Alcoholism and Substance Abuse VA Disability Ratings, Benefits, and Compensation
CCK Law: Our Vital Role in Veterans Law
With the physical and mental stress that military service can induce, it is unfortunately too common for veterans to suffer some form of alcohol or substance abuse disorder. For veterans coping with these issues, it is normal to ask whether their substance abuse disorder is compensable by the Department of Veterans Affairs (VA).
If you are a veteran seeking a VA alcoholism rating or a substance abuse VA rating, you should know that VA does not consider these compensable disabilities on their own. Instead, it will issue ratings for medical conditions caused by service-connected alcoholism or substance abuse (e.g., mental health disorders)
This article will educate you on which substance abuse-related disorders do and do not qualify for VA benefits, so you can take the proper steps before filing a claim.
Key points in this article include:
- Veterans often suffer from alcoholism or substance abuse. There are several factors that can push a veteran to abuse drugs and alcohol, ranging from mental trauma to chronic physical pain.
- Alcoholism and substance abuse are not VA-recognized disabilities on their own. However, conditions resulting from alcohol or drug abuse may qualify for disability ratings and compensation, depending on the circumstances.
- Certain conditions like liver cirrhosis or Hepatitis C are commonly linked to alcohol or substance abuse. Veterans can potentially earn disability ratings for these conditions on a secondary basis.
How Does VA Define Alcoholism and Substance Abuse Disorder?
To better grasp how VA evaluates claims involving alcoholism and substance use disorders, it is essential to first understand how VA defines alcohol and drug abuse.
Alcohol Abuse
According to VA, alcohol abuse is “the use of alcoholic beverages over time, or such excessive use at any one time, sufficient to cause disability or death of the user.”
In other words, drinking alcohol in itself does not qualify as alcohol abuse; instead, abuse is defined by excessive consumption or engaging in the behavior over an extended period.
Common symptoms of alcoholism in veterans include:
- Being unable to limit the amount of alcohol a veteran drinks
- Spending a lot of time drinking, getting alcohol, or recovering from alcohol use
- Feeling a strong craving or urge to drink alcohol
- Failing to fulfill major obligations at work, school, or home due to repeated alcohol use
- Continuing to drink alcohol even though the veteran knows it is causing physical, social, or interpersonal problems
- Experiencing withdrawal symptoms (e.g., nausea, sweating, shaking) when the veteran does not drink, or drinking to avoid these symptoms
Drug or Substance Abuse
As for drug or substance abuse, VA defines it as “the use of illegal drugs (including prescription drugs that are illegally or illicitly obtained), the intentional use of prescription or non-prescription drugs for a purpose other than the medically intended use, or the use of substances other than alcohol to enjoy their intoxicating effects.”
Some symptoms of substance abuse include:
- Feeling the need to use a specific drug, or drugs, daily. Veterans with a drug addiction may use drugs more than once a day
- Taking larger amounts of a drug than intended and over a longer period
- Experiencing withdrawal symptoms such as nausea, irritability, and tremors when the veteran stops using the drug
- Spending money on a drug even when a veteran cannot afford to
- Difficulties participating in regular activities, such as work, school, or social events
- Altered behavior, such as isolation or increased need for privacy
Why Do Veterans Abuse Alcohol and Drugs?
Due to the intense demands of military service, it is common for service members to be exposed to extreme physical and psychological stress. This stress can have a very real impact on a veteran’s overall health, potentially leading to the development of long-term physiological disorders or mental conditions.
Sometimes, when a veteran’s condition is severe enough and they lack access to quality health care, they might turn to alcohol or drugs to help them cope with their disorder.
Below are some prominent conditions that can cause a veteran to develop a substance abuse disorder, including:
- Post-traumatic stress disorder (PTSD) – PTSD is a common mental disorder for veterans to suffer from. According to VA, PTSD significantly raises the risk of developing a substance use disorder (SUD). Over 20 percent of veterans with PTSD also have SUD, and nearly 1 in 3 veterans seeking treatment for substance abuse are also coping with PTSD.
