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Help us understand

your situation

This short intake form collects important details so our team can review your information ahead of time and guide you in the right direction during your call. Take your time. Your answers help us help you.

The information you provide is private and protected.

All information to include personal, medical, and Social Security information is securely stored using encrypted systems and accessed only by licensed professionals involved in your case.

Your information is used solely to assist with your Social Security Disability claim and is shared only with the Social Security Administration when required.

We follow HIPAA privacy standards, and your information is

never sold or used for any other purpose.

Application Process

Select*
What level were you denied at?*

Medical Conditions

Employment

If you're not sure, just provide an estimate.
$
If you're not sure, just provide an estimate

Education & History

Select*

About you

Safely Secured and Encrypted. Your SSN is required for us to check SSI/SSDI eligibility and file claims on your behalf.
If so, Please provide their name and email so we can give them credit

Contact

Final Confirmation, then Submit.

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Frequently Asked Questions

We understand you feel uncertain and worried. It's completely normal to feel this way.

We've answered a few of our most common questions below.

Do I need to have everything figured out before the call?

No. Many people come to the call feeling unsure or overwhelmed. That is completely okay. The purpose of the call is to understand your situation and explain what steps may make sense next.

What if I am not sure whether I qualify?

You do not need to know that ahead of time. The call is a chance to talk through your work history, health limitations, and concerns so we can help you understand where you may stand.

Will this call affect my benefits or case?

No. Speaking with us does not impact your current benefits, application, or case status in any way. The call is simply a conversation to help you understand your situation and your options.

What happens after the call?

After the call, you will have a better understanding of your options and what the next steps could look like. If you choose to move forward, we will explain how we can support you. If not, you will still leave with clarity.

Is my data secure?

Yes. We use HIPAA compliant servers and best-practice encryption standards to ensure your data is secure.

We never sell your data. We only use your data to provide the best quality service to you.

Need Further Assistance?

If you have any questions or need additional support, our team is ready to help. Reach out by phone or email, and we’ll ensure you feel fully prepared for your hearing.

Phone: (616) 318-0009

Support team member offering assistance