Background: Opioid dependence is growing at an alarming rate in the United States, and opioid dependent patients have substantial medical, as well as psychiatric, conditions that impact their ability to work. This study evaluated the association between antisocial personality disorder (ASPD) and receipt of physical disability payments in methadone maintenance patients. Methods: Using data from 115 drug and alcohol abusing methadone maintained patients participating in two clinical trials, baseline characteristics of individuals receiving (n = 22) and those not receiving (n = 93) physical disability benefits were compared, and a logistic regression evaluated unique predictors of disability status. Results: Both an ASPD diagnosis and severity of medical problems were significant predictors of disability receipt, ps <.05. After controlling for other variables that differed between groups, patients with ASPD were more than five times likelier to receive physical disability benefits than patients without ASPD (odds ratio = 5.66; 95% confidence interval = 1.58-20.28). Conclusions: These results demonstrate a role of ASPD in the receipt of disability benefits in substance abusers and suggest the need for greater understanding of the reasons for high rates of physical disability benefits in this population. (C) 2013 Elsevier Ireland Ltd. All rights reserved.