Do I qualify for SSI/SSDI? Name(Required) First Last Email Address(Required) Do you currently receive SSDI/SSI, State disability, or Workman’s Compensation benefits?(Required) Yes No What type of benefits are you looking to receive?(Required) SSDI or SSI benefits State Disability Welfare or Food Stamps Private Insurance Claim Another Legal Matter Are you currently older than 63 years of age?(Required) Yes No Are you currently receiving medical treatment?(Required) Yes No Are you currently working?(Required) Yes No Are you planning to quit your job soon due to your disability?(Required) Yes No By contacting Disability Advocates Group Florida, you agree to receive emails, text messages, and phone calls regarding your legal inquiry, which may be considered advertising material. Emails, text messages, and phone calls may be automatically generated using the information from this contact form to better coordinate communication. You understand that your consent to this is not necessary to obtain legal services from Disability Advocates Group Florida. Messaging and data rates may apply.Please note: The results of the Social Security Disability (SSDI) or Supplemental Security Income (SSI) pre-qualification questionnaire provided by Disability Advocates Group are intended solely for preliminary informational purposes. Completion of this questionnaire does not guarantee eligibility for disability benefits under SSDI or SSI programs. Eligibility for these federal benefit programs is determined exclusively by the Social Security Administration (SSA), based on its own rules, procedures, and evaluation of your complete medical, vocational, and financial information. While Disability Advocates Group may assist you in applying for benefits and representing you throughout the claims process, we do not make eligibility decisions, nor do we award or deny benefits. Final determinations regarding eligibility and benefit payments are made solely by the SSA. If you have any questions about your rights, the claims process, or how we may assist you, please contact us directly.