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If you or a loved one would like to apply for Social Security disability benefits or to appeal a previous decision, complete the form below for a free, no obligation eligibility evaluation.
After submitting the form, a representative for from the Social Security Resource Center will contact you within one day to discuss your case.
Click here if you are applying for someone else.
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Address
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Gender
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I need help:
applying for the first time
appealing a denial
Are you currently working?
Yes
No
Are you receiving Social Security retirement benefits?
Yes
No
Have you visited a doctor in the last 12 months about your condition?
Yes
No
Do you have health insurance?
Yes
No
What is your medical condition?
List your prescription medications: (one per line)
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This site is not affiliated in any way with the Social Security Administration. The term "Social Security Lawyer" as used in this site does not mean an attorney or lawyer which is affiliated with the Social Security Administration.
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