates his problems by use of illegal drugs.  If a Judge determines that the psychological impairment is made disabling by the drug use, they will deny benefits.  This situation is likely to occur in claims of psychological disability under the 12.00 listing series in the Social Security Code, and is specifically discussed under listing 12.09.  There are several ways to approach these issues, and seeking the advice of an attorney who regularly appears before the Social Security Administration is essential to provide a chance of success. 

     One reason that an attorney’s advice is essential in these cases is because even a well meaning Claimant may run afoul of the administration’s policy on drug use. SSR 82-60 indicates that “loss of ability to control [the use of drugs or alcohol] identifies the individual as a drug addict or alcoholic diagnostically.”  This classification often becomes significant to those who have severe physical pain and become addicted to narcotic pain medication.  Under SSR 82-60, use of prescription drugs, in and of itself, should not be considered a bar to disability.  Our firm recently handled a successful appeal of this type of claim where the administrative law judge ruled that the drug use was material to the disability. In that case, we were able to overturn the Judge’s decision by showing that while the claimant may have been overusing drugs, she was doing so at her doctor’s instructions and was able to change her use based on her doctor’s advice.  Even if the Claimant was physiologically addicted to her medications, she did not demonstrate the “loss of control” discussed in SSR 82-60.  Even if there is a loss of control, there must still be a separate determination of whether or not the addiction is material to a finding of disability.

     The strategy of any claim involving drug or alcohol use will vary widely depending on the facts of the claim.  If you believe that your claim may be affected by these issues it is often useful to consult with an attorney about how to proceed. Of course, stopping the use of such substances, where possible, is often the best step you can take in helping to strengthen your claim.

 Disability Benefits Available Through the Social Security Administration:

What Social Security Benefit is Right for Me? 

By Scott Sanford

Social Security Disability Lawyers

Maryland/District of Columbia/Virginia

     When individuals finds themselves in the unfortunate position of having an injury that prevents them from working, one of the options that may be available to them is to seek disability benefits from the Social Security Administration.  The Social Security Administration is an agency of the federal government that provides retirement, social security disability, and dependant benefits to the population at large.  Although these benefits are broadly available, many people wrongly assume that Social Security is only a retirement benefit and fail to realize that they may be entitled to social security disability income if they are unable to work. 

     Among the many different benefits available through the Social Security Administration, there are two different types of benefits that are specifically designed to assist individuals who are unable to work.  The first of these is known as Social Security Disability Insurance (SSDI or SSD) Benefits, and the second is known as Supplemental Security Income (SSI).  Because both of these benefits are designed to help individuals who are disabled, they are not typically available to people who have substantial monthly income. When either one of these benefits becomes available to an individual, they become entitled to monthly disability payments from the federal government and medical coverage under the disability system.  In many cases, the disabled person is also entitled to a lump sum that represents the money that the government should have paid them since the time that they had actually become disabled. Depending on an individual’s situation at the time of their disability, they may be eligible for one or both SSD or SSI benefits.

     In most cases, Social Security Disability Insurance, when available, provides a better benefit to an injured person.  The reason that it is often considered the superior benefit is that it has less stringent requirements and usually pays a higher disability award.  SSDI benefits are generally accessible to an individual who has an established history of working.  At its heart, Social Security Disability Insurance is essentially an automatic insurance policy that is paid for by the mandatory deductions that are taken from every “on the books” employee’s salary each pay period.   Unfortunately, like all insurance policies, these benefits are not available indefinitely and will become inaccessible if too much time passes between the date you last work and the date you become disabled.  

     Although there are many complex rules involved in determining how long a person has to claim Social Security Disability Insurance benefits, a good rule of thumb is that a person who has worked regularly will typically have five (5) years to claim disability benefits.  The Social Security Administration refers to the last date that you can claim Social Security Disability Insurance benefits as your “date last insured.”  This is an important date to know and may prove very useful to you and your attorney when making a claim for Social Security benefits.  In cases where an individual has an annual income under $5,000.00, or where they have an uneven work history with many gaps in their employment record, or have not worked for many years, this type of benefit is often more difficult to obtain.  When an individual claims Social Security Disability Insurance benefits within their date last insured, then it is their burden to prove that that or incapable of performing any substantial gainful activity in the national economy in order to receive benefits.  Wealth and assets will not generally affect a person’s claim for Social Security Disability Insurance benefits.  Retaining a competent lawyer who regularly represents claimants before the Social Security Administration can be very helpful to security social security disability benefits. 

     Supplemental Security Income is similar to Social Security Disability Insurance, with the notable exception that it is designed as a hybrid between welfare and disability coverage.  I often advise my clients that Supplemental Security Income should be viewed more as a safety net than an alternate disability coverage.  The reason for this is that SSI benefits are typically not as high as SSDI benefits, and are only available to people who do not have any substantial assets or sources of income.  If a person has assets worth more than $2,000.00 or lives with a spouse who receives regular income, then they may be eligible for SSI.  Since these situations are often complex, they frequently require case by case review by a qualified attorney who regularly handles SSD and SSI cases.  However, the benefit to Supplement Security Income is that once these stringent income requirements are met, the person’s date last insured becomes irrelevant.  Since Supplemental Security Income is partially a welfare based system, it can be claimed at any time, regardless of whether a person has any established work history.  

     Choice of Social Security benefits and eligibility for Social Security benefits are crucial issues that millions of Americans must consider each year.  If you or a loved one becomes disabled and believe that you may be entitled to these benefits, we highly recommend that you speak to your local social security office or contact a qualified attorney to assist you making the right decisions.