Dual Diagnosis & Substance Abuse: Part 3 of Common & Dangerous Social Security Disability Myths

I have over the years handled many so-called “Dual Diagnosis” social security disability cases.

“Dual Diagnosis” means the person is considered to be suffering from both a substance abuse problem and a mental illness.  I often hear claimants say that they “self-medicate” with alcohol/drugs, and often feel that, because substance abuse is part of the “dual diagnosis”, that should not affect the chances of winning the social security disability case.

This is a big myth.  Drug and alcohol abuse will greatly diminish the chances of winning the social security disability case for the following reasons:

1. By law social security disability benefits cannot be paid if a claimant is disabled because of drug or alcohol abuse.  More precisely, the standard is this: if the claimant would not be disabled if the drug and alcohol abuse ceased, then social security disability benefits cannot be paid.  Obviously this is a matter of conjecture: no one really knows if a disabled claimant that is abusing drugs and alcohol would continue to be disabled if they got clean.  The presence of drug and alcohol abuse in the medical records will mean that any medical expert testifying at the social security disability hearing will be asked their opinion on this issue.  They often testify that drug and alcohol abuse is the reason the claimant is disabled, and Administrative Law Judges are often times willing to accept such an opinion from the medical expert without reservation.
2. Medical experts often testify that any current drug and alcohol abuse is “diluting” the psychotrophic medications the claimant is taking, so that, in their eyes, the drugs and alcohol are rendering the medications ineffective.  In other words, without the drug and alcohol abuse the claimant would not be disabled.
3. There is a nature inclination on the part of most ALJs to not pay social security disability benefit to someone who is abusing drugs and alcohol.

So, does this mean that any past or present drug and alcohol abuse will ruin a mental illness-based social security disability claim?  Absolutely not.  It means this:

If you have a history of drugs and alcohol along with your mental problem you need to stop abusing drugs and/or alcohol.  If you are having trouble stopping you need to trying to get clean.  That does NOT mean trying on your own.  Its means being in treatment, whether it be in-patient, out-patient, or a regular and faithful AA or NA member.  Administrative Law Judges are not looking for perfect compliance.  They are looking for complete honesty, and evidence you are trying hard to stay sober.

Read the next post in this important series on  Common & Dangerous Myths about social security disability.