Filing a Claim for Substance Abuse Disability Benefits
Substance abuse disorder can be severely disabling, affecting your daily life in serious ways. But many aren't aware that addiction can be a disease, and that if you are unable to perform the basic duties of your job because of it, you may be eligible for long-term disability benefits.
Substance Abuse vs. Addiction vs. Illegal Drug Use
A person who struggles with drug and/or alcohol addiction doesn’t become an addict overnight. Addiction may begin with a back injury or auto accident for which you were prescribed legal pain medication. The pain medication may consist of strong opioids — especially for injuries involving nerve damage, spinal injuries, or severe fractures. And in many cases, doctors may over-prescribe these medications instead of treating the injury with surgery.
So let's say your doctor prescribed two pills of oxycodone daily to treat your back pain after a car accident. You find that over time, the recommended dose is not enough and no longer having the desired effect, leading you to increase the dosage as your tolerance increased. So you start taking dosages closer together or taking it in a manner other than prescribed, such as crushing and snorting it, for increased effects. This could quickly lead to addiction and other illegal drug usage, such as heroin or cocaine.
What Is Substance Abuse Disorder?
According to the DSM-5, criteria must be met over a 12 month period, including:
- Repeated substance use
- Failure to carry out major responsibilities at work, school, or home
- Interpersonal problems due to ongoing substance use
- Higher amounts of substance use in order to achieve the same, previous effect
- Continued usage of drugs or alcohol despite the user’s knowledge of the harmful effects
For example, may have been struggling with drug and alcohol abuse over a long period of time. You may have been in and out of continuous treatment programs, as well as consistently seeing a psychiatrist and an AODA counselor. It may become clear to your psychiatrist or counselor that your drug or alcohol abuse affects your ability to maintain steady employment, since you've had to change jobs numerous times. They may also find that you are prone to other mental disorders, since substance abuse disorder often runs deeper than a simple dependence on drugs or alcohol.
In this case, your psychiatrist or counselor may recommend that you file a claim for substance abuse disability benefits.
Can You Receive LTD Benefits for Substance Abuse Disorder?
Some disability insurance policies do not provide coverage for substance abuse, or severely limit the benefits for addiction disorders. However, because drug and alcohol abuse often develops secondary to a physical or mental disability, you may still be able to obtain benefits.
When it comes to filing for substance abuse disability benefits, however, many insurance companies will deny claims. Their goal is to mitigate their responsibility for making long-term disability payments to those who suffer from addiction. They fail to acknowledge that drug and alcohol abuse is a mental disease that can only be managed, not cured.
Your long-term disability insurance company may also wrongfully deny your claim for a qualifying disability if you have struggled in the past with substance abuse disorder. They may try to attribute your disability to a pre-existing condition, leading to a denial of benefits. And sometimes, disability carriers will try to categories substance abuse related conditions as "self-inflicted."
How Can a Disability Lawyer Help?
Obtaining substance abuse disability benefits can be extremely difficult, especially if you try to tackle your claim on your own. An experienced disability lawyer can help you examine your case to determine the strength of your LTD claim. They can also make sure that you obtain the necessary medical records that establish the level of restrictions the disorder places on you.
And if your LTD claim for substance abuse is denied, your attorney can help you file an appeal.
Learn More About Filing or Appealing a Claim for Substance Abuse Disorder
While it's not impossible to win long-term disability benefits for substance abuse or addition, it is definitely an uphill battle. At CJ Henry Law Firm PLLC, we are dedicated to helping claimants fight bad-faith denials or termination of benefits. For more information about how we can help you with your LTD claim, contact us today.