Alcoholism and Disability Benefits in Pennsylvania
Most people know that the Social Security Administration (SSA) offers monthly disability benefits to qualified applicants who struggle with a long-term injury or illness. What’s less understood is how the SSA treats claims involving chronic alcohol abuse.
No one disputes the fact that alcoholism can cause or contribute to debilitating medical problems. However, the SSA does not treat alcoholism claims the same way that “standard” claims are treated. In this article, our disability lawyers will explain how the SSA’s medical examiners evaluate claims related to alcohol addiction. We’ll go over some of the obstacles and special considerations applicants should think about when filing a disability claim, including the “material” standard and related qualifying conditions.
Do you need help with how to file for benefits in New Jersey or Pennsylvania? Do you want to appeal a denial from the SSA? If so, the legal team at Young, Marr & Associates can help. To set up a free and confidential case evaluation, call our law offices at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania today.
SSA Eligibility Requirements for Disability Benefits
Before we start exploring the relationship between social security benefits and alcohol dependence, it’s important to cover the general eligibility criteria which apply to everyone, regardless of medical condition. In order to qualify for SSI (Supplemental Security Income) or SSDI, you must meet the following criteria (with a few rare exceptions, such as applicants with advanced terminal illness):
- You must be severely disabled. If your condition is easy to treat or control, and doesn’t interfere with employment, you will not be considered disabled by the SSA.
- Your condition must be long-term. Your disability must either have lasted or be expected to last for at least one year, or to end in death.
- If you are working, you must not be earning more than the income cut-offs for SSI and SSDI. The 2015 SSDI income limit is $1,090. The 2015 SSI limit is lower, but not all of your income is actually counted toward that limit.
Can You Get Disability Benefits with Alcoholism?
The short answer to this question is that it depends on the claimant. Whether a claim involving alcohol abuse is denied or approved ultimately depends on how the claimant’s alcoholism factors into the disability being cited.
When SSA medical examiners review disability claims involving alcohol or drug addiction, they essentially want to determine whether the disability would still exist if the underlying substance abuse problem went away. If the disability would ease or disappear without the addiction, the addiction is considered “material” to the claim, and the claim will be denied. If the disability would persist even without the addiction, the addiction is not considered “material,” and the claim may be approved.
Alcohol-Related Medical Conditions That Qualify for Disability Benefits
While alcoholism is not grounds for an approval in and of itself, the effects of alcoholism can lead to an approval. But how are these effects assessed?
The SSA uses a document called the Listing of Impairments, sometimes referred to as “the Blue Book,” to help guide its determinations. The Listing is effectively a large catalog of different medical problems, all of which have condition-specific severity standards. If a claimant matches or equals the Listing’s standards for his or her medical issue, he or she could be considered severely disabled, and could therefore be granted a monthly disability award. In short, it is not enough to simply have a condition — that condition must also meet certain requirements in order to be deemed truly disabling by the SSA.
With that in mind, let’s review some of the conditions which could apply to claimants with alcohol addictions.
Multiple studies have found links between alcoholism and clinical depression. You may be eligible for SSI or SSDI if you are able to meet or equal the standards noted under Section 12.04 of the Listing. A claimant may be able to qualify for disability with depression if he or she exhibits effects such as feelings of worthlessness or guilt, persistent insomnia, and difficulties with socializing or other daily tasks.
Excessive alcohol consumption can cause the liver to become inflamed, in some cases leading to permanent scarring and irreversible cirrhosis. The effects of cirrhosis, which include edema, confusion, easy bruising, and lack of appetite, can continue to ravage the body even after the individual stops drinking. The only known cure for severe cirrhosis is receiving a liver transplant, a qualifying condition under Section 5.09.
Even if you haven’t had a transplant, you could still qualify under Section 5.05 (Chronic Liver Disease) if you exhibit one of the following:
- Hemorrhaging (as proven by x-rays or other medical imaging).
- Ascites, which occurs when fluid accumulates in the space between your abdominal organs and the abdomen itself.
- Spontaneous bacterial peritonitis (SBP), an infection of the ascitic fluid (see ascites above).
- Hepatorenal syndrome, or progressive kidney failure. Kidney failure is also covered by Section 6.00 (Genitourinary Disorders).
- Hepatopulmonary syndrome, which causes breathing problems.
- Hepatic encephalopathy, which describes impaired brain function caused by liver failure.
- End stage liver disease.
Other alcohol-related conditions which may help you qualify include peripheral neuropathies or nerve damage (Section 11.14) or gastrointestinal bleeding (Section 5.02).
Our Pennsylvania Social Security Disability Attorneys Can Help You
If you or someone you love is struggling with alcohol addiction, you may be eligible for monthly SSI or SSDI benefits — even if you’ve already been denied. To set up a free and private consultation, call Young, Marr & Associates at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania.
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