DAA Materiality in 2026: How SSR 13-2p Decides Whether Drug or Alcohol Use Sinks Your SSDI Claim

By Anthony Albert, Benefits Research Director | Published May 19, 2026 | Updated May 19, 2026

If you have a history of drug or alcohol use and you're applying for Social Security Disability Insurance or Supplemental Security Income, there's one specific test SSA runs that can sink your case. It's called the DAA materiality determination, and the rules come from SSR 13-2p, 20 CFR 404.1535, 20 CFR 416.935, and POMS DI 90070.050.

Here's the short version. Congress decided back in 1996 that addiction by itself can't be the basis of a disability claim. If your substance use is the reason you can't work, SSA denies. But if you have other medical conditions, mental or physical, and those would keep you from working even if you got sober tomorrow, you can still qualify. The legal term for that second outcome is "DAA is not material." If SSA gets to "DAA is material," the case dies.

This article walks through how the determination actually gets made, what evidence wins it, the most common ways claimants lose, and what to do if you've already been denied on materiality grounds.

The Statutory Background: Why DAA Exists at All

Until 1996, drug addiction and alcoholism were treated as potentially disabling conditions on their own. Then Public Law 104-121, the Contract with America Advancement Act, ended that. Congress amended Section 105 of the Social Security Act to say that no individual can be considered disabled if drug addiction or alcoholism is a contributing factor material to the determination.

That created a problem. How do you separate the disability caused by addiction from the disability that would exist anyway? SSA had to build a framework, and that framework took until 2013 to fully land. Before SSR 13-2p, examiners and judges were applying the rule inconsistently. Some ignored DAA entirely. Some denied any claim with a substance use diagnosis. The 2013 ruling gave everyone the same six-step playbook.

SSR 13-2p doesn't change the law. It explains how SSA reads the law and how examiners are required to apply it. Together with POMS DI 90070.050, those two documents are the only thing standing between a confused mess of case-by-case interpretation and a usable test you can actually argue against.

The Six Steps of the DAA Materiality Test

POMS DI 90070.050 sets out the six steps. Each step has a yes or no exit. The exits route you either to a denial or to the next step. Here's how it plays out.

The decisive step in most claims is Step 4. SSA asks: even while the claimant was actively using, were the other conditions disabling on their own? If yes, you survive. If no, the claim dies because DAA is treated as the load-bearing condition.

Step 6 is the next most common kill point. If your impairments could improve to non-disability with continued sobriety, SSA denies. The "could improve" standard is squishy and that's where a lot of fights happen. The burden is on you to show that improvement wouldn't get you back to work.

The Threshold: When SSA Even Runs the Analysis

SSA doesn't apply the materiality test to every claim. POMS DI 90070.050 spells out the trigger:

1. Medical evidence in the file from an acceptable medical source establishes that you have a substance use disorder.
2. The adjudicator determines you meet the definition of disability considering all impairments, including the DAA.

If either condition is missing, no materiality determination happens. That means a few things in practice.

If you don't meet the disability standard even with all conditions stacked together, your claim dies at Step 2 with no DAA analysis at all. That's a straight Step 5 denial of the sequential evaluation.

If you have a history of past drug or alcohol use that's not relevant to the period under review, SSA isn't supposed to run the materiality test. A claimant who got sober five years before the alleged onset date and whose current conditions have nothing to do with the old use should never see the analysis. In practice, examiners sometimes still flag it. Push back.

If your only evidence of substance use is your own statements or non-medical sources, and there's no acceptable medical source diagnosis of a Substance Use Disorder, SSA shouldn't apply DAA. The diagnosis has to come from an MD, psychologist, or other acceptable source documenting the disorder under DSM-5 or ICD criteria.

The Sequential Evaluation, Twice

The most technical part of SSR 13-2p is that SSA runs the entire five-step sequential evaluation process twice on your claim. The first pass considers all impairments, including DAA. The second pass considers only the impairments that would exist in the absence of DAA.

If you're disabled at Step 3 (meets a listing) or Step 5 (RFC plus vocational factors) on the first pass, you survive. The question is whether you'd still be disabled on the second pass. The same Listings apply, the same RFC analysis happens, the same medical-vocational guidelines run. The only thing that changes is the assumption about substance use.

For mental health conditions, that means SSA has to project what your symptoms would look like if you weren't using. That projection draws heavily on documented periods of abstinence. If you have three months of sober treatment notes showing your depression scores stayed in the severe range, you have strong evidence the depression is independent. If your treatment notes only exist during periods of use, the picture is muddier and SSA may assume improvement.

