Is Alcohol Abuse A Disability?
The commissioner erred as a matter of law in determining that alcohol abuse was a material factor in causing Plaintiff’s disability.
An individual shall not be considered disabled if alcoholism or drug addiction would be a contributing factor material to the Commissioner’s determination that the individual is disabled.42 U.S.C. § 423(d)(2)(C). The 9th circuit has determined that the “key factor in determining whether drug addiction or alcohol abuse is a contributing factor material to the determination of disability is whether an individual would still be found disabled if [he] stopped using alcohol or drugs.” Sousa v. Callahan, 143 F.3d 1240, 1245 (9th Cir.1998) ;see also 20 C.F.R. § 404.1535(b)(1) (same). The test therefore as to whether alcohol is a material factor is the following:
“In making this determination, [the Commissioner] will evaluate which of [the Plaintiff’s] current physical and mental limitations … would remain if [the Plaintiff] stopped using drugs or alcohol and then determine whether any or all of [the Plaintiff’s] remaining limitations would be disabling.” 20 C.F.R. § 404.1535(b)(2).
SSR 82-60 is the Social Security Administration (SSA) policy used to evaluate disability where drug addiction or alcoholism is present. It cautions the ALJ, on the other hand, that a diagnosis of drug addiction or alcoholism should not have an effect on a disability evaluation:
Drug addiction and alcoholism are diagnostic terms; they do not denote impairment value or severity. It is necessary to evaluate the severity of the impairment which may be associated with, manifested by, result from, or coexist with these diagnoses. Ultimately, the decision will depend upon the severity of the impairment, as properly documented by the required medical findings, as properly documented.
As in all disability cases, the impairment must be assessed in view of the individual’s total medical condition and its effect on his or her ability to function.
In making this decision the key issue is whether the individual would continue to meet the definition of disability even if drug and/or alcohol use were to stop.
If he or she would still meet the definition, drug addiction or alcoholism is not material to the finding of disability. Stated otherwise, the trier of facts must establish that the severe impairments noted by Plaintiff’s treating physician would no longer be found disabling if the individual’s drug addiction or alcoholism were eliminated, as, for example, through rehabilitation treatment.
“The drug addiction and alcoholism requirements are imposed only (emphasis added) where (1) the individual’s impairment(s) is found disabling and drug addiction and/or alcoholism is a contributing factor material to the determination of disability, and (2) the same impairment(s) would no longer be found disabling if the individual’s drug addiction or alcoholism were eliminated, as, for example, through rehabilitation treatment.”
In Bustamante v. Massanari, 262 F.3d 949 (9th Cir. 2001), (Exhibit CL-1), the 9th Circuit has determined that before considering how a plaintiff’s alcoholism affects his condition, an ALJ must first follow the five step sequential evaluation process without separating the impact of drug addiction or alcoholism and find that the plaintiff is disabled (20 CFR Secs. 404.1535 and 416.935). Only after the ALJ finds that the plaintiff is disabled should he then determine whether alcoholism is a contributing factor to the finding of disability. Here the ALJ, by not separating the impact of alcohol on Plaintiff’s disability, correctly found him disabled:
“specifically his repeated abuse of alcohol is resulting in the following limitations: moderate restrictions in daily living activities, moderate difficulties in maintaining social functioning, and moderate difficulties in maintaining concentration, persistence of pace and repeated episodes of decompensation” (Exhibit 9F)
If the ALJ finds that the Plaintiff is disabled and there is “medical evidence of [his or his] drug addiction or alcoholism,” then the ALJ should proceed under§§ 404.1535 or 416.935to determine if the Plaintiff “would still [be found] disabled if [he or she] stopped using alcohol or drugs.” 20 C.F.R. §§ 404.1535, 416.935. In Bustamante v. Massanari
, 262 F.3d 949 (9th Cir. 2001), the Court reversed the ALJ decision, because he failed to evaluate whether Plaintiff would still be disabled if he stopped using alcohol.
If, and only if, the ALJ found that Bustamante was disabled under the five-step inquiry, should the ALJ have evaluated whether Bustamante would still be disabled if he stopped using alcohol. Bustamante v. Massanari
, 262 F.3d 949 (9th Cir. 2001).
In Hoffman v. Halter, 140 F.Supp.2d 1056 (C.D.Cal. 2001), (Exhibit CL-3), the plaintiff’s benefits were terminated when the ALJ determined that the plaintiff would not be disabled if he stopped using alcohol. This determination was not supported by substantial evidence, because the ALJ ignored the plaintiff’s mental condition. The court held that the mental impairments are not necessarily a result of the plaintiff’s alcohol dependency. “Just because substance abuse contributes to a disability does not mean that when the substance abuse ends, the disability will, too.”
“In arriving at this [non-disability] conclusion, the court failed to distinguish between substance abuse contributing to the disability and the disability remaining after the Plaintiff stopped using drugs or alcohol. The two are not mutually exclusive. Just because substance abuse contributes to a disability does not mean that when the substance abuse ends, the disability will, too.”
The ALJ has already accepted Plaintiff’s disability but erroneously ascribed it to alcohol abuse. The evidence on the record, however, does not support that conclusion. The ALJ conclusion that abuse of alcohol is a contributing factor material to the determination that Plaintiff is disabled, thereby making him non entitled and ineligible to receive disability benefit, is pure speculation and must be denied as a matter of law.