October 22, 2025 • 9 mins
🧠 Episode Overview:
In this episode, we take an honest and informative look at Alcohol Use Disorder (AUD) and how it affects veterans seeking VA disability benefits. Many veterans struggle with alcohol use after service — often as a result of PTSD, chronic pain, or other service-connected conditions. Yet, the VA’s approach to alcohol-related disabilities can be complex and confusing.
We’ll break down how the VA evaluates and compensates alcohol use disorder, when it can be service-connected, and what kind of medical and psychological evidence you need to support your claim.
🔍 Topics Covered:
- Understanding Alcohol Use Disorder (AUD) and its impact on veterans
- How military service can contribute to alcohol dependence
- When alcohol use disorder can be service-connected
- Secondary to PTSD, depression, anxiety, or chronic pain
- Linked to self-medicating behaviors caused by service-connected disabilities
- VA’s policy on primary vs. secondary service connection for substance use
- How the VA rates mental health and substance-related disorders
- Importance of nexus letters and medical opinions in AUD claims
- Strategies for veterans denied due to “willful misconduct” language
- The VA appeal process for denied alcohol-related claims
- Available treatment and recovery programs through the VA
- How to document rehabilitation efforts and long-term recovery
💡 Key Takeaways:
- Alcohol Use Disorder can qualify for VA disability if it’s secondary to a service-connected condition.
- The VA often denies claims labeled as willful misconduct, but a strong medical nexus can change that.
- Linking AUD to PTSD, depression, or pain management can establish service connection.
- Medical evidence, lay statements, and treatment records are vital to a successful claim.
- Recovery efforts and ongoing treatment can demonstrate long-term impact and help strengthen your case.
🧾 Resources Mentioned:
- VA Mental Health Services – Substance Use Program
- National Center for PTSD – Substance Use and PTSD Guide
- Veterans Crisis Line (Dial 988, then Press 1)
🎧 Tune In If You’re a Veteran Who:
- Struggles with alcohol use or recovery after service
- Has been diagnosed with PTSD, depression, or anxiety and uses alcohol to cope
- Had a VA claim denied due to “substance abuse” or “willful misconduct”
- Wants to understand how secondary service connection applies to AUD
- Is looking for VA treatment programs or appeal guidance
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Leah Bucholz (00:06):
Hey, guys. It's Leah Bee from Prestige Veteran
Medical Consulting. I am a USArmy veteran, physician
assistant, and formercompensation, and pension
examiner. So today, wanna comeon and talk about a really
important topic that affects alot of veterans, and that is
alcohol use disorder and howthat can be related to VA
disability. So did you know thatalcohol use disorder is one of
the most common challenges facedby veterans and that it can also
(00:28):
be connected to your VAdisability benefits.
Not in the most straightforwardway that you always would think
about, but in today's video,we're gonna be breaking down
alcohol use disorder, how itimpacts veterans, what the
research says, how it can leadto serious medical conditions,
and what the VA means when theytalk about willful misconduct,
and and substance abuse andalcohol or substance abuse. So
(00:51):
stick around until the end wherewe're gonna share some resources
that could help you or a lovedone. So okay. So let's try to
understand alcohol use disorderin veterans. Right?
So alcohol use disorder or AUDis more than just drinking too
much. It's a medical conditionwhere alcohol use leads to
distress or harm. For veterans,alcohol often becomes a way to
(01:14):
cope with, combating stress,trauma, or physical pain. Now
the VA recognizes alcohol usedisorder as a serious condition,
but here's the catch. VAdisability benefits usually
aren't gonna be granted foralcohol use disorder as a
primary condition.
However, the story doesn'treally end there because alcohol
use disorder often connectsother serious health issues that
(01:36):
may be considered, serviceconnected, so, like, as a
bridge. We've talked about a lotof different things that can be
used as a bridge to anothercondition, like obesity as an
intermediate step, sometimesmedications. You know, things
like smoking, we have a video onas well. So if you have a
service connected disabilitythat is going to influence that
alcohol use disorder or thatsubstance use and it leads to
(01:59):
another condition, you might beable to be service connected for
that. So let's talk about whatsome of the research says.
So research shows that veteransthat are are at a higher risk
for alcohol misuse compared tothe general population. In fact,
VA studies have found thatnearly one in ten veterans
struggles with substance usedisorder, and alcohol is by far
the most common. Other studieshave highlighted strong
(02:21):
connections between alcohol useand conditions like PTSD, TBI,
traumatic brain injury, andchronic pain. So many veterans
report using alcohol as a formof self medication.
Unfortunately, that not onlyincreases risk of depression,
suicidality, you know, it worseit can worsen other medical
conditions and physical health.