- Traumatic brain injuries (TBIs) – The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that about 19.5 percent of veterans returning from Iraq and Afghanistan have sustained a TBI. For some veterans, drugs and alcohol become a coping mechanism for their TBI symptoms.
- Chronic pain – Long-term physical injuries sustained during service often require extended use of pain management medications, particularly opioids. While these medications may be medically necessary, prolonged use can lead to dependency or addiction.
- Military sexual trauma (MST) – MST refers to sexual harassment or assault experienced during military service. According to VA, 1 in 3 women and 1 in 50 men have disclosed experiencing MST, though broader studies suggest the rates may be significantly higher. Veterans coping with MST often turn to alcohol or drugs.
For veterans contending specifically with mental illness, one of the most significant barriers to recovery is the lack of access to adequate treatment. SAMHSA reports that only about 50 percent of returning service members who need mental health care actually pursue it.
Common reasons for not seeking treatment include stigma, fear of retaliation, or simply not having access to the right resources. As a result, many veterans turn to self-medication, using alcohol or drugs to attempt to treat their mental condition.
Does VA Assign Disability Ratings for Alcoholism and Substance Abuse Disorder?
No, they do not.
Veterans cannot be directly service connected for substance abuse. However, veterans can be compensated for symptoms arising from substance abuse if the substance abuse is attributed to an already service-connected disability, such as a psychiatric condition. The substance abuse would serve as an intermediate step between the service-connected disability and the claim disability.
In other words, it is possible for veterans to receive VA compensation for a substance abuse-caused disorder. The veteran will just have to take additional steps while establishing service connection.
Establishing Service Connection Is Required to Earn Alcoholism and Substance Abuse VA Ratings
While veterans cannot establish direct service connection for alcoholism or substance abuse, it is still possible to earn service connection on a secondary basis. A secondary service-connected disability is one that was either caused or worsened by an already service-connected condition.
In other words, this method will have veterans file disability claims for disorders that have developed due to their alcoholism or substance abuse, so long as that substance abuse is linked to an already service-connected condition.
Kayla Rogers, a VA-accredited claims agent with CCK Law, provides a specific example:
- “Say a veteran has a service-connected condition like PTSD or some other psychiatric disability, and they use alcohol as a means of coping with their symptoms—like sleep disturbances.
- “As a result of that prolonged excessive alcohol use, the veteran develops cirrhosis of the liver. In this situation, the veteran may be able to receive service-connected compensation for their liver cirrhosis on a secondary basis.
- “Here, the veteran’s alcoholism serves as an intermediate step between their service-connected PTSD and cirrhosis. In other words, alcoholism—or any substance abuse—can be used as a bridge to connect a veteran’s primary service-connected condition to the secondary condition that they developed as a result of that alcoholism.”
While the scenario above is certainly possible via VA’s policies and rules, it is important to keep in mind that the veteran will need strong medical evidence linking their PTSD to their liver disease to win such a claim. They should enlist their doctor to write a nexus opinion firmly establishing the connection between their disorders.
What Evidence Does VA Look for When Assigning Alcoholism and Substance Abuse Ratings?
When veterans apply for disability benefits connected to their substance abuse issues, the strength and relevance of the evidence they provide can play a major role in the claim’s success. To build a solid case, it is important to include several essential types of documentation:
- Military Records – These documents help show a direct link between a veteran’s current health problems and incidents that occurred while on active duty. Examples might include in-service medical evaluations, personnel records, discharge paperwork, and other official military documentation.
- Medical Documentation – A thorough collection of medical records is crucial for demonstrating both the existence and progression of a disorder. This may include treatment notes from VA hospitals, reports from private doctors, or evaluations from specialists familiar with the veteran’s condition.
In addition, personal statements—also known as lay evidence—from people close to the veteran can help illustrate how their condition affects everyday life.
