Can I Get VA Disability for Alcoholism and Substance Abuse?

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No, you can’t receive a VA disability rating for alcoholism or substance abuse on its own.

There is no standalone VA diagnostic code (DC) for alcohol use disorder (AUD), or substance use disorder (SUD), and claims based on primary abuse—meaning the behavior itself—will be denied as not service-connected.

But that’s not the end of the story…

If your alcohol or drug use was caused or aggravated by another service-connected condition—such as PTSD, major depression, or chronic pain—you may be able to get VA disability compensation for the resulting medical conditions on a secondary basis.

Let’s break this down step-by-step in this expert-level guide from Brian Reese the VA Claims Insider.

Summary of Key Points

• No VA Rating for Primary Substance Abuse: The VA does not compensate for primary alcohol or drug abuse that results from willful misconduct, and there’s no diagnostic code for alcohol or substance use disorders on their own.

• Secondary Service Connection Is Possible: Under Allen v. Principi and 38 CFR § 3.310, veterans may receive compensation if their substance abuse was caused or aggravated by a service-connected condition like PTSD, depression, or chronic pain.

• Resulting Conditions Can Be Rated: Disabilities resulting from substance abuse—such as liver disease, heart conditions, or neuropathy—can be service-connected secondarily if the substance use is medically linked to a primary service-connected disability.

• Medical Evidence Is Critical: Veterans must provide a current diagnosis, strong medical evidence, and a nexus letter clearly connecting their substance abuse to the original service-connected condition.

No VA Rating for Primary Alcoholism or Drug Abuse

You can’t file a VA claim directly for “alcoholism” or “substance abuse” and expect the VA to approve it as service-connected.

Why?

Because under federal law, including 38 U.S.C. § 1110, the VA excludes compensation for disabilities that result from a veteran’s own willful misconduct—which includes voluntary substance abuse.

This includes any condition that arises due to primary alcohol or drug use during or after military service.

But There’s a Critical Exception

In the landmark case Allen v. Principi, 237 F.3d 1368 (Fed. Cir. 2001), the court ruled that the VA can pay compensation for alcohol or drug-related disabilities if the substance abuse was caused by—or is a symptom of—a service-connected condition.

That means secondary service connection is possible if:

• The alcohol or substance abuse is caused by a service-connected disability (e.g., using alcohol to self-medicate PTSD or opioids to manage chronic pain), and

• The resulting conditions (e.g., liver disease, heart issues, or addiction itself) are proximately due to that use.

Example: Alcoholism Secondary to PTSD

Let’s say a veteran is service-connected for PTSD.

To manage daily flashbacks and emotional instability, he begins drinking heavily.

Ten years later, he’s diagnosed with cirrhosis of the liver.

Even though cirrhosis isn’t directly related to military service, it may be service-connected secondarily to PTSD, with alcoholism acting as the bridge between the original service-connected condition and the new diagnosis.

What the Law and VA Policy Have to Say

The VA’s internal adjudication manual (M21-1) backs this up:

“Where there is sufficient medical evidence establishing that an alcohol or drug abuse disability is secondary to or a symptom of a service-connected disability—and not due to willful misconduct, the veteran may be awarded secondary service connection under 38 CFR § 3.310(a).”

This includes any diseases caused by substance use, so long as the root cause is a service-connected condition like PTSD, depression, anxiety, or chronic pain.

More Examples of Secondary Service Connection for Alcoholism

Back Pain → Alcohol Abuse → Liver Disease

A veteran rated at 40% for chronic back pain uses alcohol to cope with daily suffering. Over time, this results in alcohol dependence and alcoholic hepatitis. A VA examiner links the alcohol abuse to pain management. The liver disease may be awarded as secondary to the back condition.

PTSD → Alcohol Abuse → Cardiomyopathy

A veteran with 70% PTSD uses alcohol to sleep and cope with trauma. Years later, he’s diagnosed with alcoholic cardiomyopathy. A medical opinion connects the alcohol use to his PTSD. That heart condition may qualify as a secondary disability.

Pro Tip: Substance Abuse Can Indicate Worsening of a Primary Condition

Even if you don’t claim a secondary condition, the fact that you’re struggling with alcohol or drug use can support a higher rating for the original condition.

If your PTSD has worsened and led to substance use, that’s valid evidence of increased severity, especially if supported by medical documentation.

VA Secondary Conditions Caused or Aggravated by Substance Abuse

Alcohol and drug use can cause or worsen a wide range of physical and mental health conditions.

If those conditions are the result of a service-connected issue that led to the substance abuse, they may be eligible for secondary service connection:

• Liver disease (alcoholic hepatitis, fatty liver, cirrhosis)

• Heart conditions (cardiomyopathy, hypertension, arrhythmias)

• Pancreatitis (acute or chronic)

• Neuropathy (alcoholic or drug-induced nerve damage)

• Gastrointestinal disorders (GERD, ulcers, esophagitis)

• Cognitive disorders (alcohol-related dementia, memory loss)

• Mental health deterioration (worsening depression, anxiety, suicidal ideation)

• Immune suppression

• Osteoporosis and fractures

• Cancers (liver, throat, mouth, colon, breast)

Mental Health and Substance Abuse: A Complex Relationship

Many veterans turn to substances to self-medicate trauma or pain.

That doesn’t mean they are seeking a way out, it often means they’ve lost healthier coping mechanisms.

If you’re a veteran with a service-connected mental health condition, and your substance use began as a result, that’s highly relevant evidence.

However, these are complex claims.

The burden is on you to provide:

• A current diagnosis of the secondary condition.

• Medical evidence linking it to your alcohol or drug use.

• A nexus letter from a qualified provider that ties your substance abuse to your service-connected condition.

Conclusion & Wrap-Up

You can’t get VA disability compensation directly for alcoholism or drug abuse.

But if your alcohol or drug use was caused by a service-connected disability—and it led to additional health conditions—those secondary conditions may be compensable.

Build your claim on solid medical evidence.

Get a strong nexus letter.

And make sure your substance abuse is documented as a symptom and not as your own willful misconduct.

Fellow veterans: stay informed, engaged, and proactive in advocating for your rights and VA benefits.​

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