(02:42):
So alcohol use use disorder israrely just one problem on its
own. It's often part of a largerhealth picture. So how how can
alcohol use disorder lead toother conditions? So alcohol use
disorder can cause otherdisabling medical conditions
like I mentioned earlier. Sothis is a key part of
understanding how it ties intoVA disability.
(03:05):
So here are a few examples. Longterm alcohol use can damage the
liver, leading to things likecirrhosis or liver failure,
fatty liver disease. Heavydrinking often leads to weight
gain, which raises the risk ofthings like type two diabetes,
hypertension, and heart disease.We have a ton of other videos
about obesity and how that can,bridge to other conditions as
(03:25):
well. And, again, I've I'veoften seen cases where alcohol
use related to the mental healthcondition sort of ties in to the
weight gain as well leading to,again, diabetes, hypertension,
heart disease, etcetera.
So chronic alcohol use cantrigger stomach ulcers,
pancreatitis, nerve damage, andeven cognitive decline that
looks like dementia or worseningbrain injury symptoms. In these
(03:50):
cases, alcohol use disorderbecomes the bridge to serious
chronic medical conditions. Andwhile the VA may not grant
benefits directly for alcoholuse disorder, those secondary
conditions like cirrhosis ordiabetes can qualify if they can
be linked back to your serviceor to your alcohol use. So let's
talk about willful misconduct inVA disability. So this is where
(04:10):
things get complicated with theVA's rules on willful
misconduct.
So by law, VA usually is notgoing to grant disability
compensation for conditionscaused by a veteran's own
willful misconduct. If the VAbelieves that your alcohol use
was purely a matter of personalchoice or reckless behavior,
they may deny your claim. Butand this is a big but. The
(04:31):
situation changes if the alcoholuse disorder develops as a
symptom of another serviceconnected condition. For
example, if you start drinkingheavily to cope with your PTSD,
depression, or chronic pain, theVA may now view the alcohol use
disorder and any conditionscaused by it as secondary to the
service connected issue, notjust willful misconduct.
(04:52):
So that's why medical evidenceand documentation and your
personal history are soimportant. The line between
willful misconduct and a serviceconnected disability isn't
always clear, and how your caseis presented can make all the
difference. So I wanna talkabout some resources for
veterans. I'm gonna pull up awindow on va.gov here in a
second. But if you or somebodyyou love is struggling with
(05:14):
alcohol use, you don't have toface it alone.
So let's see. Let me let me justshift over here really quick to
this other screen I have. K.Okay. This is va.gov.
(05:36):
I like to come on va.gov a lotbecause they have a lot of
really great resources. So asyou can see, this is, I just
looked up va.gov, you know,alcohol use disorder, and it
brought me here. So substanceuse treatment for veterans, and
it just outlines what servicesVA offers. So there's
medications, medically manageddetox for substance abuse. Drug
(06:01):
sub drug substitution therapiescan be used for cravings.
There's opiate addiction. We'renot really talking about that
today, but there's some otheroptions for alcohol as well.
There's short term outpatientcounseling, intensive outpatient
treatment. They offer marriageand family counseling, self
help, groups, residential care,relapse prevention, special
(06:23):
programs for veterans withspecific concerns like women
veterans. And so there's somemore links here, treatment
options for substance use.
So I'm gonna click on that realquick. One second. Okay. So if
we get to this tab, it itactually has an overview of
different things. So we're gonnakey in on alcohol today.
(06:45):
And and, again, it talks aboutwhat alcohol use disorder is.
Twenty nine point five millionpeople in The US had an alcohol
use disorder in 2022. So so justsome statistics, right, some
signs of simp and symptoms ofalcohol use disorder. It says
you might have alcohol usedisorder if you experience two
or more of the 11 symptomslisted below, like things like
(07:07):
wanting to cut down or stopdrinking, experiencing cravings,
drinking more than you intended,spending a lot of time getting,
getting, drinking, or recoveringfrom drinking, neglecting your
responsibilities at home,continuing to drink even though
it's causing or worsening yourphysical and mental health
challenges, continuing to drinkthough it's causing relationship
(07:27):
problems, giving up importantwork, social, or recreational
activities, risky drinking inrisky settings that put you in
danger, developing tolerance,and experiencing withdrawal. So
then there's some effects herewhere it sort of goes into some
of those things that we talkedabout chronic diseases, harmful
medication interactions, justsome really good education.