These can come from family members, friends, or former service members. While not as authoritative as official documents, these personal accounts can offer valuable perspective and help paint a fuller picture of the veteran’s experience.
Alcoholism and Substance Abuse VA Ratings
There are several conditions connected to alcoholism and substance abuse that VA will provide ratings for. So long as a veteran applies for these conditions on a secondary basis and successfully connects them to their primary service-recognized condition, it is possible to earn ratings and compensation for disorders including:
- Liver cirrhosis
- Pancreatitis
- Fatty liver disease
- Hepatitis C
- And more
If a veteran’s secondary service connection claim is successful, VA will rate the severity of the veteran’s secondary condition using specific diagnostic criteria. These criteria correspond to specific percentage ratings, with VA assigning a final percentage rating based on which of the criteria the veteran’s condition fulfills.
Alcoholism and Liver Cirrhosis
Liver cirrhosis is one potential condition that can arise from alcoholism. If a veteran is able to establish that their alcoholism first developed due to a service-connected condition like depression or PTSD, then the resulting liver cirrhosis can be linked to that primary condition, and the veteran can receive a rating for it.
Liver cirrhosis is rated under Diagnostic Code 7312 of 38 CFR § 4.114 – Ratings of the Digestive System. Depending on the severity of a veteran’s cirrhosis, they can receive ratings of 100, 60, 30, 10, or 0 percent. The criteria for these ratings are as follows:
- 100 percent – Liver disease with Model for End-Stage Liver Disease score greater than or equal to 15; or with continuous daily debilitating symptoms, generalized weakness, and at least one of the following:
- ascites (fluid in the abdomen), or
- a history of spontaneous bacterial peritonitis, or
- hepatic encephalopathy, or
- variceal hemorrhage, or
- coagulopathy, or
- portal gastropathy, or
- hepatopulmonary or hepatorenal syndrome
- 60 percent – Liver disease with Model for End-Stage Liver Disease score greater than 11 but less than 15; or with daily fatigue and at least one episode in the last year of either:
- variceal hemorrhage, or
- portal gastropathy, or
- hepatic encephalopathy
- 30 percent – Liver disease with Model for End-Stage Liver Disease score of 10 or 11; or with signs of portal hypertension such as splenomegaly or ascites (fluid in the abdomen) and either weakness, anorexia, abdominal pain, or malaise
- 10 percent – Liver disease with Model for End-Stage Liver Disease score greater than 6 but less than 10; or with evidence of either anorexia, weakness, abdominal pain or malaise
- 0 percent – Asymptomatic, but with a history of liver disease
Alcoholism and Pancreatitis
Pancreatitis is another condition that can arise from long-term, heavy alcohol use. Similar to liver cirrhosis, to earn a VA rating for alcohol-induced pancreatitis, the veteran must establish a link between their pancreatitis and the service-recognized condition that first caused them to develop alcoholism, which could be anything from depression to TBI.
Pancreatitis is rated under Diagnostic Code 7347 of 38 CFR § 4.114 – Ratings of the Digestive System. Possible ratings include 100, 60, or 30 percent, depending on the following criteria:
- 100 percent – Daily episodes of abdominal or mid-back pain that require three or more hospitalizations per year; pain management by a physician; and maldigestion and malabsorption requiring dietary restriction and pancreatic enzyme supplementation
- 60 percent – Three or more episodes of abdominal or mid-back pain per year and at least one episode per year requiring hospitalization for management of either complications related to abdominal pain or complications of tube enteral feeding
- 30 percent – At least one episode per year of abdominal or mid-back pain that requires ongoing outpatient medical treatment for pain, digestive problems, or management of related complications, including but not limited to cyst, pseudocyst, intestinal obstruction, or ascites
Note that for pancreatitis in particular, the proper diagnostic studies must be conducted to confirm the condition. Only then will VA assign the veteran a corresponding rating.
