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Do you qualify? Free Disability Evaluation:
Applicant currently receiving Social Security (SSI/SSDI) benefits? *
YES
NO
Has the applicant already applied for Social Security (SSI/SSDI) benefits? *
YES
NO
Does applicant expect to be out of work for at least 12 months? *
YES
NO
Is an attorney or Advocate helping you with this case? *
YES
NO
Applicant currently receiving treatment from a doctor for these medical conditions? *
YES
NO
Have you worked 5 out of the last 10 years?
YES
NO
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