Are findings of disability in rural areas on the decline?

The headline in the Athens (Georgia) News Courier is, "Disability claims challenging in rural areas; data shows low approval rates."  The story is from last October, though it just showed up in my Twitter timeline yesterday.  Here's an excerpt:  

Getting approved for disability payments from the Social Security Administration isn't easy, but depending on where you live, it could be even harder.

In North Alabama, for example, three of the judges who hear disability claims have the lowest approval record of any administrative law judge in the state; two of them also have among the lowest approval rate of any of the 12,000 judges nationwide.

In 2020, 39% of initial disability applications were approved nationwide, according to SSA data. August 2021 data shows that Alabama has the fourth lowest disability claim approval rating — 32.3% — while nationwide data shows a 41.7% approval rate.

Receiving disability payments isn't easy to begin with and that's by design. In the past decade, the Social Security Administration has changed the regulations to make it harder to get disability claims approved.

Social Security has a tight definition of disability: "the inability to engage in substantial gainful activity (work) due to a medically determinable physical or mental impairment that has lasted or is expected to last at least one year or to result in death," said Patti Patterson, regional communications director for the Atlanta region Social Security office, which represents Alabama and seven other Southern states.

The Social Security Disability website lists a range of impairments and disorders that could qualify for disability including mental, respiratory system, immune system and cardiovascular system if it is deemed through medical records to be severe enough to prevent one from working. 

Many disability applicants think they'll only need a letter from their doctor saying that they need to be on disability. Not only has it never been that simple, but in 2017, the Social Security Administration made it even easier to dismiss the recommendation of doctors by allowing denial due to the doctor's specialty, and length of treatment and type of treatment, among other factors.

Rachael Henderson of Georgia Legal Services Program, which represents disability clients in 155 counties outside of metro Atlanta, said access to transportation has been a longstanding barrier in rural counties where its clients have tried to get disability.

“In rural areas you will frequently not have any physicians. Over the last few years in some of our rural areas, in one or two counties, they lost the hospitals,” she explained. “You have to get to a city of significant size in order to get to a physician."

You'll find lots of other posts about disability determinations in rural places, and associated issues, here.  Certainly, this article flies in the face of the assumption that it is easier to get adjudicated as disabled in rural America than in urban America.  Specifically, here is a post focused on disability and transportation, in the context of New York.  And this is from a Washington Post series in 2017.