The Administrative Burden Experienced by U.S. Rural Residents Accessing Social Security Administration Benefit Programs in 2024

Abstract

Grounded in the existing literature on administrative burden and using a qualitative and community-engaged research approach, the research examined the administrative burden experienced in accessing disability, retirement, and survivor benefits from the Social Security Administration (SSA). The research team held in person and virtual focus groups and interviews with 40 adults with disabilities, older adults, and family members of people with disabilities who resided in rural areas of the U.S. State of New Hampshire in 2024. The qualitative analysis revealed that rural residents, regardless of type of SSA benefit receipt, were experiencing high levels of administrative burden in their interactions with the SSA and preferred to turn to in-person assistance at local SSA field offices (rather than phone, mail, or web-based service options) to address these concerns. Overall, people living in rural counties that do not have local SSA field offices voiced a distinct disadvantage in terms of knowing where to turn with questions about their benefits. A lack of ready and reliable access to information and advice led to endangering their own economic stability and to increased calls and visits to the SSA. Persons with stronger social networks were better able to overcome these barriers to services.

1. Introduction

The Social Security Administration (SSA) administers social insurance and income assistance programs that improve economic security for many U.S. residents by providing monthly benefits (i.e., income) to eligible individuals (Romig 2023a). These programs provide particularly important sources of support for low-income families by reducing poverty rates (Meyer and Wu 2018; Shrider 2024; Bailey and Hemmeter 2015). In fiscal year 2024 (FY24), Old-Age and Survivors Insurance (OASI), the program that provides monthly retirement and survivor benefits to qualified workers and their family members, provided benefits to an average of 59 million people per month (Social Security Administration 2024a). Disability Insurance (DI) provided benefits to over eight million workers who became disabled and their families each month in FY24 (Social Security Administration 2024a). Supplemental Security Income (SSI) provided monthly benefits to an average of 7.4 million older and disabled adults who had limited income and resources in FY24 (Social Security Administration 2024a). Older adults who meet eligibility for two programs can concurrently receive OASI and SSI, while disabled working-age adults can concurrently receive DI and SSI. Nearly 2.5 million individuals received benefits concurrently (Social Security Administration 2024a). People who reside in rural areas of the U.S., areas that have a lower population density than urban or suburban areas, have lower educational attainment rates and higher unemployment rates than non-rural residents (Farrigan et al. 2024). People living in rural areas rely more heavily on SSA benefits as a share of personal income and are more likely to participate in Old-Age and Survivors’ and Disability Insurance programs than others (Bishop and Gallardo 2011; King et al. 2007; Michaud et al. 2019). Despite this overrepresentation of SSA participation among people living in rural areas, rural residents may face higher barriers in accessing information from and communicating with government offices. This study provides new in-depth information about how rural U.S. residents were experiencing interactions with the SSA in 2024, providing baseline evidence that should inform current SSA administrative and policy changes.

2. Literature Review

Administrative burden is a term that is used to describe the onerous nature that citizens encounter when interacting with the government (Halling and Baekgaard 2024; Moynihan et al. 2015). Such burdens can be conceptualized as occurring in three areas: learning costs, compliance costs, and psychological costs (Herd et al. 2023). Learning costs are the challenges that people face finding out about a program, its application and eligibility criteria, and its benefits (Herd et al. 2023, p. 4). Compliance costs involve the time and effort spent on administrative tasks such as filling out forms, driving to government offices, waiting on hold for phone services, documenting status, and responding to bureaucratic requests (Herd et al. 2023). Psychological costs are the anxiety, stigma, and stress caused by applying for or maintaining access to benefits and services (Herd et al. 2023; Savin 2025).

Higher levels of administrative burden can hinder access to services and benefits and can reinforce existing social inequities (Chudnovsky and Peeters 2021; Halling and Baekgaard 2024; Herd et al. 2023). Administrative burden is experienced differently by different subpopulations, with people living in poverty, people with disabilities, and people with limited social networks experiencing higher levels of burden compared to others (Carey et al. 2021; Christensen et al. 2020; Chudnovsky and Peeters 2021; Herd 2023). Many of these same individuals experience stigma for seeking or receiving public benefits, which may serve as a further barrier to equitable access (Whittle et al. 2017).

As the required administrative processes vary by the type of SSA benefits, the levels of administrative burden experienced may vary across beneficiary types. For example, applying for retirement or survivor benefits is straightforward with shorter estimated times to fill out forms and handle in-office processes, fewer requirements for providing outside documentation, and much shorter processing times before benefits are awarded as compared to applying for disability benefits. The application process for disability benefits can be especially cumbersome, comprising multiple steps that take an average of 232 days to process (Social Security Admnistration 2024b). People with certain types of disabilities or multiple health conditions may face distinct disadvantages in navigating the disability benefits application process (Bell et al. 2022).

The quality of frontline service delivery and government communication can increase or decrease administrative burden (Halling and Baekgaard 2024). A scoping review that examined the communication preferences of populations served by a variety of government programs, including those provided by SSA, identified agency communication with rural populations as an area in need of more in-depth study (Henly et al. 2023). This synthesis of prior research found that the mode of communication affects the public’s knowledge and benefits enrollment and that communication approaches that consider community-specific contexts are most effective. In addition, this research highlighted some of the unique barriers that people residing in rural areas might face, including lack of Internet access, no local government offices to visit in person, or a lack of transportation. Specific to SSA disability benefits, the research has noted that providing more information to potentially eligible populations and reducing learning costs increases applications to SSI and DI (Armour 2018; Bailey and Hemmeter 2015), and that simplifying the online application process, a form of reducing compliance costs, increases DI application rates (Foote et al. 2019).

Other research has shown that restricting access to SSA field offices increases the administrative burden and decreases application rates because applicants need to travel further to access in-person services at field offices that are processing higher volumes of applicants (Deshpande and Li 2019). With recent changes to the availability of local SSA offices, this research provides additional insight into the increased learning, compliance, and psychological costs rural residents face in accessing their SSA benefits. Additional research has highlighted the inverse relationship between higher rates of poverty and lower access to social services found in rural counties in the U.S. (Shapiro 2021). This suggests that people living in rural areas have less access to formal social networks (e.g., case managers at health or social service agencies; advocates) which may further hinder their ability to learn about and apply for SSA benefits when eligible (Boswell and Smedley 2023).

Further, although the SSA has increased access to online services, SSA agency staff in rural areas have noted continued challenges with slow Internet speeds and low bandwidth (Government Accountability Office 2022). Without consistent Internet services, SSA beneficiaries experience heightened levels of disadvantage. As a recent GAO report noted:

(SSA) faces challenges reaching and providing services to certain groups who may face disproportionate barriers, including a lack of consistent access to technology. These vulnerable populations include older adults, those with limited English proficiency, those experiencing homelessness, those in rural areas, individuals with low incomes, individuals with disabilities, and those without legal representation in the disability appeals process. The transition to remote services disproportionately affected vulnerable groups, according to those we interviewed, because of their previous reliance on in-person services. (Government Accountability Office 2022, p. 33).

