Formulario de Discapacidad

Hola, me llamo Lupe.

Juntos, veremos si cumples los requisitos y crearemos un plan para que obtengas beneficios. Tardarás menos de 3 minutos.

A woman with long brown hair, wearing an orange shirt, poses against a solid blue circular background.

Hola, me llamo Aaron.

Juntos, veremos si cumples los requisitos y crearemos un plan para que obtengas beneficios. Tardarás menos de 3 minutos.

A man with light brown hair styled upward, wearing an orange collared shirt over a black top, smiles at the camera against a solid blue circular background.

Have you ever applied for benefits before?

No, and I need help!Sí, I've applied or been denied.

Have you applied or been denied in the last 60 days?

Sí.No.

First up, your claim

You’re on your way to disability coverage! You’ll learn if you qualify and get an advisor to help with your claim today.

Good news!

That means your claim is still open and we may be able to help. Select all that apply:

I submitted my application.I received a denial notice.I had a hearing with a judge.I have been approved for benefits.

Are you currently working?

Sí.No.

How much are you currently working?

Full-time.Part-time.

RESULTS: Not Eligible ❌

Unfortunately, we can only help those have not been approved to receive benefits.

WAIT! Before you go,

we’d like to send you our free e-book "SSI vs SSDI: What’s the difference?" that explains the qualification requirements, process, and more.

Fill out the form below for your FREE copy:

By submitting, you are acknowledging and agreeing to our Terms & Privacy Policy and expressly consenting to receive marketing and automated communications, which may include calls, texts, emails, and/or prerecorded messages.

RESULTS: Not Eligible ❌

Unfortunately, the criteria for benefits are very strict and to qualify you must be too ill or injured to continue working fulltime. If or when that changes, we are here to help you through the process!

WAIT! Before you go,

we’d like to send you our free e-book "SSI vs SSDI: What’s the difference?" that explains the qualification requirements, process, and more.

Fill out the form below for your FREE copy:

What is your current monthly income?

Over $1,500 a month.Under $1,500 a month.

RESULTS: Not Eligible ❌

Unfortunately, the government automatically denies those who are currently making more than $1,500 per month before taxes. If or when that changes, we are to help you through the process!

WAIT! Before you go,

we’d like to send you our free e-book "SSI vs SSDI: What’s the difference?" that explains the qualification requirements, process, and more.

Fill out the form below for your FREE copy:

If given the opportunity, could you work full-time?

Sí.No, I'm too sick.

RESULTS: Not Eligible ❌

WAIT! Before you go,

we’d like to send you our free e-book "SSI vs SSDI: What’s the difference?" that explains the qualification requirements, process, and more.

Fill out the form below for your FREE copy:

Since 2014, how many years did you work and pay taxes?

Less than 4 years.5 years or more.

If you are married, does your spouse currently work?

Sí, my spouse works.No, my spouse does not work or I am not married.

RESULTS: Not Eligible ❌

Unfortunately, you are likely ineligible to receive disability benefits. This quiz helps people apply for two programs: SSDI and SSI. For SSDI, you must have worked 5 out of the last 10 years and for SSI you need to have few assets and no income.

WAIT! Before you go,

we’d like to send you our free e-book "SSI vs SSDI: What’s the difference?" that explains the qualification requirements, process, and more.

Fill out the form below for your FREE copy:

How much do you currently have in savings?

Under $3,000.Over $3,000.

Do you already have a lawyer helping with your claim?

Sí, I do.No, I do not.

Although we can't offer official assistance if you have current representation, we're happy to help you understand your eligibility better. Let’s continue so you can learn more about it!

Let's continue the quiz.

RESULTS: Likely Eligible! ✅

The good news is that based on your answers you may qualify for the Supplemental Security Income program. The bad news is we can only help people who have submitted an application and been denied.

What's next?

Complete this form and our team will contact you within 24 hours!

Connect with us now for a FREE Consultation.

Connect with us

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RESULTS: Not Eligible ❌

WAIT! Before you go,

we’d like to send you our free e-book "SSI vs SSDI: What’s the difference?" that explains the qualification requirements, process, and more.

Fill out the form below for your FREE copy:

Are you receiving disability payments?

Sí, I am.No, I am not.

RESULTS: Not Eligible ❌

Unfortunately, we can only help people who have not already been approved for disability.

WAIT! Before you go,

we’d like to send you our free e-book "SSI vs SSDI: What’s the difference?" that explains the qualification requirements, process, and more.

Fill out the form below for your FREE copy:

That’s great! Let’s see how much you qualify for. How old are you?

Under 18 years old.18-29 years old.30-49 years old.50-64 years old.Over 65 years old.

RESULTS: Not Eligible ❌

Unfortunately, you do not qualify to receive benefits due to your age.

WAIT! Before you go,

we’d like to send you our free e-book "SSI vs SSDI: What’s the difference?" that explains the qualification requirements, process, and more.

Fill out the form below for your FREE copy:

By checking, you agree to receive marketing communications from the firm. You can opt-out anytime. Message & data rates may apply.

Do you have a serious medical condition that prevents you from working?

Sí.No.

RESULTS: Not Eligible ❌

Unfortunately, based on your answers you likely do not qualify to receive benefits. Social Security Disability is a program designed for those with severe medical conditions that are expected to last more than one year.

WAIT! Before you go,

we’d like to send you our free e-book "SSI vs SSDI: What’s the difference?" that explains the qualification requirements, process, and more.

Fill out the form below for your FREE copy:

How often do you see your primary Doctor or go to a specialist?

Weekly.Monthly.Every few months.Once a year.I’m not currently receiving medical care.

Do you anticipate being able to return to work within the next 12 months?

No.Sí.

RESULTS: Not Eligible ❌

WAIT! Before you go,

we’d like to send you our free e-book "SSI vs SSDI: What’s the difference?" that explains the qualification requirements, process, and more.

Fill out the form below for your FREE copy:

RESULTS: Not Eligible ❌

WAIT! Before you go,

we’d like to send you our free e-book "SSI vs SSDI: What’s the difference?" that explains the qualification requirements, process, and more.

Fill out the form below for your FREE copy:

RESULTS: Likely Eligible ✅

For 30 years, we’ve helped over 400,000 individuals like you apply for and secure benefits, including health insurance and monthly payments of up to $3,822.00.

What's next?

Complete this form and our team will contact you within 24 hours!

Connect with us now for a FREE Consultation.

Connect with us

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