We Can Tell You If You Have a Case!

Do you or your loved one suffer from a medical of mental condition that is so severe that you are unable to work and provide for yourself and your family? We are here to help.

Attorney Bernard L. Shapiro will personally review your information and contact you promptly to discuss whether you have a strong case to receive disability benefits (SSDI, SSI) offered through the Social Security Administration.

Social Security Disability Case Evaluation

Please fill out the required fields in the form below to receive your disability case evaluation from qualified Social Security Attorneys. There is no obligation to you and no fee for this service.

* Marks Required Fields
First Name: *	Last Name: *
Email Address: *
Phone Number: *	Phone Number Type:  Home Work Mobile
Street Address:
City: * State: * ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code: *
Please tell us what kind of disability limits your ability to work? *
When did your disability become so severe that you became unable to work? *
Are you working now? *  Yes No
What type of work have you done for the past 15 years? *
Have you applied for disability? *  Yes No	If so, when did you apply?
Please Enter Your Date of Birth:
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