(614) 545-9998
Fax:
(614) 721-5217
Step
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Have you applied for disability benefits?
Have you applied for disability benefits?
Yes
No
Has your application been denied?
Has your application been denied?
Yes
No
How long can you stand?
How long can you stand?
I have no limitations with standing.
I can stand for 2 or more hours before I need a break.
I can stand or walk for 1-2 hours without a break.
I can stand or walk for less than 1 hour.
How much can you lift or carry?
How much can you lift or carry?
50 pounds or more
10 to 50 pounds
10 pounds or less
I don’t know
How long have you been off work due to your conditions?
How long have you been off work due to your conditions?
More than 12 months
6-12 months
Less than 6 months
I am currently working
Do you have a primary care physician?
Do you have a primary care physician?
Yes
No
Can you drive a car?
Can you drive a car?
Yes
No
Do you have health insurance?
Do you have health insurance?
Yes
No
Does someone have to help you with daily activities?
Does someone have to help you with daily activities?
Yes
No
What is your age range?
What is your age range?
Under 18
18 - 49
50 or older
You may qualify for disability benefits but we need some additional information to make a final determination.
How would you like to proceed?
How would you like to proceed?
Schedule a complimentary appointment with a Social Security Disability Specialist to get my results
Have a Social Security Disability Specialist contact me with my results
Contact Information
First Name
Last Name
Contact Phone
Contact Email
Message (optional)
