Red state workers at risk for losing disability benefits as Trump admin rewrites the rules

It’s never been easy to qualify for Social Security disability benefits. Christopher Tincher knows this firsthand.

Tincher began his working life in a coal mine in Aflex, Kentucky, as a teenager in the 1980s. As mines across the region shuttered, he turned to scraping grills at a Hardee’s, then cleaning office buildings at night, then stocking shelves and changing tires at a Walmart in Arkansas. Later, he was hired by a nearby town’s wastewater department. Often, he had to wade into sewage to fix equipment and clean out feces, needles and tampons entering the treatment facility.

In 2017, some of that liquid got into his work boots, which didn’t fit properly and had caused blisters to form. It soaked into his flesh, infecting his right foot all the way to the bone. Doctors cut his leg off below the knee so the infection wouldn’t spread.

Tincher was now a manual laborer on one leg, but he was denied disability benefits by the Social Security Administration the following year. On average, 65% of applicants are rejected, though some successfully appeal.

In Tincher’s case, it was partly because he was 48, and the agency’s rules give priority to disabled workers in their 50s, who are officially deemed to be nearing advanced age and therefore less able to switch careers or develop new skills.

Tincher got a prosthetic leg and went back to work, this time for a medical supplies delivery company. He did this for seven years, frequently in pain, he said. His other leg was almost always in a cast, due to further infected blisters and diabetic nerve damage, and his eyesight was rapidly deteriorating.

This February, he applied for disability again. He was desperate; he was in a wheelchair, and he’d had to move in with his son’s family in Cabot, Arkansas, because he couldn’t pay the rent on his trailer. And there just weren’t other, less physically demanding jobs available locally for someone with his experience: “About the best job I could’ve got would’ve been a door greeter at Walmart, but I don’t think they have those anymore,” he said.

Tincher is now 55, and reaching that age marker helped him qualify, in June, for just over $1,500 a month in Social Security Disability Insurance benefits. A three-time Donald Trump voter, he was approved just in the nick of time.

That’s because the Trump administration is rewriting the disability eligibility rules, ostensibly to modernize the program, in ways that will make it even harder for aging blue-collar workers like Tincher to get benefits. Hundreds of thousands just like him would become ineligible for aid.

These changes would fall disproportionately on some of Trump’s most loyal supporters in red states. Most affected would be 50- to 60-year-olds without a high school or college education who have, for decades, toiled in physically grueling jobs, including coal mining, logging, and factory and construction work. The five states where the highest proportions of people rely on these benefits are West Virginia, Arkansas, Kentucky, Mississippi and Alabama. Unlike New York, California and a few others, these states do not have their own disability insurance programs for workers to turn to amid federal cuts.

“The Trump administration does not think that simply being 50 years old is a disability,” said a senior administration official who would speak only on condition of anonymity. In the 1970s, when the current rules were written, the official said, many more jobs involved manual labor, but in the internet age that isn’t true anymore. Workers in their 50s with physical injuries are thus receiving disability benefits “when they don’t need to be,” given that they could get a more sedentary job in the modern economy.

The administration has also justified cuts like these on fiscal grounds: The federal budget deficit is massive, the Social Security retirement system could become insolvent in less than a decade and savings need to be found.

But the disability program is paid for, via payroll taxes, by its own trust fund, separate from the one for the retirement program. So reductions in disability payments would not help the retirement system stay afloat. Indeed, cutting eligibility for disability could result in more disabled workers claiming retirement benefits early, actuarial experts note, which would only increase pressure on the retirement system. Meanwhile, the money in the disability fund, which is projected to remain solvent through at least the end of this century, would just sit there, unused.

The Trump administration’s upcoming proposed regulation would make two hugely consequential changes to the Social Security Administration’s disability system, according to four SSA officials with knowledge of the plans. First, it would modernize the job listings that Social Security’s disability adjudicators and judges use to decide if there’s work available in the U.S. economy that a manual laborer could do despite physical impairments — like a low-skilled desk job at a computer or driving for Uber or DoorDash. Second, the new rule would almost entirely remove age as a criterion, in most instances making a 50-plus-year-old like Tincher no more eligible for assistance than a 20-something.

