SSI Associates

Get the Social Security Benefits You Deserve

Call Us
(216) 225-9562

Free Claim Evaluation

SSI Associates Free Social Security Disability Claim Evaluation

We take careful consideration and attentive individual attention to each case that is presented to our Social Security lawyers. To introduce yourself to us and for us to better understand your situation, please fill out the following Social Security disability evaluation form.

Someone from our office will contact you shortly so that we may help you with your Social Security claim.

If you prefer, you may call us at any time at (216) 225-9562

  • Basic Information

  • Full Name: *

  • How should we get in touch with you?

    Email
    Phone
    No Preference

  • Email Address: *

  • Phone Number: *

  • Do you have another number to reach you on?

  • Best time to call:

  • Case Information

  • What are you filing for?

    SSDI
    SSI
    Children’s Claim
    Not Sure/Other

  • When did you or your child become disabled?

  • Please describe your disability: *

  • What city and state are you in? *

  • Is a doctor currently treating you?

    Yes
    No

  • Have you worked 5 out of the last 10 years?

    Yes
    No

  • Are you working now?

    Yes - Full Time
    Yes - Part Time
    No

  • Have you already applied for Social Security disability benefits?

    Yes
    No

  • Are you currently receiving benefits from Social Security?

    Yes
    No

 


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