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Free Assessment Quiz:

Take our free assessment to check if you qualify for Social Security Disability benefits up to US$3,345 per month.

Take our free assessment to check if you qualify for Social Security Disability benefits up to US$3,345 per month.

Name*
First Last
Email*
LaPorte Law Firm can help you with your claim

Simply answer a few quick questions, so we can determine your eligibility for Social Security Disability benefits.
Are you currently working full time?*
- Yes
- No
Have you worked full time for at least 5 out of the past 10 years?*
- Yes
- No
If you are currently not working, when was your last day of work?*
YYYY slash MM slash DD
Do you have a medical condition preventing you from working?*
- Yes
- No
What is the medical condition(s) preventing you from working?*
Do you expect the condition(s) to prevent you from working for at least a year (12 months)?
- Yes
- No
Are you receiving medical treatment currently?*
- Yes
- No
City of residence*
Have you applied for Social Security Disability benefits before?*
- Yes
- No
By providing a telephone number and submitting the form you are consenting to be contacted by SMS text message. Message & data rates may apply. Reply STOP to opt out of further messaging.
Email
This field is for validation purposes and should be left unchanged.

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