The SSA’s administrative budget aims to efficiently serve the needs of a growing number of beneficiaries within the complex framework of federal regulation while also keeping fraud prevention efforts on track. In the last few years, reductions in the SSA’s administrative budget have substantially reduced its staff and resources and impacted its ability to effectively serve all eligible beneficiaries (Romig 2023b). This fiscal pressure may require the SSA to rely more heavily on automated or electronic processes rather than hard copy or in-person forms of service delivery. New administrative budget reductions and proposed field office closures may further hinder access to SSA services for people living in rural areas (Butrica and Schwabish 2025; Thorpe 2025).

As the SSA strives to ensure it is providing equitable access to support communities with these limited levels of resources, understanding the impact of the current service delivery environment on certain subpopulations is particularly important (Farid et al. 2024; Sizemore et al. 2024). With this background in mind, we embarked on a community-engaged research project to explore how rural disabled and older adults are interacting with the SSA, and to identify action steps at both the community and the SSA levels that can improve communication and service delivery.

3. Materials and Methods

Community-engaged research approaches, which involve people with lived experience in intentional, meaningful ways to guide the research process, provide research outputs that better align with community needs (Daley et al. 2010; Harb and Taylor 2024; Israel et al. n.d.; Joosten et al. 2015). Figure 1 shows how we engaged with members of the community at various stages of our study: (Stage 1) at the outset of our study, (Stage 3) after data collection; and how we will engage again, and (Stage 5) at dissemination; after final publication of our results.

3.1. Stage 1 Community Engagement

Before beginning the data collection phase of our study, we sought input from a dozen community members in New Hampshire (NH), including those with lived experience with disability, family members of persons with disabilities, older adults, and other stakeholders to refine research questions, develop our focus group protocol, and solicit recommendations for recruitment. For the purposes of this study, we term these individuals community advisors. Most of these community advisors had personal experience with the SSA as beneficiaries. In this phase of the project, we shared an overview of our project, a draft focus group guide developed based on prior research (Henly et al. 2023), and our initial ideas about recruitment strategies with these community advisors to solicit their input. We recruited community advisors for this first phase of community input through our contacts at the University of New Hampshire’s (UNH) Institute on Disability. Due to a logistical need to accommodate schedules, four separate meetings were arranged, with community advisors participating in one meeting each. Of the four meetings, two meetings were one-on-one meetings held over Zoom. One meeting was hybrid, with one member of our research team attending in person, one attending on Zoom, and nine attendees. The final meeting was conducted one-on-one by phone. Advisors in each meeting were asked to provide the same type of input.

At each meeting, we first described our overall study aims and clarified that we were only seeking input on possible focus group questions and recruitment methods and that we could not use any information from these meetings as ‘research results’ as we were using this formative stage of community engagement to inform the development of our Institutional Review Board (IRB) materials. In essence, the community advisors who participated in this stage were considered research collaborators, not participants. Each meeting lasted approximately 30–45 min. We reviewed the draft set of focus group questions developed by the research team and solicited recommendations for improving the types and content of the questions, adding additional questions, or removing some. Once the reviews and discussions were complete, we asked for suggestions about how we could best recruit people to participate in our focus groups. Last, we asked community advisors if they would be willing to reconnect with us after we completed our data collection to help discuss and provide input into interpreting our findings. Most of our community advisors participated in their capacity as members of a larger, long-term statewide community advisory council, for which they were compensated. Two advisors were not compensated.

All community advisors were white. Most of the 12 community advisors were from rural counties. Only two were from non-rural counties. We had diversity in age, sex, and connection to the older adult and/or disability communities. The youngest person we spoke with was a 30-year-old male who had a disability. The oldest person who contributed input at this stage was a female in her 70s, who was also a family member of an adult person with a disability. Overall, we met with three people with disabilities, seven people who were family members of people with disabilities, and two people who were involved with disability advocacy or direct support professional roles. Of these twelve, two were older adults as well as family members of people with disabilities. As mentioned, many of these people, who were familiar with DI and SSI, also had experience with other SSA benefits, including retirement and survivor benefits, and, thus, represented an appropriate community to guide this study.

The feedback from the community advisors slightly changed our research aims to focus more on understanding the lived experience of SSA applicants and beneficiaries in terms of their communications and customer service experiences with the SSA and less on how sociodemographic differences might influence such experiences. Our final set of research questions were: (1) What barriers do people living in rural areas face when applying for and maintaining SSA benefits? (2) How have rural residents experienced interacting with the SSA in terms of comfort level and satisfaction with timeliness, ability to obtain the answers needed, and understandability of the information provided? (3) How do rural residents experience providing necessary documentation to the SSA? (4) How have rural residents been satisfied with the service they experienced when visiting their local SSA field office? (5) How comfortable and/or able are rural residents with using technology (e.g., online, by smartphone) to communicate with the SSA? (6) What recommendations do rural residents suggest community-level organizations and/or the SSA implement to improve interactions (or communication) with the SSA?

We submitted Institutional Review Board (IRB) materials to our institution’s IRB in the Spring of 2024 and were approved shortly thereafter.

3.2. Methods

3.2.1. Design

Overview of Focus Group and Interview Research

We held six focus groups and three interviews, achieving a final sample of 40 people. We provide details below about the characteristics of these data collection activities.

Location/Dates of Focus Groups and Interviews

Four of the nine focus groups and interviews were held virtually on Zoom. The five others were held in various community locations in rural counties in NH.

Table 1. Focus groups and interviews.

	Total Participants	Date	Meeting Location (All Rural NH Counties)
Focus group 1	5	23 July 2024	Grafton County
Focus group 2	5	23 July 2024	Grafton County
Focus group 3	3	22 August 2024	Virtual—Merrimack County
Focus group 4	8	17 September 2024	Grafton County
Focus group 5	2	26 September 2024	Virtual—Belknap County *
Focus group 6	14	23 October 2024	Carroll County *
Interview 1	1	24 July 2024	Coos County *
Interview 2	1	24 October 2024	Virtual—Merrimack County
Interview 3	1	25 October 2024	Virtual—Merrimack County
TOTAL	40

* County does not have an SSA field office.

shows the details of these focus groups and interviews. Counties that include an asterisk (*) after their names do not have a local SSA field office.

Study Setting

The study was based in NH and run by faculty and staff at a research institute within the state’s public university. The research institute is well connected with the local disability and older adult communities. The study was limited to rural residents in NH. NH is a geographically small state in Northern New England with a population of nearly 1.4 million people. Overall, half of NH’s 10 counties have a field office. Seven of its ten counties are classified as ‘rural’ according to the federal Office of Management and Budget (OMB) (Cromartie and Bucholtz n.d.), and four of these rural NH counties do not have a local SSA field office. Trust in government is low among NH residents, ranging from 44% having trust in local government to only 14% having trust in the federal government in 2019 (Mallory 2024). About 21% of NH’s population is aged 65 years and older and approximately 12% of working-age persons in NH have a disability (Thomas et al. 2025). NH’s population is predominantly white with 1.2 million people reporting as white alone, not Hispanic or Latino (88% of the population). NH has a slightly larger proportion of residents with a bachelor’s degree or higher (41%) than the nation as a whole (36%). In 2023, the median household income in NH was higher than the national median household income (USD 96,838 and USD 77,719, respectively) (United States Census Bureau 2025).