Alcoholism and Fatty Liver Disease
Fatty liver disease is another condition that can result from chronic alcohol consumption. Fatty liver disease is rated under Diagnostic Code 7345 of 38 CFR § 4.114 – Ratings of the Digestive System.
This diagnostic code covers any chronic liver disease without cirrhosis. Under this code, veterans can receive ratings of 100, 60, 40, 20, or 0 percent. The rating criteria for it are as follows:
- 100 percent – Progressive chronic liver disease requiring use of both parenteral antiviral therapy (direct antiviral agents), and parenteral immunomodulatory therapy (interferon and other), for six months following discontinuance of treatment
- 60 percent – Progressive chronic liver disease requiring continuous medication and causing substantial weight loss and at least two of the following:
- daily fatigue
- malaise
- anorexia
- hepatomegaly
- pruritus
- arthralgia
- 40 percent – Progressive chronic liver disease requiring continuous medication and causing minor weight loss and at least two of the following:
- daily fatigue
- malaise
- anorexia
- hepatomegaly
- pruritus
- arthralgia
- 20 percent – Chronic liver disease with at least one of the following:
- intermittent fatigue
- malaise
- anorexia
- hepatomegaly
- pruritus
- 0 percent – Previous history of liver disease, currently asymptomatic
Substance Abuse and Hepatitis C
Hepatitis C is a serious viral illness that can spread through contact with infected blood or contaminated medical instruments like needles and syringes. Since certain drugs require the use of needles to enter the bloodstream, it is more likely for drug users to contract Hepatitis C and similar bloodborne conditions.
Hepatitis C is rated under Diagnostic Code 7354 of 38 CFR § 4.114 – Ratings of the Digestive System. Under this code, veterans can receive ratings of 100, 60, 40, 20, or 0 percent for Hepatitis C. The rating criteria are similar to those for fatty liver disease.
Does VA Provide Resources to Treat Alcoholism and Substance Abuse?
Yes, VA provides several resources to help veterans struggling with alcoholism or substance abuse, particularly if that veteran is assigned a disability rating and gains access to VA health care.
These treatment options take the form of medication, therapy, and treatment of any conditions that might have accompanied or caused the substance disorder. Some of the treatment options VA offers include:
- Medically managed detoxification to stop substance use safely, and services to stabilize
- Drug substitution therapies and medicines to lessen cravings
- Nicotine replacement therapy or medications
- Short-term outpatient counseling
- Intensive outpatient treatment
- Residential care
- Continuing care and relapse prevention
- Programs for veterans with specific needs (e.g., women veterans, former combat veterans, or homeless veterans)
Additional Support for Veterans
In addition to the above options, there are other support services out there that veterans can make use of.
One of these options is the Veterans Crisis Line, an around-the-clock, confidential support service that ensures complete anonymity, helping veterans feel safe in seeking help without concern about judgment or repercussions. The hotline is open to all veterans—regardless of whether they are enrolled in VA health care or have a service-connected disability. To get support, veterans can dial 1-800-273-8255 and press 1 or send a text to 838255.
Another is VA’s National Call Center for Homeless Veterans, which provides 24/7 assistance for veterans at risk of or experiencing homelessness. This support line is also available to concerned family members or friends who want to help a veteran in need. To connect with the call center, dial 877-424-3838.
VA Disability Compensation for Alcoholism and Substance Abuse Ratings
Monthly Compensation for Alcoholism and Substance Abuse VA Ratings
In addition to health care benefits, VA can also award financial compensation, depending on a veteran’s alcoholism or substance abuse VA rating.
Generally, veterans with more severe service-connected conditions receive higher disability ratings, and those higher ratings typically lead to increased monthly compensation. The table below provides a breakdown of the VA payment amounts for 2025 based on a veteran’s assigned disability percentage.
