Information

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Need a faster way to get your disability benefits? Check here to see if you qualify.

First Name

Last Name

Email Address

Phone Number

Date of Birth - mm/dd/yyyy

Zip Code

Please Describe Your Condition

Do you expect to be out of work for at least 12 months? ? Yes No

Have you worked for at least 5 of the last 10 years? Yes No

Are you currently working and making more than $1,470/month? ? Yes No

Are you prescribed medication or being treated by a doctor? ? Yes No

Do you already receive some Social Security benefits? ? Yes No

Do you already have a Social Security attorney or advocate? ? Yes No

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You are entitled to a free, no-obligation evaluation to discuss your case and potential eligibility for disability benefits with a professional SSDI/SSI advocate or attorney. We represent the nation's largest network of disability legal representatives and are not affiliated with the SSA. Forms to apply for disability without assistance are available at no cost at socialsecurity.gov.

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