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... 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. ...