Mar 2, 2022

Harder To Win In Rural States Which Are Mostly Red States

      From Blue Virginia:

Recent data from the Social Security Administration (SSA) shows that rural states are more likely to have low disability claim approval rates as compared to more urban states.

Of the top 15 states with the lowest disability claim approval rates, Oklahoma (30 percent), Hawaii (30.2 percent), and West Virginia (31.9 percent) have the lowest overall approval rates.

Seven of the remaining 15 states have approval rates that fall at or below 35 percent: Alabama (32.3 percent), Kentucky (32.9 percent), North Carolina (33.5 percent), New Mexico (34.4 percent), Florida (35 percent), Indiana (35.2 percent), and Maryland (35.9 percent).

The other six states have marginally higher approval rates. Still, they fall below the national approval rate average of 41.7 percent: Montana (36.2 percent), Utah (36.2 percent), Arizona (36.4 percent), Mississippi (36.6 percent), Georgia (36.7 percent), and Tennessee (37.9 percent). ...


16 comments:

Anonymous said...

This data would be more meaningful if paired with per capita application rates. There may be a correlation between the two. Would higher per capita application rates result in lower overall allowance rates?

Drew C said...

9:08

Agreed. Poorer rural states like Kentucky and Alabama have a much higher per capita rate of disability compared to states like New York. Without knowing the per capita rate of application this stat is not especially revealing on its own--and could be used as a talking point by conservatives that blue states are exploiting the disability process.

Anonymous said...

Here's the irony as to lack of access to health care: people are sicker in those states, but medical records are inadequate to support disability.

Anonymous said...

10:33 has it in one. Its an evidence issue.

Anonymous said...

@10:33

While my state (AZ) has absurdly low award rates, we do reasonably well with over double the award rate average on claims we represent. Between doctors who are unwilling to cooperate, and a few unreasonable ALJs, it's a significant struggle. Feels good at least to know we are being effective. I would note, because AZ surprisingly expanded medicaid and the ACA, almost overnight there was a notable increase in medical treatment.

Anonymous said...

I thought Hawaii ALJs averaged like 80% approval or something.

Tim said...

"Between doctors who are unwilling to cooperate, and a few unreasonable ALJs, it's a significant struggle."

This is at least as much of a factor (or more so) than anything else. A mountain of evidence can be ignored by a "sceptical" ALJ. How else do you get 20-25% approvers? I know of someone who is 62, can't stand for long, has breathing (covid related) and heart problems and is obese. Orher problems too (knees, etc.). His doctor (woman in 30s) won't help him because, "she told him to lose wait and he hasn't."

Anonymous said...

So the firm that paid for that sponsored content basically plagiarized and shortened an article from a few months ago?

https://www.enewscourier.com/news/disability-claims-challenging-in-rural-areas-data-shows-low-approval-rates/article_ca876d8e-38db-11ec-9bd7-6bc9d3d51cb8.html

I came across the original article trying to find the data used on the Blue Virginia “story.”

Anonymous said...

10:33 & 11:05,

Is the idea that people in states like West Virginia are sicker just a hypothesis, or is there some research to back it up? I'm not necessarily discounting it, I just haven't seen any evidence one way or the other.

I've read that West Virginia has the highest percentage of adults on disability benefits (20%), which means that they must have managed to generate some medical evidence. Those people get government-subsidized health insurance, which provides greater access to health care. Are the 20% with disability benefits and insurance getting better and going back to work in droves, or are they permanently disabled? Is it even possible to use a return to work as a metric in West Virginia, where there may be few local jobs that pay enough to outpace disability benefits?

Also, if we assume that a large number of people in West Virginia are disabled in part because they lack access to adequate health care, but their condition doesn't improve once they obtain SSI and Medicaid, then do we have to assume that West Virginians are more prone to chronic illness for reasons other than limited health care? I suppose it's possible that they receive just enough health care to prove their disability claims and obtain insurance, but then stop going to the doctor for one reason or another.

I don't have the answers, but I'm not as confident as you are that people in places like West Virginia are sicker, and that they're denied only because they can't prove how sick they are. It's also plausible that people in economically depressed states apply for disability benefits in greater numbers, and that many of those claims are denied because the claimant would be capable of working if there were more local jobs.

Anonymous said...

This is sponsored content, not a legitimate news article. Take it with a grain of salt.

Anonymous said...

This article is pretty interesting about how some states have low approval rates.

https://socsecnews.blogspot.com/2022/03/harder-to-win-in-rural-states-which-are.html

"Lowest Average Disability Approval Rates by State

Of the top 15 states with the lowest disability claim approval rates, Oklahoma (30 percent), Hawaii (30.2 percent), and West Virginia (31.9 percent) have the lowest overall approval rates.

Seven of the remaining 15 states have approval rates that fall at or below 35 percent: Alabama (32.3 percent), Kentucky (32.9 percent), North Carolina (33.5 percent), New Mexico (34.4 percent), Florida (35 percent), Indiana (35.2 percent), and Maryland (35.9 percent).

