Free Case Assessment

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FREE Case Assessment for
Social Security Disability Insurance (SSDI) &
Supplimental Security Income (SSI)
Initial Application - Denied - Reconsideration - ALJ Hearing

Determine your chances of receiving Social Security Disability Benefits without cost or obligation. Steven will evaluate your case and contact you with the results. Again, there is no cost or obligation.

Steven Handfinger respects your personal information with the highest level of respect.  The information gathered on this site will never be sold or discussed with anyone.

Personal Information

First Name:

Middle Name:

Last Lame:

E-mail:

Address:

Address, Line 2:

City:

State: - Select state -

Zip Code:

Cell Phone:

Work Phone:

Home Phone:

Date of Birth:  

Highest Grade in School Completed: - Select - GED High School Diploma Some College AA/BA Degree Master's Degree Higher Level Degree None/Other

Average Annual Income: - Select - 0 - 10K 25 - 50K 50 - 75K Over 75K

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Case Information

Date of Onset of Condition:  

Are you currently working?:  NO    YES  

When did your impairment stop you from working?:  

Are you seeking a medical source?:  YES    NO  

Are your medical records available electronically?:  NO    YES  

Does your impairment interfere with your ability to do normal activites?:  YES    NO  

Does your condition cause sever pain?:  YES    NO  

Does your condition restrict use of your hands?:  NO    YES  

Does your condition restrict your ability to see?:  NO    YES  

Does your condition restrict your ability to hear?:  NO    YES  

Has your condition resulted in loss of employment?:  YES    NO  

Has your condition caused a physical deformity?:  NO    YES  

Has your condition caused a decline in your ability to memorize or concentrate?:  NO    YES  

Do you feel your condition has gotten worse with time?:  YES    NO  

Please list all the impairments you feel have reduced your ability to work:

Please list all medications and side affects:

Send Electronic Records

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