What Wins the Materiality Argument

Periods of Abstinence

This is the single strongest evidence type. Inpatient detox stays, residential treatment, sober living, jail or prison time, and documented gaps in use all create windows where SSA can see what your functioning looks like without substances. Build a timeline. Annotate it with treatment records, mental status exams, employment attempts, and any functional reports written during those windows.

If your symptoms persisted, that's the answer. If your symptoms improved meaningfully but still kept you from Substantial Gainful Activity at the 2026 thresholds, that's also the answer. You don't have to be fully impaired during sober periods. You just have to be unable to sustain SGA-level work.

Irreversible Conditions

POMS DI 90070.050 explicitly carves out Step 5 cases where DAA caused an irreversible condition. Cirrhosis, alcoholic cardiomyopathy, alcoholic hepatitis with permanent damage, encephalopathy, peripheral neuropathy, fetal alcohol effects in adult claimants, and certain dementias all sit in this bucket. If you have one of these, the analysis ends in your favor at Step 5 even though DAA caused the damage.

The takeaway: get the medical records that document permanence. A liver biopsy showing established cirrhosis, an echocardiogram showing reduced ejection fraction, an EMG documenting nerve damage. Soft findings won't carry it. Hard findings will.

Treating Source Statements That Separate Conditions

Generic letters that say "my patient has depression independent of substance use" carry no weight. The opinion has to do the work of separating the conditions on a symptom level. The treating psychiatrist or psychologist needs to identify which symptoms are present even during abstinence, explain why those symptoms are caused by the underlying mental disorder rather than the substance, and provide a chronology that supports the conclusion.

A psychiatrist who has seen you over multiple years across sober and active periods can write the most useful opinion. A one-time consultative examiner usually can't.

Third-Party Statements

SSR 13-2p allows non-acceptable medical sources to opine on whether functioning would improve in the absence of DAA. Family member function reports, case manager observations, sober living staff notes, and outpatient counselor notes all count. They don't establish the diagnosis, but they help with the functional projection at Step 5 and Step 6.

The most useful third-party statements describe specific incidents, specific symptoms, specific limitations during sober periods. "She couldn't get out of bed for two weeks in March even though she hadn't used in six months" is gold. "She has trouble with depression" is filler.

The Hard Cases: Co-Occurring Mental Illness

The toughest DAA materiality cases involve a serious mental health condition with active or recent substance use. PTSD with alcohol use. Bipolar disorder with stimulant use. Schizophrenia with cannabis use. Depression with opioid use.

Disability law firms and judges have flagged this category as the place where materiality denials concentrate. Psychologists called as medical experts at hearings often default to saying substance use is the primary driver, even when the underlying disorder predates the substance use by years. The Keller and Keller analysis published in December 2025 called this pattern "the easy way out" and noted that medical experts know a materiality finding produces a denial.

To beat it, you need three things. First, a chronology that establishes the mental disorder before the substance use started, ideally from childhood or early adulthood records. Second, treating source statements that explain the relationship between the two conditions in clinical terms. Third, documented sober periods that show the mental disorder symptoms continued.

If your alleged onset date is during a period of active use, expect the materiality issue to surface. If your onset date is during a sober period, the analysis is much easier because the disability is established without DAA in the picture.

Common Mistakes That Cost the Claim

1. Hiding the substance use history. If the records show it and you didn't disclose, your credibility takes a hit at every step. SSA reads treatment notes. Be honest in your disability report and your hearing testimony.
2. Letting the consultative examiner control the narrative. CE psychologists often spend twenty minutes with a claimant and write up the visit as "primary substance use disorder with depressive features." Pre-empt this with your own treating source statement.
3. Failing to document abstinence. If you've been sober, get the records. AA attendance logs, sponsor statements, primary care visits with negative tox screens, mental health treatment notes from sober periods. These are gold.
4. Not understanding the legal exception for irreversible damage. If DAA caused permanent organ damage that's now disabling, you may already have the case under POMS DI 90070.050 Step 5. Many representatives miss this and argue the harder Step 6 case.
5. Filing without representation. DAA cases are not pro-se territory. The legal framework is technical, the evidence requirements are specific, and the standard of review at the hearing is intricate. A qualified representative earns their fee on these claims.

Federal Court and Appeals Council: Where Denials Get Reversed

DAA materiality denials are among the more frequently reversed claim types in federal court and at the Appeals Council. The reason is that the six-step process leaves a long paper trail and ALJs sometimes shortcut it.