To provide some context for our target population,

Table 2. Rurality, SSA field office, and target populations by NH County 2023.

County	Rural	Has SSA Office	Focus Group Participant(s)	County Total Population	% with a Disability	% of Working Age Adults with a Disability	% Aged 65 and Over
Belknap	Yes	No	2	63,459	16%	13%	23%
Carroll	Yes	No	14	50,844	16%	14%	30%
Cheshire	Yes	Yes	0	76,273	15%	12%	21%
Coos	Yes	No	1	29,526	21%	18%	25%
Grafton	Yes	Yes	18	90,928	14%	11%	22%
Merrimack	Yes	Yes	5	151,745	15%	13%	19%
Sullivan	Yes	No	0	43,063	15%	14%	23%
Hillsborough	No	Yes (2 offices)	0	420,612	12%	10%	16%
Rockingham	No	Yes	0	315,032	11%	8%	19%
Strafford	No	No	0	130,021	14%	11%	16%
TOTAL			40

Note: Sourced from 2023 ACS 5-Year Data from Census Table Builder, Table ID: S1810.; Cells shaded in gray indicate rural counties.

shows the percentage of working-age adults with disabilities (among all working-age adults) and the percentage of older adults (among the total county population) for each NH County as of 2023. The table also notes whether a county is rural and indicates the counties in which SSA field offices are located. Rural counties generally have higher proportions of residents who are aged 18–64 who (1) have a disability, and (2) are older adults. Four of the seven rural counties in NH do not have an SSA field office.

On a national level, 71 percent of U.S. counties do not have a full-service SSA office or access to other options like video service delivery and resident stations (small SSA offices that only offer limited services) (Butrica and Schwabish 2025). This suggests that access across the U.S. is even more limited than it is in NH. Nationally, people who do have a field office in their county are able to travel to a field office within 20 min of their home. Others, who may be able to travel to a resident station or video service delivery station, face driving times of 80 min or more (Butrica and Schwabish 2025). These national distances align closely with the NH experience in that NH residents who do not have a local field office will have to travel an hour or more to a different county to access one.

Personnel Involved in Focus Groups and Interviews

Three research team members attended each focus group: Dr. Debra Brucker, Dr. Megan Henly, and Ms. Stacia Bach. Ms. Bach handled logistics, participant screening, recording/transcribing, and participant payments. Dr. Brucker reviewed informed consent, the meeting purpose, and the meeting structure at the start of each focus group. She and Dr. Henly both posed questions during the groups. All three took notes to supplement the transcription resulting from audio recordings. One or two members attended each of the interviews, which were also recorded and transcribed.

As we recognize that our own lived experiences may impact the lens through which we interpret the focus group feedback, we share some detailed information about our personae. The full research team included five members. In addition to the three listed above, two additional team members provided additional research and recruiting guidance and support for writing up the project results: Dr. Kelly Nye-Lengerman and Dr. Andrew Houtenville. All five research team members are white and cisgender. Four are middle-aged and one is a young adult. Four are women and one is male. Two people identify as neurodivergent. Two members of the research team have experience living in rural areas. Members of the research team have lived experience with chronic health conditions, mental health disabilities, substance use disorder, post-traumatic stress disorder, and law enforcement-induced trauma. The research team has educational backgrounds that include economics, public administration, public policy, social work, and sociology. Their work experience, outside of academia, includes experiences as a child protective social worker, a direct support professional, a professional guardian of a person with a disability, a psychiatric technician, a Social Security claims representative, and a social worker.

Description of Consent Process

At the in-person focus groups and interviews, a member of the research team verbally reviewed the IRB-approved consent form and then participants reviewed and signed the form. For the virtual focus groups and interviews, participants were mailed or e-mailed versions of the consent form prior to participation, and, in cases where participants had not been able to return signed copies prior to the focus group or interview, the research team provided a verbal overview and recorded verbal consent.

Facilitator Guide

The development of the draft guide was informed by the current literature, previous research conducted by members of the research team, and community advisor input, as described above. Our guide covered the following topic areas: (1) How and approximately when a participant heard about SSA benefits and decided to apply; (2) comfort levels in speaking or interacting with someone at the SSA (on the phone; in-person); (3) satisfaction with timeliness, accuracy of information, and clarity of information when interacting with the SSA; (4) experiences with paperwork; (5) in-person visits to field offices; (6) comfort using technology; and (7) community and SSA-level recommendations for improving communication/understanding of SSA benefits. A copy of the facilitator guide is included in Appendix A.

Participant Recruitment

After obtaining IRB approval, we worked with UNH partners, including community advisors, to assist us with our recruitment efforts to organize in-person focus groups within rural counties. Active recruitment occurred between May and October 2024. We initially used word-of-mouth and self-referral recruitment in the hopes of finding people who were not using social media or were not formally connected to local advocacy or service groups. In this phase, we e-mailed and mailed hard-copy flyers to local contacts, including libraries, disability and older adult organizations, and senior centers. We also placed ads in local printed newspapers. Recruitment using these strategies was slow, therefore, we shifted our strategy to include social media approaches in early July 2024. We also modified our IRB to allow for individual interviews (in person, by phone, or by Zoom) and for Zoom focus groups in addition to in-person focus groups. We redesigned our flyer, simplifying it for readability and accessibility. The new flyer did not explicitly detail the geographic region in which this study took place (NH’s rural counties). To determine if an applicant met the geographic inclusion characteristics, we asked which city or town they lived in and determined eligibility by the county in which their town is located. Leaving out this detail helped filter out potential scammers during the recruitment process who dishonestly reported meeting all eligibility criteria in order to receive the incentive being offered. We also shifted to using more direct outreach (e.g., phone calls, e-mails, and attendance at existing meetings to share study information) to specific organizations that we identified through our contacts at UNH. These direct approaches yielded a much stronger response. Reaching out to key personnel at community-based organizations was helpful, as they connected us to the communities they support and serve. All the in-person focus groups were a direct result of connecting with community-based organizations. They actively contributed to recruiting participants by promoting the study at their centers, and by helping interested community members apply for the study. We utilized their spaces to host the focus groups.

Criteria and Methods for Selecting Participants

Interested applicants reached out by calling or emailing the contact information on the flyer. A member of the research team followed up within two business days to schedule a time to conduct a screening call. During the screening call, the research team member followed a screening script that we had developed as part of our IRB package to determine whether the person met the following study inclusion criteria: (1) at least 18 years of age; (2) primarily speak English at home; (3) reside in a rural county of NH; and (4) meet one of the following three descriptions: (a) have a cognitive, communication, mental health, physical, or sensory (hearing/vision) disability which limits your ability to work; (b) are a family member of a person with intellectual and developmental disabilities who receives Social Security benefits; or (c) are near or in retirement age. After determining if they met the qualifications, we informed them of the time, date, and location of the focus group or interview.

