Map shows the percentage of the population in each county that receives Social Security Disability Insurance payments;
click on the image to enlarge it; click on the story to view an interactive version with data for each county.
"Changes to the Social Security Disability Insurance program proposed in January by the Trump administration could make it harder for over 8 million Americans with disabilities to maintain federal benefits. That’s particularly true for those in rural communities, where we have worked and studied for the past 35 years," Lillie Greiman and Catherine Ipsen write for The Conversation.

Almost 8.4 million people receive an average of $1,200 a month in Social Security disability benefits. In each case, a judge has ruled that the person is unable to hold a job because of a mental or physical impairment, but they must undergo periodic reviews to prove that they're still unable to work. Reviewers classify recipients into one of three groups: Medical Improvement Expected, Medical Improvement Possible, and Medical Improvement Not Expected. Recipients deemed more likely to improve get more frequent reviews, Greiman and Ipsen write.

The Trump administration is proposing a fourth category, which would be called "Medical Improvement Likely." The government expects that about 1 million now categorized "Medical Improvement Possible" would probably move to the new category and get more frequent reviews, leading to more benefit terminations and saving about $200 million a year. "These proposed changes are based on research from the Office of Research, Demonstration and Employment Support showing that, after losing benefits based on a review, 70 percent of people had some earnings within the next five years. However, this research also shows that a majority continue to live below the poverty line," Greiman and Ipsen write.

They say adding the fourth category would disproportionately affect rural residents, who would have a harder time appealing terminations and finding work. Appealing a benefit termination is a lengthy process that often requires travel to a Social Security office or court. That can be a barrier for those without access to transportation, especially for in rural areas, where there are fewer offices.

Rural residents who lose benefits are more economically vulnerable than their urban counterparts overall, Greiman and Ipsen write. Not only are rural residents 5 percentage points more likely to be disabled than urban residents, but they tend to develop disabilities at a younger age. On top of that, "access to economic opportunity is not equally distributed across the U.S. Our research group’s work shows that rural Americans with disabilities are still trying to recover from the recession," they write. "Overall, fewer rural people with disabilities have jobs now than did in 2008 – this at a time when the U.S. unemployment rate is at historic lows. The drop in employment is particularly pronounced across a few geographic areas, including the Mid-Atlantic, Southern, Mountain and Pacific regions."