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Category 17:
Social Security
SOCIAL SECURITY. You need a lawyer to help you with a claim
for Social Security benefits on your behalf or on behalf of a friend or
family member.
We have great lawyers that can help you with your Social Security case.
Tell us how you think you qualify for Social Security, and we will try
to help.
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Are you looking for a lawyer for yourself or for
someone else?* |
Myself |
Someone else |
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If you are looking for a lawyer for someone else, is
it a friend or family relation? |
Friend |
Family member |
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What help do you need from a lawyer?* |
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Have you already filed a claim or application for disability or
social security benefits with the Social Security Administration?* |
Yes
I don't know |
No |
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If you have already filed a claim or application, what was the
response of the Social Security Administration? |
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What is the age of the person seeking Social Security Benefits?* |
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What is the reason you believe qualifies
you for Social Security Benefits?* |
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If you are seeking Social Security
Benefits because of an injury or disability, approximately when did that
physical or mental condition begin? |
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When was the last time you were able to
work?* |
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What is the medical condition that has
been diagnosed by a doctor?* |
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What work restrictions has a doctor
placed on your ability to work?* |
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How much in wages were you earning at
your last full-time job?* |
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Marital status:* |
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Number of dependent
children:*
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Please state any other particular facts
that
may apply to the application for Social
Security Benefits:* |
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Please enter your full name* |
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Please enter your email address* |
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Please re-enter your email address* |
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Mailing Address* (Street, City, State,
Zip Code) |
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Home Phone* (include
area code) |
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Cell Phone |
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Work Phone* (include
area code) |
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Note: Initially, LawyersYouNeed.com will only
provide your e-mail address to the lawyers who may be interested in
discussing your legal situation with you. Your mailing address and
telephone numbers will not be disclosed unless the attorneys certify
that there is a problem or malfunction with receiving or sending e-mail
to you. |
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Basic
Agreement and Terms of Use: |
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To submit this form, please enter the characters you see in the image |
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