In some cases, where focus groups were organized through a contact at a specific community-based organization, we conducted participant screening on-site. The screening process allowed us to provide more details about our study and participation expectations and ensured that participants met the inclusion criteria. During either the phone or in-person screenings, we also gathered some demographic information and collected basic information about how people currently or have ever interacted with the SSA. We captured this screening information in a spreadsheet so that we had full information about eligible candidates as we moved to scheduling focus groups and/or interviews in particular parts of the state. We enrolled people who met our screening criteria in the study by assigning them to attend a specific focus group or interview.

E-mail was a means for interested participants to contact us during this screening phase, however, it did lead to unwanted bot responses. Therefore, we had to screen out fictitious participants who had contacted us using bots (a computer application that automatically sends many e-mails from different e-mail addresses) or some other means. The monetary incentive made screening for bots important. Of the 62 verified real applicants for the study, 44 met our inclusion criteria and were invited to participate in the focus groups or interviews. In total, 4 of those did not follow through with participation, resulting in a final sample of 40 people.

Another challenge we faced was that some people who initially expressed interest were wary of the research team calling them back and asking for more information, given their concerns about possibly being scammed. We addressed these concerns by using a combination of emails and phone calls to verify that we were part of a legitimate research study based at a university.

Enrollment Process and Number of Participants in Each Group

We were most successful at scheduling in-person focus groups at local organizations when our meetings were held immediately before or after previously scheduled community events with our populations of interest. For example, we held two focus groups, one immediately before and one immediately after a free ‘congregate lunch’ and on location at a senior center. As another example, we met with an advocacy group at the end of their regularly scheduled meeting at a restaurant to coordinate member attendance at a focus group. We also held a focus group on-site at a U.S. Department of Housing and Urban Development (HUD)-assisted rental housing complex that houses older adults and persons with disabilities. We held our final in-person focus group on-site at a behavioral health peer support organization. As an alternative to these in-person focus groups, we also held three virtual Zoom focus groups and two individual interviews. Table 1 describes the focus group and interview features.

We audio-recorded the focus groups and interviews, and generated transcripts. We provided physical USD 50 gift cards to participants at the conclusion of each focus group or interview, in person for the in person events and by mail for the virtual events.

Participants

Table 3. Participant sociodemographic characteristics (n = 40).

Characteristics	Participants
	n	%
Age
Mean	64.4	-
18–34	3	7.5%
35–44	1	2.5%
45–54	5	12.5%
55–64	9	22.5%
65+	20	50.0%
Missing	2	5.0%
Gender
Male	11	27.5%
Female	28	70.0%
Other	1	2.5%
Race
White	37	92.5%
Other	3	7.5%
Education
Less than HS	2	5.0%
HS	19	47.5%
Some college & associates	14	35.0%
Bachelor’s or more	3	7.5%
Missing	2	5.0%
Disability
Yes	29	72.5%
No	10	25.0%
Missing	1	2.5%
County
Belknap *	2	5.0%
Carroll *	14	35.0%
Coos *	1	2.5%
Grafton	18	45.0%
Merrimack	5	12.5%

* No SSA field office.

provides sociodemographic information about our study participants. Most (n = 29) participants were age 55 and older, and most (n = 28) were female. Only three participants were non-white. More than half (n = 21) of the participants had a high school or less than a high school education. Twenty-nine identified as having a disability. All participants either received some form of Social Security benefit or were family members of a person who received a Social Security benefit.

3.3. Analysis

We entered the participants’ demographic information into a spreadsheet to allow for the compiling of descriptive statistics. We held research team debriefs after each interview or focus group to identify key themes that emerged from our conversations with participants. We then de-identified and uploaded transcripts into NVivo software, version 14 for analysis. One team member completed initial open coding within NVivo version 14, basing initial coding on the key themes identified in the debriefs, and having frequent iterative check-ins with the other team members to discuss emerging codes and themes. Once the initial set of codes and themes was agreed upon by the research team, one researcher completed coding all of the transcripts and shared the preliminary findings, in separate meetings, first with the rest of the research team, and then with the community advisors. The research team verified that the findings aligned with the research participants’ views that were expressed in the focus groups and interviews. Upon completion of the qualitative analysis, we invited our initial set of twelve community advisors to help us review and verify the findings at a virtual meeting. In December 2024, we held a virtual Zoom meeting where the three primary research team members presented our preliminary themes and illustrative quotes to the subset of this group that chose to attend. We asked the advisors to react to the identified themes and to share policy and practice suggestions at the community and SSA levels. The input received from the community advisors was helpful in verifying the trustworthiness of the qualitative findings.

We discuss each of the themes in our Section 4 below.

4. Results

The findings from the focus groups and interviews can be conceptualized as falling within four overarching themes, as shown in

Table 4. Thematic findings from the focus groups.

Themes
One: Applying for and Maintaining Benefits
Two: SSA Customer Service
Three: Technology Experience
Four: Recommendations to Improve the Beneficiary Experience

. While not all of the themes relate to administrative burden, we do denote in the narrative below where these themes overlap with the administrative burden literature. Please note that when we use the terms “many” or “most” in describing our findings, we are referring to more than half of the participants; “some” denotes more than one but less than half of the participants.

4.1. Theme One: Applying for and Maintaining Benefits

Most people seeking retirement or survivor benefits experienced low levels of learning, compliance, and psychological costs. They thought that the application process for these types of benefits was straightforward and that the receipt of benefits was efficient. Most people apply for these benefits without outside help. Some people, including this woman below, stated that their employers helped them with the process of applying for retirement benefits. She shared:

Oh, I started getting Social Security. I believe when I was 62, it may have been 62 or it may have been 65. I’m not sure which. But I had a very good experience. … I retired from ________, which was a wonderful place to work, and they helped a lot in telling me what I should be doing while I was doing the application.

These retirement and survivor beneficiaries were pleased with how efficient the application process was and particularly liked how their benefits were direct deposited each month. “I just love the fact I’ve never once had a problem with getting my Social Security in all those years,” said one participant who was speaking about her receipt of retirement benefits. She further stated “I just think that it’s doing the very best. I wish that all of the government services were as good as [the] Social Security Administration is.” Of note, no one mentioned any sort of stigma or psychological burden associated with applying for these types of benefits.

Within this theme, however, participants noted that the process of applying for SSA disability benefits was much more complicated than applying for other types of benefits, and usually required assistance from others to either alert them that they might be eligible for benefits and/or to manage the application and maintenance process and was associated with some stigma. As one participant noted, “I did look into Social Security for disability benefits. But like (another participant) has said, the red tape and paperwork was just overwhelming, and I didn’t get very far.” This alludes to both the learning and compliance costs of administrative burden as the participant expressed lacking an understanding of the process (i.e., a learning cost) and a perception of an ‘overwhelming’ amount of paperwork (i.e., a compliance cost).

A few participants mentioned not understanding how they could earn income from employment while also receiving disability benefits. This complexity served as a barrier to work. As one person stated, “I wanted to try going back to work. And I thought about calling them because it’s hard. I looked into it on the website … It was confusing. Then I would just hold off.”