The other six states have marginally higher approval rates. Still, they fall below the national approval rate average of 41.7 percent: Montana (36.2 percent), Utah (36.2 percent), Arizona (36.4 percent), Mississippi (36.6 percent), Georgia (36.7 percent), and Tennessee (37.9 percent)."

Notes: We all knew this anyway. I supervise attorneys in Cali, Arizona, Utah, Nevada, and some in New Mexico. In Arizona, it is usually 1 or 2 ALJs who drag down the approval rate. In Utah, it seems the same in Utah w/ a few bad ALJs spoiling the approval rates.

In Cali, I have seen more restrictive ALJs in more higher income OHO locations like Santa Barbara, West LA, and San Diego. The SSA seems to plant the more restrictive ALJs in higher income areas. In contrast, the more lenient ALJs seem to be in more liberal areas like Downtown LA, Norwalk, and Long Beach. So it goes both ways.

"How Judges Affect Disability Approval Rates

Though judges are supposed to be impartial and operate under specific federal rules and regulations, several disability lawyers and advocacy groups have suggested that judges' decisions are affected by internalized biases. One representative from the Tennessee Disability Coalition referenced a recent claim denial and alleged that it was based on the judge's bias toward the applicant's history of alcohol and drug use rather than evidence (or lack thereof) of a disability.

But any prevalence of bias was discounted by Patti Patterson, the regional communications director for the SSA office that represents eight Southern states. She reiterated that judges are bound by impartiality rules and said that judges go through additional related training throughout their careers."

Notes: Wow the SSA regional communications director really can spin things. This is just complete nonsense. All judges have some sort of bias or prejudice just like any trier or fact like a juror. In fact, it is good if an ALJ brings some sort of personal experience to each case.

I have told many claimants that most ALJs do not want to give SSD/SSI to claimants who are addicted to drugs or alcohol. It just is a fact. ALJs and their writers will come up with ways to deny based on DAA even if the problems are non-related like orthopedic problems.

The SSA really knows how to bloviate.

Anonymous said...

I know a couple of those judges who will deny anyone with any history of substance abuse. One questions the claimants in a matter in which he appears to be determining if they are morally worthy of receiving benefits. The regulations are so vague that, in a large percentage of cases, a judge can find things to justify going either way. Other judges absolutely will not give benefits to anyone in their 20s unless they are on their deathbed. I've seen some denials on people who are severely mentally ill and there is no way they could function in the workplace but they are denied based on their age. One of these, we have statements from 4 treating providers but the claim was denied because the opinions of the treating providers were not consistent with the opinions of the DDS consultants. Another thing I've noticed is that, because courts review based only on substantial evidence, that is the standard of proof that many ALJs apply. If they can find substantial evidence to support a denial, that is what they do. The standard shouldbe preponderance of the evidence but I never see that in decisions and never see any real weighing of the evidnece. The new regualtions use the word "persuasive" which, in my opinion, is a lesser standard than the preponderance standard.

Tim said...

If "substantial evidence" is all that is required to uphold a denial, then, in effect, you need "beyond a reasonable doubt" (or even beyond an "unreasonable" doubt) in order to insure an approval. Too many disabilities are, by their nature or limits of technology, unprovable at this standard of "proof."

Anonymous said...

ALJs (SSA's glorified title for hearing examiners) overall do not understand the preponderance standard and consistently apply clear and convincing or for many GOP-voting ALJs, beyond a reasonable doubt. They take their politics into their decision-making

Tim said...

Preponderance isn't that hard. Technically, it's 50.000000000001% I know that's a slight exageration. It simply means "more likely than not." Take schizophrenia. There is ZERO "objective evidence" to support it. ZERO. This simply means we have NO TESTS that can confirm it. But, that doesn't mean that it doesn't exist. Much of medical science is more of an art than "objective" and is therefore subjective in its application. The problem lies when a "sceptic" expects evidence that cannot be supplied by medical science...at least until someone invents the tricorder. So, the evidence is based upon the opinions of people who have examined and those who have not examined a particular person and the statements of that person and others. The issue here is that a real court would never value the opinion of someone with no direct knowledge at anything close to one with direct knowledge. It's like putting the same weight of a trained eye witness to an accident and overruling their opinion based upon someone who read about it in a newspaper.

Anonymous said...

Snowballing factors. Rural states have:

1. Poorer access to healthcare, leading to a dearth of medical history.
2. Poorer education, meaning the claimant is less effective representing themself, preparing for interviews and answering questions.
3. A greater antipathy to disability and disability recipients, thanks to decades of cultural poisoning by the Grand Ole Party.
4. #3 doesn't just affect claimants, it affects SSA and DDS employees. I moved from a blue state to a red state, and the personal disdain in my office for claimants is stomach-turning at times.