Find Out if You Can Get Disability

Get a FREE evaluation below

Free SSD Claim Evaluation! Progress: 20%

Do you already get disability benefits? Or are you using a disability attorney?

YES   NO  

How old are you?

please select your age 65 or older 64 63 62 61 60 59 58 57 56 55 54 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 Under 18

* All Fields Required * * Invalid Date of Birth *

Start Evaluation »

Next Step - Work Status Progress: 40%

Do you have a disability that stops you from working full-time?

YES   NO  

Have you been treated for your disability within the past year?

YES   NO  

Do you have a doctor or medical records to support your disability claim?

YES   NO  

* All Fields Required *

Continue »

Next Step - Conditions Progress: 60%

Were you physically hurt in an accident that wasn't your fault?

YES   NO  

What kind of accident?

Please Select Auto Accident Motorcycle Accident Truck/18 Wheel Accident Work Accident Medical Malpractice Slip and Fall Dog Bite Birth Injury Product Liability Defective Drug Lead Poisoning Other Accident

Do you have an IVC Filter implant?

YES   NO  

Would you like to speak to an attorney about possible compensation for injuries related to IVC filters?

YES   NO  

Do you have a Long Term Disability (LTD) policy?

YES   NO  

Who is your LTD Insurance Provider?

Please Choose Aetna AFLAC AIG American United Ameritas Anthem Assurant AXA Equitables/DMS Berkshire Boston Mutual Broadspire Cigna Colonial Life Companion Life Dearborn National Great-West Guardian Hartford HM Life Insurance Illinois Mutual ING/Reliastar Jackson Jefferson Pilot Liberty Mutual Lincoln Financial Lloyds of London Mass Mutual Matrix Medicare / Medicaid MetLife Monarch Mutual of Omaha New York Life Northwest Mutual Prudential Reassure Reliance Standard Sedgewick Standard Sun Life Symetra The Reed Group Trustmark Union Central Union Security Unum Other -- Not Listed Not Sure / Unknown None

Has your LTD claim been denied or terminated?

YES   NO  

What was your monthly income before you stopped working?

Please Select $0 / No income $1 - $500 / month $500 - $1000 / month $1000 - $2000 / month $2000 - $4000 / month $4000 - $6000 / month $6000 - $8000 / month $8000 - $10,000 / month $10,000 / month or more

* All Fields Required *

Continue »

Next Step - Work History Progress: 70%

Out of the past 10 years, how many years have you worked?

number of years worked 8 - 10 years 5 - 7 years 0 - 4 years

Are you a widow or widower?

YES   NO  

What's your birth date?

Month JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Do you have any of the following conditions?
(please check all that apply)

Cystic Fibrosis Multiple Sclerosis ALS (Amyotrophic Lateral Sclerosis) Hepatitis C Chronic Kidney Disease that requires dialysis Chronic Respiratory Disease that requires portable oxygen Legally Blind History of Transplant (lung, heart, liver, bone marrow, etc)

Please describe your disability:

* All Fields Required *

Continue »

Next Step - Accident Details Progress: 70%

When was the accident?

MO JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC / YEAR 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001

Were you hopsitalized or did you have to see a doctor because of your accident?

YES   NO  

Are you using an attorney for this injury claim?

YES   NO  

Please describe your case:

* All Fields Required *

Continue »

Next Step - Case Description Progress: 70%

Please describe your disability:

Continue »

Final Step - Contact Info Progress: 90%

First Name:

Last Name:

Street Address:

City, State:

Zip Code:

Phone Number:

--

Please enter a valid phone number so that we can call you to complete your evaluation.

Email:

I would like a free injury evaluation from a local attorney

* All Fields Required *

Get Your Evaluation!

Your Information is secure | Privacy Policy

Accurate information is required for a free evaluation

By submitting my information, I agree to the Terms & Conditions and I consent to receive autodialed and/or pre-recorded marketing calls and text messages from or on behalf of MyAttorneyHome or their attorney network at the number(s) above to discuss my potential options. I understand that consent is not a condition of purchase. I understand that this authorization overrides any previous registrations on a federal or state Do Not Call registry.

Would you rather talk to someone? Our agents are available 24/7.

Call Now » 855-934-4001

Become One of the Over 1 Million People We've Helped

Disability benefits can pay up to $3148/month, depending on your work history and disability condition. You can also qualify for a lump sum of money owed to you. See how much you may be able to collect - get a 100% free evaluation now!

Privacy Policy | Do Not Sell My Personal Information
Filling out this form is not applying for Social Security Disability benefits through the Social Security Administration.

If you are disabled the first step is to Apply for Social Security Disability benefits with the Social Security Administration. You can only apply for benefits in person through your local Social Security Administration office, by calling 1-800-772-1213 for help by phone, or online at www.socialsecurity.gov/applyfordisability.

ATTORNEY ADVERTISEMENT: This website is a group advertisement. DisabilityBenefits.co is not a lawyer referral service. Subscriber Attorneys appearing on DisabilityBenefits.co have paid an online advertising fee. Use of this Service is not intended to and does not create an attorney-client relationship between a Subscriber Attorney and any Requestors. DisabilityBenefits.co is not a law firm. The information contained herein is not legal advice. The attorneys listed do not in any way constitute a referral or endorsement by this website.