Some disability benefit recipients expressed concerns about how the lengthy application and award process impacted their lives as they needed quicker access to financial support. One such person shared how delays in being awarded disability benefits led to his imprisonment. He was repeatedly denied but eventually had a lawyer help him gather the necessary documentation:

I had to wait three years, you know. Yes, you get a retro check and so on, but at that time I had to pay child support…. I was like ‘I’m not allowed to work.’ If I work … Social Security will deny you for trying to work, you know, and, you know, I was denied one time for that. Because I had no choice, I went to jail for almost six months because I couldn’t pay my… child support which I was waiting for disability. So, I was in a weird situation then. But you know no one told me. No one from the community told me how it was, or so on. I had to figure it out myself by going to jail at least.

An older woman, who had work experience helping people apply for SSA disability benefits, in addition to having lived experience in interacting with SSA, stated that “maybe SSA should streamline its disability determination process.” She continued:

So many people are denied and end up on appeal. I mean, I think I don’t know what the percentage is anymore. I know it used to be pretty high. And then on appeal, they get it. And it doesn’t make any sense to me that someone would have to go through the whole appeal process once or twice, even before they’re eligible for benefits, because if they’re eligible for benefits on appeal, they were eligible for benefits at application. And to me that’s a waste of manpower in Social Security. And it’s a waste and people who are applying for DI or SSI and doing it because they need the funds. And yes, I know it’s retro, but retro doesn’t help if you have to support a family. And what do you do in the meantime?

These two quotes above point to the high levels of financial stress that many people with disabilities and their families face as they await benefit receipt.

People who were successful in being awarded disability benefits relied on formal and informal social networks for their knowledge. Among people who were receiving disability benefits, most had received assistance from medical personnel, lawyers, or other service providers (case workers, etc.) to notify them that disability benefits were an option and to initiate the application process. One participant noted that she was hospitalized three times for a mental health condition (over a decade ago) before a doctor mentioned that disability benefits (and its associated health insurance) could be an option for her. She stated, “I didn’t know that I could get it for mental health. I thought you had to have a physical disability or [be] retired.” Yet other participants who had mental health conditions mentioned the ease of being approved for benefits the first time they applied, although they too usually had a medical or social service advocate help them with the process. Another participant, in speaking generally about disability benefits, noted:

People should not have to rely on a lawyer in order to initially apply for Social Security. I think that … if they’re looking for SSI and they need SSDI … They’re not applying for those benefits because they have resources. And they don’t have the money to hire a lawyer and many of them feel like that’s the only way they’re gonna get benefits. That’s not cool.

Some other participants echoed this concern about having to hire a lawyer who would then take a portion of any disability benefits they might eventually receive.

Regardless of the type of SSA benefit receipt, many rural residents expressed that getting copies of paperwork to apply for benefits was challenging. To address these specific compliance costs, many people relied on a social network (e.g., family/friends), libraries, or field office staff to make copies for them. As one person noted:

The library charges and they normally, Social Security, they don’t charge. Yeah, usually they say ‘I’ll make a copy for you’ and they’ll give you back the original. Depends on who’s at the desk, too. You know, [if] they’re nice enough to do that for you.

Some people mentioned the psychological costs of applying for disability benefits, stating that they viewed disability benefits as a last resort and something they did not want to have. Most felt stigma from friends and family about their receipt of disability benefits, and most would prefer to work. “I’m keeping it (disability benefits) because I need it and I know I can’t get a full-time job, but if I could handle a full-time job, I’d probably just get rid of that [disability benefits],” said one participant who was describing the stigma associated with receiving disability benefits. Another participant shared concern with “the whole process of not being able to work like I used to.” He continued, “I still have a problem talking about disability or me being on disability because I’ve been working since I was 15. All physical labor I used to do.”

People recognized the importance of SSA benefits for improving their economic security (“If I didn’t have it, I’d be homeless”), but worried about being able to keep benefits once they had been awarded benefits. One participant noted the psychological costs this way:

The system, because, boy, it really came into play and helped us. It helped me when I had my little children. … So, I had enough money to pay my bills when I had my little children, and if I hadn’t had that I would have been in a deep pickle, which is why it’s so anxiety producing. Because you’re counting on it.

Others shared stories about the complications that ensued when overpayments occurred. Overpayments can occur when beneficiaries have changes in income, living situation, or marital status that are either not reported in a timely manner by a beneficiary or when these changes are not properly accounted for by SSA. Participants mentioned the added stress associated with trying to pay back amounts owed to the SSA while living on a fixed income.

4.2. Theme Two: SSA Customer Service

Participants noted high levels of satisfaction with in-person service when they could access it at a local field office. While 17 of our 40 participants resided in counties without field offices, those who were able to visit a field office were quite satisfied. In describing the local field office staff, one participant who lived in a county that had a field office stated, “They were really kind, very helpful. Toward the end … they were sick of me. And I was sick of them. But they were so good and so kind. I wish I could remember their name.” An older adult noted, “I would say we’re lucky in the town, because we have the office right here, very convenient. People that don’t have an office right in their town have to travel.” Many participants noted a strong preference for visiting a field office in person over communicating with the SSA through other means:

When you try to reach them [SSA] by phone or you try to get on the computer, it’s a whole different story [compared to visiting a field office] … So, I feel bad for people who don’t have an office.” Field offices were also useful in helping people decipher information received from SSA through the mail, as one participant stated, “If I received something I didn’t understand, I went [to the field office] … with my daughter who was a nurse … A lot of it, I didn’t understand.

Most participants who had visited field offices were satisfied with the location, hours, and staff. This finding suggests that high-quality-front-line services reduce administrative burden. Still, for certain participants, visiting a field office incurred psychological costs. Some noted that having a guard on-site, rather than helping ensure a feeling of safety, felt intimidating:

There’s usually a police officer there. And it is a little scary in there, you know, like for me, because I’m not used to being in a room for long periods of time, at least. In my experience it was long periods of time. Thank God there was a bathroom, but sort of waiting, and having being guarded with an armed person in the room, you know, so for me, that’s intimidating to be there.

Another participant, although noting that the guard was “friendly and helpful,” stated that “other staff seem annoyed but aren’t outwardly rude. But part of the issue with going to an office is that [I] struggle to go outside some days due to disability” so visiting a field office is difficult because it raises anxiety, even though she had a vehicle and lived somewhat close to the field office.

Transportation to field offices was a concern for these rural residents, even for those who had a field office in their county. This finding relates to compliance costs as it added to the time and effort required to access services. People who resided in congregate housing were sometimes able to use transportation provided by the facility to travel to a field office. Most, however, did not have access to any sort of affordable public transportation. Concerns were heightened for people living in counties that did not have field offices as they mentioned that they would need to travel an hour or more to the closest office. One person mentioned how some of the choices he needed to make while living on a limited income impacted his ability to travel:

There should be more offices …[It’s] so far … from here. About an hour and 40 min. I don’t know about everybody else, but everybody might not have cars to get there. Transportation is a real problem. Me personally, I’m homeless living in my car. It’s real hard, you know, since you’re using gas money just to heat up the car like and then that takes away going to Social Security if I need to. And it’s (the ability to travel to a field office) hard.

