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woman searching online for social security disability benefits for drug addiction complications

Does Drug Addiction Qualify for Social Security Disability Benefits?

Last Updated on

If you have struggled with drug addiction and it has led to complications, you may be eligible to qualify for disability benefits. Your addiction alone does not qualify you for benefits, but the complications that result from that addiction do.

What Programs are Available

The Social Security Administration (SSA) oversees two disability programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). To be approved for either form of disability benefits, you must prove that you meet the criteria set forth by the SSA to be declared legally and permanently disabled. The SSA will not grant disability benefits based on an addiction. You want the SSA to deem your drug addiction as immaterial to your disability claim so you can be approved for benefits. However, your drug usage could have led to another medical condition that warrants disability benefits. For example, drug addiction could lead to heart disease or HIV. Either of those medical conditions can be approved for disability benefits.

Disability Approval for Heart Disease

The Blue Book, which is the medical guide used by the SSA to determine whether an individual is approved for disability benefits, has a listing for heart disease. Heart disease can be very serious in nature. Coronary heart disease, which is sometimes called coronary artery disease, results from the buildup of fatty deposits in the coronary arteries. In turn, the arteries that supply oxygen and blood to the heart muscle experiencing hardening and narrowing. Thus, blood flow is reduced or stopped when in route to the heart and a heart attack can result. To meet the medical criteria for disability benefits, you must meet the requirements of Listing 4.04 of the Blue Book. This states that you must suffer symptoms because of “myocardial ischemia,” which could be:

  • Anginal equivalent, which are shortness of breath on exertion without chest discomfort or pain.
  • Atypical angina, which is discomfort or pain other than in the chest, such as in the back, upper abdomen, inner left arm, neck, or jaw.
  • Variant angina, which are episodes of angina while at rest caused by a coronary artery spasm.
  • Angina pectoris, a form of chest discomfort relieved by rest and caused by motion or activity.
  • Silent ischemia, which is myocardial infarction or myocardial ischemia without additional symptoms or pain.

To determine if you are disabled, you must have an abnormal stress test, which is an exercise tolerance test at a workload of 5 METS or less and revealing at least one of four listed abnormalities; or, have abnormal imaging results that reveals 50% to 70% narrowing of a coronary artery that has not been bypassed; or, documentation supporting evidence of three ischemic episodes within a 12-month timeframe that require angioplasty or bypass surgery or be too severe to benefit from a procedure.

Here’s a little more information on how to apply for disability benefits for heart failure.

Meeting Medical Requirements for HIV

If you have a drug addiction that involves the use of needles, you could acquire HIV. While there are treatments available to help manage the complications and symptoms caused by HIV, working is impossible for those with advanced symptoms or for those who have seen their condition advance to AIDS. HIV is a viral infection that compromises the immune system. For medical approval, you would need to meet the criteria in listing 14.07 of the Blue Book under Immune System Disorders. One of the following must be true regarding your HIV diagnosis in order to qualify for benefits:

  • You have developed advanced or terminal cancer.
  • You are suffering HIV-wasting syndrome, which is severe weight loss.
  • You needed IV fluids and nutrition supplied by tube for a month or longer because of uncontrolled, persistent diarrhea.
  • Brain swelling or fluid on the brain causing a disruption of thinking and the ability to function or move.
  • Infections that require IV therapy, hospitalization, or that are treatment resistant.
  • You experience persistent or frequent fungal, bacterial, parasitic, or viral infections.

Applying for Disability Benefits

If you are ready to apply for Social Security Disability, you can start the application online.  You can also apply by calling 1-800-772-1213, or by visiting your local SSA office. Documentation is the key to a successful claim, so make sure you have thorough medical records to support your claim.

Helpful Links

The SSA Blue Book: https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm

Ischemic Heart Disease Blue Book Listing: https://www.ssa.gov/disability/professionals/bluebook/4.00-Cardiovascular-Adult.htm – 4_04

How to Apply for Disability Benefits for Heart Failure: https://www.disabilitybenefitscenter.org/how-to/apply-with-congestive-heart-failure

HIV Blue Book Listing: https://www.ssa.gov/disability/professionals/bluebook/14.00-Immune-Adult.htm – 14_07

Local SSA Office: https://www.disabilitybenefitscenter.org/state-social-security-disability

Social Security Disability Online Application: https://secure.ssa.gov/iClaim/dib

  • Disability Benefits Center (www.disabilitybenefitscenter.org) is an independent resource dedicated to helping people across the country receive the disability benefits they need. For more information, feel free to reach out to our team at [email protected]

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