Under the current system, eligibility for benefits ticks up at ages 50, 55 and 60, as workers become more medically vulnerable and less adaptable. Disability adjudicators use a series of grids that consider an applicant’s age, work experience and education level to determine whether they may have the skills to do another, less strenuous job. (The adjudicators make a yes-or-no decision on eligibility; each person who qualifies then receives a set amount based on their lifetime earnings. Once the person starts receiving Social Security retirement benefits, they no longer receive disability payments.)

The regulation that would undo this framework is slated to be formally proposed by December, according to a federal bulletin, although that deadline could push into next year, multiple officials said. The draft, which is based in large part on a plan that the first Trump administration tried to enact in 2020 before running out of time, still needs to be reviewed and edited by the White House’s Office of Management and Budget. After that, it will undergo the standard process of allowing the public to submit comments and objections.

But in its current form, the regulation would slash at least 830,000 people’s eligibility for disability benefits, according to an initial estimate from the Urban Institute, an economic policy think tank. As many as 1.5 million could lose eligibility over the next decade, including the widows and children of workers. Disability attorneys and experts familiar with who most relies on the program contend that the numbers could be considerably higher.

Separately, the Trump administration is preparing a proposed regulation that would eliminate or sharply cut the Supplemental Security Income benefits of roughly 400,000 extremely poor and disabled people. This second regulation would reduce support for adults and children with severe disabilities who are living in low-income households, as well as elderly people living with their adult children on tight budgets.

Barton Mackey, a spokesperson for the Social Security Administration, confirmed in a series of emailed statements that the Trump administration is working on what he called “improvements to the disability adjudication process.” These changes would ensure that the disability system “remains current” and can be more efficiently administered, Mackey said, while also promoting “dignity in work.” (Mackey did not respond to a question about the change to the SSI program.)

Further “speculation on any proposed rule prior to it being published,” he said, “only serves to misguide public discourse and stoke fear in those who rely on disability benefits for economic stability.”

White House spokesperson Kush Desai, in response to detailed questions, said that “President Trump will always protect and defend Social Security for American citizens” and pointed to Trump’s recent remarks commemorating the 90th anniversary of Social Security.

Retirement benefits — the largest and most popular of Social Security’s programs — would not be cut under the new regulation. But union leaders and advocates for older Americans said that the likely changes to disability eligibility for aging workers would undermine the financial and retirement security of working-class people and their families. Those who are denied benefits in their 50s would be forced to draw down any savings they have, which could lead them to apply for Social Security’s retirement benefits at age 62 instead of 67. That, in turn, would diminish their and their spouses’ monthly benefit amount by up to 30% until the day they die. Losing eligibility for disability would also block these workers’ access to Medicare, which they’re currently eligible for at their age precisely because they’re disabled.

Disability benefits frequently save recipients from bankruptcy, foreclosure and homelessness, according to research by University of Chicago economists and others.

George Piemonte, a former president of the National Organization of Social Security Claimants’ Representatives, has spent 30 years working on disability cases across the South. He emphasized that that’s where these disability cuts would be most acutely felt. “They call it modernizing the program, but that’s political speak,” Piemonte said. “This is a matter of life and death. If these workers don’t get their benefits, some of them are not even going to live to retirement.”

Social Security officials under both Republican and Democratic administrations have long agreed that the disability program needs to be modernized in some practical ways.

For example, disability adjudicators continue to use a Dictionary of Occupational Titles, created in the 1930s and last updated in 1991, to determine whether there are jobs that exist in “significant” numbers in the national economy that an applicant with declining “residual functional capacity” could still do. The DOT, as it is called, is almost comically outdated: It includes “pneumatic tube operator” but not web designer. (Reporting by The Washington Post has helped bring attention to these issues in recent years.)

Under President Barack Obama, the Social Security Administration and the Bureau of Labor Statistics undertook a yearslong effort to replace the DOT with what would be called the Occupational Requirements Survey, an updated catalog of modern occupations as well as the levels of physical exertion and cognitive difficulty that each job can entail. Field economists surveyed employers across the country, asking how often their employees typically had to climb stairs or lift items of various weights and so on. That detailed dataset now exists, but it isn’t widely used yet; the new regulation would require its implementation.

“So, the technical part of all this has sort of already been accomplished,” said David Weaver, a former top Social Security Administration official who helped to develop the survey, known as the ORS, during the Obama years. (Weaver is now a professor of statistics at the University of South Carolina.)