Some participants who did not have a field office in their county discussed and dismissed using cabs as a travel option (“The cab guy, they would come get you, but I mean, it costs money a lot of money. It’s like USD 25 one way.”). Relying on family or friends for transportation was a concern due to expense (“Most people can’t afford to bring you anywhere from here.”) and inconvenience. As one disability beneficiary noted:

You know, I have to let my wife know, who you know, works 40-h weeks that you know I have to … be here at a certain time, so she’ll have to take the day off for just me to go there, which you know she will. She understands but … it’s an inconvenience a little bit.

Participants continually shared that communicating by mail, phone, or on the Internet was less valued and led to misunderstanding, missed opportunities, and increased in-person visits for clients. The high levels of learning, compliance, and psychological costs that participants were experiencing were not alleviated by these modes of SSA communication. Participants expressed some concerns related to the language that the SSA used to communicate information. “A lot of their [SSA] words [written or online] … sometimes I don’t understand,” said one participant. Another stated, “Sometimes when they write something that doesn’t make sense, we have to call and find out what’s going on.” One person noted that navigating the SSA website was complicated. They shared that going to the field office is easier compared to online because “you don’t need to know the terminology [that you need to look online].”

Participants had mixed reviews about the service they received from the SSA over the phone. They shared stories about long wait times (with one participant comically noting that he was sad when the SSA stopped having Beethoven music while on hold). One participant shared positive views about the call-back system; “I’m pretty happy because they always call me back.”

Many participants expressed frustration in calling and getting different people each time who did not seem to know the participants’ records (prior calls, etc.). One older adult noted:

On the phone … you have to tell them a lot of details about your situation and everything else, over and over and over again, the same way, and then they usually say something like, ‘Gosh! You know my system’s down,’ or ‘Gosh! Sorry, but you know I don’t have that information,’ or ‘You’re gonna get it in the mail,’ and that ‘You should get it within two weeks.’ And then you can talk to them two weeks later, saying that never came, ‘Oh, check back another month.’…. So, there’s … a lot of waiting and not knowing and feeling vulnerable, feeling exposed. It’s not particularly user friendly and very, I would say, uncomfortable on the whole. And so, nobody likes to ask for a handout. But when you’re dealt the hand your dealt with, and you have to deal with life, it feels like it shouldn’t have to be such a burden, but it is.

Similarly, a different participant noted:

Customer service is horrible… I understand the calls are recorded, but for some reason it’s not getting to the Social Security Administration … They know nothing that I called, and I’m like, ‘well, I just called and tried to set up an appointment here, but you know nothing about it so…’ And they’re … looking at me like I’m lying to them, and I’m like, ‘Man, I called, and they said to come in.’ So, you know, and they look at me like I’m just making something up trying to get in there, so on, you know. So, I’m not sure why the calls that you call the 1 800 number doesn’t go to Concord [NH] or the main [local] offices. For some reason, I’m not sure where it goes. But there’s no notes on their computer that I called or anything like [another participant] said, it’s weird because you go in there [to the field office]. And then when they look at you like that, it’s like I’m not trying to make something up. I was told to come in, you know.

The administrative inefficiencies mentioned above were causing participants to experience high levels of psychological burden including stress and stigma. Developing a data system within the SSA that accurately captures all interactions with applicants and beneficiaries could alleviate some of this burden.

Participants also noted frustration in receiving different answers from different SSA staff. “They’re just as confused in person, usually. And then when you call on the phone, those are confused, too” said one participant. The participant continued:

And you can get, if you call three times about the same topic, you’ll most likely get three different answers, because … I think the information on the whole system is so changeable, plus very vast, that any one person doesn’t really know the answer to your question.

Participants noted some successes and some concerns with disability accessibility within the SSA processes and offices. Some people experienced higher compliance costs than others, related to the type of disability or limitations they experienced. Positively, some residents mentioned how helpful the SSA was in accommodating their disabilities. For example, one rural resident was pleased with how well the SSA accommodated his visual disability by calling him and reading aloud their letters to him. Another person who had a traumatic brain injury reported that even though “I sometimes have a hard time understanding things … they’ve always been willing to explain to (me).” Concerningly, however, some residents were unable to access appropriate accommodations. One person with a musculoskeletal condition noted:

So, from the beginning of the process, there was a lot of paperwork. For me, it was, I found it to be overwhelming, especially [because] I couldn’t use my hands, and everything is online now. So, I had to have someone do the paperwork for me. It was overwhelming, honestly, it was long and tedious, and I have major anxiety. So, it was very hard.

In terms of visual accessibility, one person mentioned a concern that “[It’s hard for] someone who can’t see very well to know that they’re supposed to rip the two sides and pop off to get [benefit information for a tax return].” Another participant who had light sensitivity noted that the bright lighting at the field offices discouraged her from visiting the field office; “(To) go into the office can be difficult. It’s way too bright.” These variations in the ability to access necessary accommodations suggest variations in how the SSA offices may be inquiring about whether beneficiaries need accommodations and in how offices are handling accommodation needs. As a starting point, as one community advisor suggested, SSA staff should ensure that they ask about the need for all types of accommodations, not just physical or visual.

Participants shared that they are worried about privacy and security concerns when dealing with the SSA, particularly over the phone. This concern increases the psychological costs associated with accessing SSA benefits and services as this concern was causing stress. Many residents had heard about the possibility of scams where bad actors pretended to be the SSA and noted that the SSA had been very clear with them that they would never text them. Some rural residents had been victims of scams unrelated to Social Security, which increased their level of wariness. “I mean … I don’t want to give out a lot of information on the computer,” said one resident. Another shared:

Yeah, I think they tell you straight up, we will never text you exactly, they’ve always said ‘we will not do this’. So, if you know, if you get a text, it’s not them. They usually don’t even call you unless you ask them to return a call. They don’t bug you. Like right now on the internet it says, [though] if you want more money in your disability.something.something.com (click here).

A different person stated:

If you get online and you’re talking to somebody, how do you know you’re talking to somebody at Social Security (or) … on the other side of that phone, unless you’re calling them? … That’s why I’d rather go there and talk to somebody in person because then I know you’re not going to rip me off. It’s true.

4.3. Theme Three: Technology Experience

Most rural adults were not comfortable using technology to communicate with the SSA. Some of their hesitation to use technology was related to concerns about scams, as noted above, but more often this hesitation occurred due to a lack of access to reliable technology and a lack of knowledge about how to use technology. One older adult stated:

So elderly folks up here, many of them don’t have computers. The only access could be at the local library. But they don’t know how to use computers. So, having access at the local library is already a huge barrier.

One woman described the challenges her husband faced in using technology to apply for retirement benefits; “For someone who’s not super savvy [with computers] … it’s not an easy process, and that was his only option as to how to apply was doing it online.”