(07:50):
And then there's a section hereon treatment, and it wants you
to talk it talks about local VAmedical centers. And then
there's a treatment and nextsteps page where it, again,
gives you some of those evidencebased therapies like CBT,
motivational interviewing,enhancement therapy. So it it
just gives you a lot ofdifferent resources that VA is
(08:13):
gonna offer to help and and, ofcourse, scheduling those mental
health appointments. So let mejump back over to my regular
screen. Okay.
So I hope this was helpful foryou guys to sort of untangle
some of the issues with alcoholrelated disorders because I know
a lot of veterans and theirfamily members suffer from this,
and there are a lot of resourcesout there. Also, you don't if
(08:34):
you're a veteran, there are alot of options even if you're
not service connected for a d VAdisability to get, resources to
help with this. I hope this washelpful to you guys. Again, I'm
I'm a PA. I assist veteranssometimes with medical opinions.
I'm not a legal professional. Soif you want help with your claim
or advice, you always wannacheck with an accredited legal
professional like a BSO,accredited claims agent, or
(08:55):
attorney. If you have troublefinding one of those, they're on
va.gov. You guys can go take alook. We've even got a video on
how to use the search tool onva.gov to find somebody like
that in your area or nationwideto help you.
So I hope this was helpful.Please drop some comments and
like and subscribe. Alright.Thanks, guys.
Hey, guys. It's Leah Bee from Prestige Veteran
Medical Consulting. I am a USArmy veteran, physician
assistant, and formercompensation, and pension
examiner. So today, wanna comeon and talk about a really
important topic that affects alot of veterans, and that is
alcohol use disorder and howthat can be related to VA
disability. So did you know thatalcohol use disorder is one of
the most common challenges facedby veterans and that it can also
(00:28):
be connected to your VAdisability benefits.
Not in the most straightforwardway that you always would think
about, but in today's video,we're gonna be breaking down
alcohol use disorder, how itimpacts veterans, what the
research says, how it can leadto serious medical conditions,
and what the VA means when theytalk about willful misconduct,
and and substance abuse andalcohol or substance abuse. So
(00:51):
stick around until the end wherewe're gonna share some resources
that could help you or a lovedone. So okay. So let's try to
understand alcohol use disorderin veterans. Right?
So alcohol use disorder or AUDis more than just drinking too
much. It's a medical conditionwhere alcohol use leads to
distress or harm. For veterans,alcohol often becomes a way to
(01:14):
cope with, combating stress,trauma, or physical pain. Now
the VA recognizes alcohol usedisorder as a serious condition,
but here's the catch. VAdisability benefits usually
aren't gonna be granted foralcohol use disorder as a
primary condition.
However, the story doesn'treally end there because alcohol
use disorder often connectsother serious health issues that
(01:36):
may be considered, serviceconnected, so, like, as a
bridge. We've talked about a lotof different things that can be
used as a bridge to anothercondition, like obesity as an
intermediate step, sometimesmedications. You know, things
like smoking, we have a video onas well. So if you have a
service connected disabilitythat is going to influence that
alcohol use disorder or thatsubstance use and it leads to
(01:59):
another condition, you might beable to be service connected for
that. So let's talk about whatsome of the research says.
So research shows that veteransthat are are at a higher risk
for alcohol misuse compared tothe general population. In fact,
VA studies have found thatnearly one in ten veterans
struggles with substance usedisorder, and alcohol is by far
the most common. Other studieshave highlighted strong
(02:21):
connections between alcohol useand conditions like PTSD, TBI,
traumatic brain injury, andchronic pain. So many veterans
report using alcohol as a formof self medication.
Unfortunately, that not onlyincreases risk of depression,
suicidality, you know, it worseit can worsen other medical
conditions and physical health.
(02:42):
So alcohol use use disorder israrely just one problem on its
own. It's often part of a largerhealth picture. So how how can
alcohol use disorder lead toother conditions? So alcohol use
disorder can cause otherdisabling medical conditions
like I mentioned earlier. Sothis is a key part of
understanding how it ties intoVA disability.
(03:05):
So here are a few examples. Longterm alcohol use can damage the
liver, leading to things likecirrhosis or liver failure,
fatty liver disease. Heavydrinking often leads to weight
gain, which raises the risk ofthings like type two diabetes,
hypertension, and heart disease.We have a ton of other videos
about obesity and how that can,bridge to other conditions as
(03:25):
well. And, again, I've I'veoften seen cases where alcohol
use related to the mental healthcondition sort of ties in to the
weight gain as well leading to,again, diabetes, hypertension,
heart disease, etcetera.