“But,” he added, “conservative economist types want to also make it harder for certain workers to get disability benefits, which would be a policy choice.” The complexity of the potential changes — the draft of the Trump regulation is hundreds of pages long and has been called the “mega reg” by insiders — has helped to mask this, Weaver and others said.

“Simplifying and Modernizing the Disability Adjudication Process” is how Mark Warshawsky headlined his written remarks when he testified in 2023 before a congressional subcommittee examining the issue. Warshawsky, an architect of the disability overhaul during the first Trump administration as the deputy commissioner for retirement and disability policy at the Social Security Administration, testified that the current system wrongly “presumes a workforce with low levels of education which is largely involved in physical labor, works long hours, has little flexibility in work schedules, low adaptability, little access to assistive technology, never works from home, and retires early fairly often.” He also said that increasing eligibility starting at age 50 is not very scientific; for starters, it’s unfair to 49-year-olds. (Warshawsky, who is now a senior fellow at the American Enterprise Institute, declined an interview request from ProPublica.)

Warshawsky was unable to get the disability regulation across the finish line before Trump lost the 2020 election. But Russell Vought, the powerful head of Trump’s Office of Management and Budget and one of the originators of Project 2025, picked up on this first-term agenda item and has pursued it again this year.

The disability restructuring was “Russ Vought’s No. 1 priority for the Social Security Administration from Day 1,” said Leland Dudek, who was acting commissioner of the agency from February to May. In February, Dudek said, his staff met with Vought’s staff on multiple occasions; together, they “dug up what was done four years ago,” he said, indicating that the new proposed rule will be similar to a 2020 draft that was leaked to the press. (The senior Trump administration official said that Dudek is “disgruntled” and that the disability changes are no more of a priority for Vought than the rest of the administration’s “deregulatory agenda.” In the past, Vought has publicly pressed for fewer veterans and others to receive disability benefits.)

To opponents of the forthcoming regulation, including many still inside the Social Security Administration, Warshawsky and Vought’s conception of the modern economy neglects the fact that workers like Tincher grew up in a different world. They started their working lives at a time when most people didn’t have personal computers, when it wasn’t as common to get a high school education and when physical labor offered a path to eventual retirement security. To switch the rules now pulls the rug out from under them just as they’re reaching their most vulnerable years, officials and experts said.

“I believe disconnects occur when more highly educated policy people do not fully understand or appreciate what workers in physically demanding, labor-intensive occupations, such as longshoremen, have gone through,” said Steve Rollins, who was deputy associate commissioner of the Social Security Administration’s Office of Disability Policy during the latter years of the first Trump administration and associate commissioner through the Biden administration. Rollins oversaw the agency’s work on modernizing the disability program from 2019 to 2024.

What’s more, vocational experts said in interviews, even if 50- or 60-year-old former coal miners or factory workers are denied the disability benefits they say they need, they’re still likely to retire early, a finding backed by recent research. After all, if they try to get a desk job — assuming one is available in their rural or exurban community — they may feel they don’t have the education or training for it, and they may also be subject to age discrimination in the hiring process. As Michelle Aliff, a certified rehabilitation counselor who testifies at Social Security disability hearings nationwide as an impartial vocational expert, put it: “An oil field roustabout in his 50s isn’t going to just sit down at a computer for work without additional training.”

The Trump administration’s plan to transform the U.S. disability system, once finalized, would interact with other cuts to the social safety net that the president and Republicans in Congress have already authored. For example, under legislation dubbed the One Big Beautiful Bill Act and signed into law by Trump, work requirements will be added to Medicaid; people with disabilities will largely be exempt, but the best way to establish eligibility for that exemption is to qualify for Social Security’s disability program, which would become harder under the new rule. A disabled worker could instead turn to Obamacare’s individual exchanges for insurance coverage, but Republicans are allowing the tax credit that makes those premiums affordable to expire.

Tincher feels lucky he applied when he did. Being approved for disability has meant his copays are covered, he can finally afford groceries and he has time to help watch over his grandkids. Still, he also feels a tinge of guilt. “I wish every day I could still work,” he said. His dad, a coal miner, once told him to work until the day he died. “Having to ask for help is hard especially for men to do, men of my generation.”

All Tincher would say to the officials pushing the changes to the disability program, he said, is “you don’t know until you’re here, at this point in a working life.”