As of 2026, the VA disability rate benefit amounts are as follows:
- 0 percent disability rating: $0.00 per month
- 10 percent disability rating: $180.42 per month
- 20 percent disability rating: $356.66 per month
- 30 percent disability rating: $552.47 per month
- 40 percent disability rating: $795.84 per month
- 50 percent disability rating: $1,132.90 per month
- 60 percent disability rating: $1,435.02 per month
- 70 percent disability rating: $1,808.45 per month
- 80 percent disability rating: $2,102.15 per month
- 90 percent disability rating: $2,362.30 per month
- 100 percent disability rating: $3,938.58 per month
Veterans who have qualifying dependents, such as a spouse or child, may also be eligible for additional compensation each month. These dependent-related benefits can increase the total amount a veteran receives.
Special Monthly Compensation (SMC) for Alcoholism and Substance Abuse
Special Monthly Compensation, or SMC, is an additional benefit that VA offers to veterans with serious disabilities or particularly complex medical needs. This enhanced payment is designed to help cover extra expenses that standard VA disability compensation might not fully account for.
In some cases, a veteran’s condition may be tied to a more severe injury or involve complications that lead to greater functional loss. When symptoms are especially debilitating, VA may grant SMC as a way to recognize the increased level of disability and provide additional financial support.
Can I Get Total Disability Based on Individual Unemployability (TDIU) as a Result of Alcoholism and Substance Abuse?
Even if your combined VA disability rating is below 100 percent, you may still qualify for Total Disability Based on Individual Unemployability (TDIU) if your service-connected conditions prevent you from securing or keeping substantially gainful income. Basically, if your alcohol- or substance-abuse-related conditions prevent you from making more than the federal poverty income threshold over the course of a year, then you may be eligible for total disability.
When TDIU is approved, VA provides compensation at the 100 percent disability rate, regardless of your actual combined rating.
Veterans can pursue TDIU through two main pathways:
- Schedular TDIU – This option applies to veterans who meet specific rating thresholds:
- One service-connected condition rated at 60 percent or more, or
- A combined rating of at least 70 percent, with one individual condition rated at 40 percent or higher.
- Extraschedular TDIU – Veterans who do not meet the usual rating criteria may still be considered under “extraschedular” TDIU. In such cases, VA’s Director of Compensation Services evaluates whether the veteran’s service-connected impairments prevent them from holding substantially gainful employment, regardless of their official disability percentages.
Filing for TDIU benefits can be complex, but working with a VA-accredited attorney or claims representative may improve your chances of a successful outcome. Reach out to CCK Law for a free case evaluation and the chance to connect with an experienced attorney who can help guide you through VA’s claims process.
Was Your VA Disability Claim Denied? Contact CCK Law
If your substance-abuse-related disability claim was denied by VA, then the VA-accredited team at Chisholm Chisholm & Kilpatrick may be able to assist. With decades of combined experience advocating for veterans, our team has recovered more than $1 billion in compensation for veterans and their dependents.
Call us at (800) 544-9144 or contact us online for a free case evaluation.
Veterans Also Ask
Some additional questions veterans frequently ask about alcoholism and substance abuse issues include:
Does My Alcoholism or Substance Abuse Need to Have Started in Service?
No. To receive VA compensation for alcoholism or substance abuse, a veteran must prove that their substance-abuse-related disability is linked on a secondary basis to a separate, already service-recognized condition, like depression or PTSD. Their substance abuse issue need not have started in service.
Can VA Deny My Alcohol- or Substance Abuse-Related Claim by Declaring It “Willful Misconduct”?
VA defines “willful misconduct” as “an act involving conscious wrongdoing or known prohibited action.”
It is possible for VA to deny a substance abuse-related disability claim based on willful misconduct. Bethany Cooke, a VA-accredited claims agent with CCK Law, provides an example of how this might happen:
“Say during a veteran’s active-duty military service, they had a substance-abuse related accident—say a car accident—and in that accident, they suffer injuries. In a case like that, what VA might do is find that the initial accident was a result of willful misconduct, given that substance abuse was the cause of the accident. This would make the veteran unable to get any compensation for any injuries or disabilities that resulted from the car accident.”