Smartphone access to the SSA is not the answer. Many people had smartphones but were not savvy about using them (“But do I know how to really use my smartphone? That’s a whole ‘nother story.”), or could not afford to use data on their phones (“Yeah, just because some people have smartphones doesn’t mean that they have enough money for the data that can go on the internet.”). In addition, cell and Internet service stability varied throughout these rural counties, with some people having stable service and others experiencing frequent (and sometimes multi-day) outages or spotty service. A few people mentioned still having landline telephones. When asked “what participants would think if the SSA developed an app to communicate with clients?”, one person stated:

I don’t think I would get a straighter answer from an app. From the few apps that I do use and knowing that they’re not perfect by any means, I don’t know if I want to go to one more type of thing with the Social Security Administration. It’s already confusing enough as it is.

Rural residents who had higher levels of education and/or had work experience that involved working with computers were more willing to engage with technology to access information from or provide information to the SSA. As an example, one older adult who worked for many years in the insurance industry stated, “I know there are some elderly people that don’t want to be bothered with a cell phone or all of that, but I bank online and I love technology.” People living in rural areas generally have lower levels of educational attainment and less employment opportunities, however, some of these cases were exceptions among our participants.

For people who were able to look at the SSA website, most did not find it to be user-friendly. Accessing the website to apply for benefits, address administrative tasks, or gather information about programs did not lessen the administrative burden. “To me, it hasn’t worked out very well to try to get it through that way,” said one rural resident. Some found it confusing. “It’s awfully confusing. I wouldn’t get very far in the web,” said one older adult. Another stated:

Don’t get me wrong, there’s not, there’s nothing wrong with how it’s placed, but trying to navigate when you go on one page, and you’re like, Oh, you have to go to another after you click on that and then go back because you have the wrong one. It’s just all these pages are opening up.

One participant shared that she wished the website had more functionality; “I like their website, but it doesn’t allow you to do everything through that.”

4.4. Theme Four: Recommendations to Improve the Beneficiary Experience

In addition to the findings described above, our participants suggested three additional ways that administrative burden could be reduced. First, several people suggested that it would be helpful to have someone from the SSA serve as a more personal advocate or come to peoples’ homes to help with applications and questions. As a way to reduce administrative burden, one person who had a disability offered this suggestion:

Maybe Social Security ought to have an internal advocate or whatever that helps people, helps walk people through the system. So that they don’t have to hire a lawyer, I mean, you know, that’s not there to try and prevent benefits, but that’s there to try, you know, … that person who (can) hold their hand through the process.

This quote alludes to the participants’ feeling as if current SSA processes are set up as an adversarial process designed to prevent benefit receipt.

Second, the SSA should consider better ways to serve the population that is unhoused as the lack of a physical address and a place to receive mail is a large barrier to effective communication. One person stated:

But it’s not that easy. If Social Security says, oh, you don’t have a physical address or you don’t have a mailbox, we’re not giving you your money. That’s not right because then how am I going to be able to live.

Relying on a P.O. Box at a local post office was deemed too expensive:

And you need that check through the mail, then you have to rely on your family members or a P.O. Box. And those P.O. Boxes are not cheap because I used to do that too. It’s USD 166 for a year. Yeah. I can’t afford that just to get mail. Some participants and advisors wondered if the SSA field office could please receive and hold their mail for them.

Third, some participants suggested that benefit amounts were too low. Although the SSA does increase benefits each year through a cost of living adjustment that is supposed to ensure that inflation does not erode purchasing power, the participants we spoke with were still struggling to make ends meet. In speaking about disability benefits, one person mentioned:

I think that every year they should increase. Right now, everything is so [expensive] right now and I only make so much a month and I can’t do anything. And if you’re only making, let’s say USD 800 a month on your disability and everything is going up so high, you will never survive. And it’s too bad that disability couldn’t come up with a program that maybe every two years, we’ll give you a USD 500 income [bonus]. Because the [way] that we’re going right now and the way everything’s going right now pretty soon we’re going to be paying USD 5000 a month (for rent) and there’s no way on disability. Everybody on disability will end up wanting to be dead because you can’t … we can’t go buy groceries. You can’t do anything on disability because once you pay your rent, your gas, everything else you’re doing, you’re broke.

Another stated, “Yeah, I don’t know how anyone with a family can live on disability.”

In terms of community-level recommendations, most participants were advocating for increasing the availability of general social services in their rural areas. One person who was unhoused stated:

You know, they b**** about all the homeless people here in this town, right? And all they do is just kick them out, arrest them. You got it here … Go, move, next town. That’s not okay. We were here, we owned an apartment, you know, we lived here, we worked here, and somehow things get messed up and now we’re homeless and you’re just (shoving) us away, not helping us. That’s wrong for the town to do. That’s wrong for the state to do. And they all know it. So no, there’s nothing here.

Another person stated that many social services agencies that serve older adults and people with disabilities in these rural areas are understaffed due to an inability to hire and retain workers:

But you have less services here … [For example], we have home health [but] we don’t have any workers. …Yes, you can get them to homes, you can get them to state independent living. But there’s no one working for those people. So even though you qualify, you don’t.

As some rural residents are able to rely heavily on other community-based organizations or staff for assistance with SSA-related tasks, many suggested expanding these options. For formal social network assistance with SSA-related tasks, some people relied on community-based case managers or social workers while others relied on staff at residential facilities. These types of support did not seem to come from one particular type of community-based organization, and access to these types of people seemed to vary greatly. One of our participants had prior experience as a town selectman, and so was knowledgeable about government agencies and was able to help her friends. Overall, these ‘helpers’ provided different types of assistance, including helping people with phone calls (i.e., putting the phone on speaker so that the helper and the SSA client could jointly answer questions), taking people to the field office, navigating the Internet, interpreting SSA communications, and preparing paperwork.

The community advisors echoed these suggestions for expanding community support options, offering that a ‘one-stop’ way of providing services would be the most beneficial to this population as many people are involved with multiple service providers and systems that do not provide comprehensive assistance. Vocational rehabilitation was mentioned as a possible resource, although these advisors did not view it as providing effective services in NH. New Hampshire’s ten Aging and Disability Resource Centers (e.g., Service Link) were mentioned, although the community advisors stated that they primarily just provide referral services.

In terms of disseminating study results, the community advisors thought that the findings of this study should be shared broadly, including with NH field offices and regional (Boston) SSA staff, with community-based organizations in NH, and with school social workers so that parents of children with disabilities would be aware of some of the complications they may face in accessing and maintaining SSA benefits.

5. Discussion

The results of this study extend prior research that has examined administrative burden and federal agency communication with target populations in rural areas by providing information that is particularly relevant for agencies communicating with and serving people with disabilities and older adults who reside in rural areas of the U.S. This information is particularly relevant given recent changes that the SSA has implemented and is proposing as of mid-2025 to reduce staff and close some local offices. We briefly summarize the key points from the findings from the focus group and interview participants discussed above, discuss some limitations of this study, and provide concluding remarks.