Common reversible errors include:

• The ALJ didn't explain why DAA was material. POMS DI 90070.050 says a single statement isn't sufficient. The decision must walk through the steps.
• The ALJ assumed Step 6 improvement without medical evidence supporting the projection.
• The ALJ ignored documented periods of abstinence in the record.
• The ALJ failed to apply the irreversible-damage exception at Step 5 when the record showed permanent organ damage.
• The ALJ relied solely on a medical expert opinion that didn't address the chronology of substance use versus the underlying impairment.

If your decision contains any of those errors, you have grounds to ask the Appeals Council to remand. If they refuse, federal court is the next step. The Hallex and POMS guidance gives you the specific procedural failures to argue.

What to Do Right Now if You're Filing

If you're filing a new claim and you have a history of substance use, do these things before you submit.

1. Get your medical records together going back at least five years. Include hospital visits, ER tox screens, mental health treatment, and primary care.
2. Identify your sober periods. Write them down with dates and supporting documents.
3. Talk to your treating psychiatrist or therapist about a written statement separating the conditions. Provide them with the POMS guidance if they're not familiar with materiality.
4. If you have a co-occurring chronic medical condition (chronic pain, neuropathy, COPD, congestive heart failure, cirrhosis), build that case in parallel. It's often the path of least resistance.
5. File a clear protective filing to lock your back pay date while you assemble the evidence.

If you've already been denied on materiality, get the decision in front of a representative immediately. The 60-day appeal deadline is firm, and a missed deadline forces a re-filing that costs you months of back pay.

Frequently Asked Questions

What does DAA materiality actually mean?

DAA stands for drug addiction or alcoholism. Materiality is the legal test SSA uses to decide whether your substance use is the deciding factor in your disability. If SSA finds that you would not be disabled in the absence of drug or alcohol use, DAA is material and they deny the claim. If SSA finds you would still be disabled without DAA, the substance use is not material and the claim is allowed.

When does SSA apply the materiality test?

Only when two conditions are met. First, there is medical evidence from an acceptable medical source diagnosing a substance use disorder. Second, the adjudicator finds you disabled when considering all impairments, including the DAA. If either condition is missing, SSA does not run the analysis. A history of past use that is not relevant to the period under review is also excluded.

What is the six-step DAA evaluation process?

Step 1: Does the claimant have DAA? Step 2: Is the claimant disabled considering all impairments including DAA? Step 3: Is DAA the only impairment? Step 4: Is the other impairment disabling by itself while the claimant is using? Step 5: Does the DAA cause or affect the other impairments? Step 6: Would the other impairments improve to non-disability without DAA? POMS DI 90070.050 lays out every step with decision rules.

Does irreversible damage from DAA still qualify?

Yes. SSR 13-2p and POMS DI 90070.050 carve out an exception when the substance use caused conditions that are irreversible or could not improve to the point of non-disability even if the use stopped. Examples include cirrhosis, alcoholic cardiomyopathy, hepatitis with permanent damage, encephalopathy, and peripheral neuropathy. Even though DAA caused the damage, the materiality finding goes in your favor.

How do I prove my other condition is disabling on its own?

The strongest evidence comes from documented periods of abstinence where your symptoms persisted. If you were sober for 30 days, 90 days, or longer and your depression, anxiety, PTSD, or physical condition still limited you, that record carries the case. Treating source statements that explain the persistence of symptoms during sober periods, third-party function reports from family, and treatment notes from inpatient or outpatient programs all matter.

What if my mental health condition is the issue?

Co-occurring substance use and mental illness is where DAA materiality gets hard. Examiners and judges often struggle to separate symptoms caused by the drug use from symptoms caused by the underlying mental disorder. To win, you need a treating psychiatrist or psychologist who can document the chronology, the response to medication during sober periods, and the persistence of the symptoms across abstinence.

Can prescription medication count as DAA?

Generally no. SSR 13-2p specifically excludes addiction to prescription medications taken as prescribed from the Substance Use Disorder definition. It also excludes occasional maladaptive use. The materiality analysis applies only when there is a documented diagnosis of a substance use disorder from an acceptable medical source. Marijuana use, even in legal states, can still be flagged if the claimant has a diagnosable cannabis use disorder.

DAA materiality is one of the trickier parts of disability law because it sits at the intersection of medical fact, legal projection, and credibility. The rules give you a path through when the evidence is built right. They also give SSA every excuse to deny when it's not. If you have a substance use history and you're heading into the claim process, get the medical record squared away first. The cleanup is much harder after a denial than the prep work is before the application.