But it offers no data to support the general idea that this is the case (that denials are through the roof, even if TN is a higher rate than the national level, it is marginal. Also it leaves out the median which would be more interesting, since a few states could greatly bring down the average.) The approvals are reviewed because denials can be appealed. It's a safe guard against fraud. I'm not saying there aren't perverse incentives, but "doctors earn big money approving disability claims" has less of a moral outcry from the reverse.