In general, rural retirement and survivor beneficiaries experienced lower levels of administrative burden than disability beneficiaries. Yet, all were facing some level of burden when interacting with the SSA, before the SSA’s recent cuts to administrative services. To alleviate this burden, most older adults and people with disabilities residing in rural areas still very much preferred having access to a local field office where they could interact in person with SSA staff. While other studies have documented the effects of field office closures on applications, backlog, and wait times (Deshpande and Li 2019; Farid et al. 2024; Romig 2023b), our study provides details about the first-hand experiences of people who live in rural areas and who, in 2024, were challenged by a lack of access to in-person services. The rural residents who participated in our study were generally very satisfied with in-person services and were glad to have this resource to help address the learning, compliance, and psychological costs associated with their interactions with the government. Many residents reported using in-person services to address questions that might arise when they receive information from the SSA by other means. For example, rural residents who received information from the SSA in the mail reported that they often needed to visit a field office in person to have someone there help them interpret the information they received from the SSA or address the administrative tasks necessary to maintain their benefits. While most (54%) of the rural residents we spoke with had only high school or lower levels of education, this finding held true across educational levels.

Not all individuals had a positive experience at the field offices. Some individuals noted that visiting a field office either raised anxiety or was complicated by a lack of physical accessibility. While the SSA does offer alternatives to in-person services, these alternatives were not effective in reducing the administrative burden for the population included in our study. If the rural residents were not able to visit a field office, some tried to use the 800 number to contact the SSA. In general, however, people were dissatisfied with the SSA’s phone service given that they usually faced long wait times, did not know what questions to ask, did not have SSA staff who appeared to have electronic access to their call history, and sometimes received different answers from different staff. Others, who had access to the Internet, attempted to use the SSA website but usually faced challenges in navigating the website. These findings about the SSA phone and web-based services underscore the importance of having local field offices available. Of course, these alternative communication options should remain available for people who would prefer these over in-person services, but the SSA should seek to enhance these alternative options to ensure that they are providing as timely, effective, and accessible services as in-person services.

High levels of administrative burden can provide negative consequences to the agencies in question. In addition to the restrictions in applications for benefits noted by others (Deshpande and Li 2019; Foote et al. 2019), high levels of administrative burden were noted in our study as limiting whether people on disability benefits attempted to return to work. Lessening the administrative burden associated with decisions to attempt work could be expected then to increase the proportion of disability beneficiaries who are working. The SSA has taken steps to do so in the past, however, without seeing increases in employment among beneficiaries (Levere et al. 2025). As another example of negative impacts to agencies, several participants noted issues with receiving overpayments of disability benefits from the SSA, which creates more administrative work for the SSA in correcting those overpayments and taking steps to collect the overpaid amounts from beneficiaries. Listening to the policy recommendations of people who have lived experience can provide some guidance about how to effectively reduce administrative burden to levels that impact real outcomes for agencies and beneficiaries alike.

For most rural residents, travel burdens were a concern, and so many recommended increasing the availability of field offices in rural areas. These rural residents further advocated for increased community-based and SSA resources to assist with SSA tasks, in essence requesting an expansion of formal social networks. At the state level, this may mean increasing the services available through existing disability and aging resource centers or through vocational rehabilitation, community mental health centers, and area agencies on disability. At the SSA level, this may mean providing more SSA staff in rural areas to increase outreach and services, perhaps by having these staff interact more closely and on-site with senior centers, schools, or other community agencies. Rural residents also suggested that the SSA improve the accessibility of its services for people with all types of disabilities.

Overall, people living in rural counties that do not have local SSA field offices voiced a distinct disadvantage in terms of knowing where to turn with questions about SSA disability, retirement, or survivor benefits. While some residents have access to helpful informal and formal social networks that can help to alleviate some of this burden, most do not. As these residents noted, a lack of ready and reliable access to information and advice led to endangering their own economic stability and to increased calls and visits to the SSA.

Limitations

We note that this study faced several limitations. First, it was possible that people who had complaints about the SSA were more likely to participate in the study. This limitation was perhaps minimized a bit when we changed our strategy to visit community-based locations that were frequented by our target populations. Second, we realize now that it might have been helpful to expand our inclusion criteria to include representative payees and also other community-based people who help people apply for SSA benefits so that we could more fully understand communication and customer service barriers. Third, we acknowledge a lack of racial diversity in our focus groups and interviews. Although we did have diversity in terms of age, disability type, education, employment, and gender, we recognize that speaking with people from counties that included higher proportions of racial/ethnic minorities might have yielded different results, as suggested by Jang-Trettien and Bolger (2024). Future studies held in states with more diverse populations can address this limitation. Fourth, we acknowledge that the lived experience of our research team and their prior research related to SSA disability programs may have impacted the lens through which we analyzed our results. Having community advisors review and verify our findings helps to minimize this limitation. Fifth, we were not able to differentiate between people receiving DI or SSI benefits as this distinction was not crucial to our recruitment and as most disability beneficiaries were not about clear which types of disability benefits they were receiving. We recognize that the demographic characteristics that differ between these two disability beneficiary populations may impact service experiences and preferences. For example, people who participate in DI likely have higher educational attainment and more extensive work experiences than people who participate in SSI, which may suggest that DI beneficiaries are more comfortable using technology to interact with the SSA. Future research should explore these differences. Sixth, this study was conducted within NH, which has a state motto (live free or die) that alludes to the independent nature and general mistrust of the government felt by many NH residents. Studies conducted in different areas of the country may find different results. Seventh, the fact that almost three-quarters of our participants had some sort of disability may have biased our findings to disproportionately represent the concerns of people who faced challenges accessing and maintaining disability benefits. However, as meeting our screening criteria for disability did not equate to a formal SSA definition of disability, and as half of the participants were aged 65 and older, we feel that our sample represented a balanced group of our target population. Lastly, we note that we were unable to fully engage with the northernmost (and most rural) county in NH. This limitation provides a reminder that the findings presented here actually do not represent the people who are most isolated in rural areas. As a result, our findings are not generalizable to a broader population but do provide key insights about the rural experience with the SSA.

6. Conclusions

In 2024, rural residents in NH, regardless of the type of SSA benefit receipt, were experiencing administrative burden in their interactions with the SSA and preferred to turn to in-person assistance at local field offices to address these concerns. Most rural residents did not prefer or were not able to use technology to communicate with the SSA. As mentioned earlier, NH residents have greater access to field offices than much of the country and so it can be assumed that people living in rural areas of the U.S. have less access to in-person services. Future research should examine, from an administrative standpoint, the inherent costs that accrue to the SSA (e.g., additional beneficiary contacts, missed opportunities to discuss return to work options, and costs associated with resolving overpayment issues) when beneficiaries are not able to connect with the SSA in person and whether such costs outweigh the costs associated with keeping field offices open and sufficiently staffed.

Rural residents suggested that existing community-based agencies such as aging, independent living, mental health services, or vocational rehabilitation agencies could provide more targeted support to rural communities about SSA programs. They further suggested that the SSA increase its own level of in-person outreach and assistance from the SSA to assist people with SSA-related tasks. These types of supports, at both the community and SSA levels, could include presentations at community centers to larger groups of people as well as one-on-one guidance that would assist with SSA processes. Future research, conducted in collaboration with rural community members and organizations, could develop and test the impact of such support on not only the administrative burden experienced by these residents but also on the need for additional customer contacts and administrative actions on the part of the SSA. Such research will be particularly relevant in the near term to understand the impact of recent SSA reductions in staffing and in reorganizing the way it provides services.