So chronic alcohol use cantrigger stomach ulcers,
pancreatitis, nerve damage, andeven cognitive decline that
looks like dementia or worseningbrain injury symptoms. In these
(03:50):
cases, alcohol use disorderbecomes the bridge to serious
chronic medical conditions. Andwhile the VA may not grant
benefits directly for alcoholuse disorder, those secondary
conditions like cirrhosis ordiabetes can qualify if they can
be linked back to your serviceor to your alcohol use. So let's
talk about willful misconduct inVA disability. So this is where
(04:10):
things get complicated with theVA's rules on willful
misconduct.
So by law, VA usually is notgoing to grant disability
compensation for conditionscaused by a veteran's own
willful misconduct. If the VAbelieves that your alcohol use
was purely a matter of personalchoice or reckless behavior,
they may deny your claim. Butand this is a big but. The
(04:31):
situation changes if the alcoholuse disorder develops as a
symptom of another serviceconnected condition. For
example, if you start drinkingheavily to cope with your PTSD,
depression, or chronic pain, theVA may now view the alcohol use
disorder and any conditionscaused by it as secondary to the
service connected issue, notjust willful misconduct.
(04:52):
So that's why medical evidenceand documentation and your
personal history are soimportant. The line between
willful misconduct and a serviceconnected disability isn't
always clear, and how your caseis presented can make all the
difference. So I wanna talkabout some resources for
veterans. I'm gonna pull up awindow on va.gov here in a
second. But if you or somebodyyou love is struggling with
(05:14):
alcohol use, you don't have toface it alone.
So let's see. Let me let me justshift over here really quick to
this other screen I have. K.Okay. This is va.gov.
(05:36):
I like to come on va.gov a lotbecause they have a lot of
really great resources. So asyou can see, this is, I just
looked up va.gov, you know,alcohol use disorder, and it
brought me here. So substanceuse treatment for veterans, and
it just outlines what servicesVA offers. So there's
medications, medically manageddetox for substance abuse. Drug
(06:01):
sub drug substitution therapiescan be used for cravings.
There's opiate addiction. We'renot really talking about that
today, but there's some otheroptions for alcohol as well.
There's short term outpatientcounseling, intensive outpatient
treatment. They offer marriageand family counseling, self
help, groups, residential care,relapse prevention, special
(06:23):
programs for veterans withspecific concerns like women
veterans. And so there's somemore links here, treatment
options for substance use.
So I'm gonna click on that realquick. One second. Okay. So if
we get to this tab, it itactually has an overview of
different things. So we're gonnakey in on alcohol today.
(06:45):
And and, again, it talks aboutwhat alcohol use disorder is.
Twenty nine point five millionpeople in The US had an alcohol
use disorder in 2022. So so justsome statistics, right, some
signs of simp and symptoms ofalcohol use disorder. It says
you might have alcohol usedisorder if you experience two
or more of the 11 symptomslisted below, like things like
(07:07):
wanting to cut down or stopdrinking, experiencing cravings,
drinking more than you intended,spending a lot of time getting,
getting, drinking, or recoveringfrom drinking, neglecting your
responsibilities at home,continuing to drink even though
it's causing or worsening yourphysical and mental health
challenges, continuing to drinkthough it's causing relationship
(07:27):
problems, giving up importantwork, social, or recreational
activities, risky drinking inrisky settings that put you in
danger, developing tolerance,and experiencing withdrawal. So
then there's some effects herewhere it sort of goes into some
of those things that we talkedabout chronic diseases, harmful
medication interactions, justsome really good education.
(07:50):
And then there's a section hereon treatment, and it wants you
to talk it talks about local VAmedical centers. And then
there's a treatment and nextsteps page where it, again,
gives you some of those evidencebased therapies like CBT,
motivational interviewing,enhancement therapy. So it it
just gives you a lot ofdifferent resources that VA is
(08:13):
gonna offer to help and and, ofcourse, scheduling those mental
health appointments. So let mejump back over to my regular
screen. Okay.
So I hope this was helpful foryou guys to sort of untangle
some of the issues with alcoholrelated disorders because I know
a lot of veterans and theirfamily members suffer from this,
and there are a lot of resourcesout there. Also, you don't if
(08:34):
you're a veteran, there are alot of options even if you're
not service connected for a d VAdisability to get, resources to
help with this. I hope this washelpful to you guys. Again, I'm
I'm a PA. I assist veteranssometimes with medical opinions.
I'm not a legal professional. Soif you want help with your claim
or advice, you always wannacheck with an accredited legal
professional like a BSO,accredited claims agent, or
(08:55):
attorney. If you have troublefinding one of those, they're on
va.gov. You guys can go take alook. We've even got a video on
how to use the search tool onva.gov to find somebody like
that in your area or nationwideto help you.
So I hope this was helpful.Please drop some comments and
like and subscribe. Alright.Thanks, guys.
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