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Are you already receiving Social Security Disability benefits?

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Are you being treated or seeking treatment for your disability?

Yes
No

Are you currently employed?

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Is an attorney or advocate helping you with your disability case?

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Please Note: This site is privately owned and is not administered by or affiliated with the Social Security Administration. 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.

By submitting your request, you grant permission for one of our premier partners to contact you using the phone number or email address that you have provided so we may assist you with your request. You agree that the matched partner may use an automatic telephone dialing system even if the number you provided is a wireless phone number.