Drug Addiction & Alcoholism: The 6th Step of the Sequential Evaluation Process

 Posted on May 31, 2011 in Social Security Disability

In order to be adjudicated as disabled before a Social Security Administrative Law Judge (ALJ), an attorney or claimants representative must follow and complete what is called the five step Social Security disability evaluation process. The evaluation process asks the individual seeking disability benefits five separate questions: (1) Are you working and are you performing substantial gainful activity; (2) Is your condition severe; (3) Does your condition meet or exceed a listed impairment; (4) Can you do previous work; and (5) What work can you do. If a claimant meets each of the five steps of the evaluation process, then an ALJ will usually find that individual to be disabled. One exception to meeting the five step evaluation process and qualifying for disability is if the finding was materially effected by a drug addiction or alcoholism.

Drug Addiction and Alcoholism (DA&A) is often referred to as the silent "6th step" of the five step Social Security evaluation process for disability benefits. The Social Security Administration's regulation 20 C.F.R. Section 404.1535 governs DA&A and states, "If we find that you are disabled and have medical evidence of your drug addiction or alcoholism, we must determine whether your drug addiction or alcoholism is a contributing factor material to the determination of disability. The key factor we will examine in determining whether drug addiction or alcoholism is a contributing factor material to the determination of disability is whether we would still find you disabled if you stopped using drugs or alcohol." If DA&A was material in the disability determination and you would not be found disabled but for the use of those substances, SSA will not find that you have met the 6th step.

In order to meet the 6th step of the five step evaluation process, SSA must decide whether the individual would still be disabled if the drug or alcohol usage stopped. To make that determination, SSA will evaluate the claimant's current physical or mental limitations and decide which of those limitations would be disabling had the use of drugs and alcohol stopped. If SSA finds that the remaining limitations would not be disabling, then the DA&A is a contributing factor material to the determination of disability. However, if SSA finds that the remaining limitations are disabling, you are then considered disabled independent of the DA&A. Although the five step evaluation process is important to meet for a claimant to receive disability benefits it is equally important to meet the DA&A component of the process, also called the 6th step.