Only make a DAA materiality determination when:

• •

  There is medical evidence in the file from an acceptable medical source that establishes that the claimant has a substance use disorder. (For more information on acceptable medical sources and medical evidence, see DI 22505.003A and DI 25205.005); and

• •

  The adjudicator determines the claimant meets our definition of disability considering all impairments, including DAA.

NOTE: We do not make a determination regarding materiality if a claimant has a history of DAA that is not relevant to the period under consideration.

Apply the sequential evaluation process a second time to determine whether the claimant would continue to meet our definition of disability if they were not using drugs or alcohol.

NOTE: We follow the same rules for evaluating evidence in DAA claims that we use to follow other types of claims. (For additional information on evaluating evidence, see DI 24503.000.)

We find that DAA is material to the determination of disability if the claimant would not meet our definition of disability if they were not using drugs or alcohol. If DAA is material, we find that the claimant is not disabled.

Scenarios when DAA is material

DAA is material in the following situations:

1. a. 

   The claimant’s only severe impairment is a substance use disorder.

2. b. 

   The claimant's other impairment(s) is not severe by itself. Examples are osteoarthritis of the hip with minimal changes on imaging and an allegation of an anxiety disorder that is not severe.

3. c. 

   The claimant’s other impairment(s) may be severe but is not disabling by itself. For example, the claimant may have a back impairment that does not meet or medically equal a listing and does not prevent the claimant from performing past relevant work.

We find that DAA is not material to the disability determination if the claimant would still meet our definition of disability if they was not using drugs or alcohol. If DAA is not material, we find that the claimant is disabled.

Scenarios when DAA is not material

DAA is not material when the claimant has a disabling impairment independent of DAA. The following list provides examples of other disabling impairments that the claimant may have that could be disabling on its own:

1. a. 

   a degenerative neurological disease;

2. b. 

   a hereditary neurological disease;

3. c. 

   kidney disease that requires chronic dialysis,

4. d. 

   an intellectual disability;

5. e. 

   a listing-level diagnosis of schizophrenia;

6. f. 

   The claimant acquired a separate disabling impairment(s) while using substance(s). For example, the claimant has:

   • •

     quadriplegia because of an accident while driving under the influence of alcohol; or

   • •

     listing-level human immunodeficiency virus (HIV) from sharing a needle for intravenous drug use; and

7. g. 

   The claimant’s DAA medically caused the other disabling impairment(s) but the resulting impairment(s) is irreversible or could not improve to the point of nondisability. For example:

   • •

     peripheral neuropathy,

   • •

     permanent encephalopathy,

   • •

     cirrhosis of the liver, and

   • •

     substance-induced persisting dementia and substance-induced persisting amnestic disorder that develop from long-term alcohol or drug use.

The claimant has the burden of proving disability throughout the sequential evaluation process. As in all disability determinations and decisions, our burden is limited to producing evidence that work the claimant can do exists in the national economy at step 5 of the sequential evaluation process. For more information on the claimant’s burden of proof, see 20 CFR 404.1512, 404.1560, 416.912, and 416.960 and SSR 13-2p, Question 8. The claimant continues to have the burden of proving of disability throughout the DAA materiality analysis, when we apply the steps of the sequential evaluation a second time to determine whether the claimant would be disabled if he or she were not using drugs or alcohol.

We must provide sufficient information in a determination or decision so that a subsequent reviewer can understand the reasons for the following findings whenever DAA materiality is an issue:

• •

  The claimant has DAA.

• •

  The claimant is disabled at step 3 or step 5 of the sequential evaluation process considering all of his or her impairments, including DAA.

• •

  If the claimant is still disabled at step 3 or 5 of the sequential evaluation process in the absence of DAA, or the finding that the claimant would not be disabled at step 2, 4, or 5 of the sequential evaluation process in the absence of DAA.

NOTE: A single statement by an adjudicator that DAA is or is not material to the determination of disability is not sufficient. For documenting materiality, see Question 14 in DI 90070.041B. Adjudicators must provide explanations in their determinations or decisions, or on other appropriate documents, such as residual functional capacity assessment forms.