Let's get started!

This should only take about 2 minutes to find out if we can help you get your benefits

YesNo

Are you currently out of work due to a mental or physical condition?

YesNo

Do you plan to be out of work for at least 1 year?

YesNo

Looking at all the jobs you’ve had, would you say you’ve worked at least 5 years since 2015?  


(It doesn't have to be 5 years in a row)

YesNo

Are you already receiving any disability benefits?

Great, almost there! Finding disability help in {state}

YesNo

Are you currently working with a lawyer on your disability claim?

Last question! Help is on the way!

How old are you?

Final Step

Based on your answers, your odds of getting the benefits you need are looking good


We'll just need a few more details to get started.

By clicking "Submit", I provide my express written consent via this webform interaction for an agent of Citizens Disability to contact me on the landline or mobile number: {phone} provided for marketing purposes even if I am on a Federal or State Do Not Call registry via live and/or automated dialing system telephone calls, and/or text messages. Consent is not a condition of any purchase. Standard data rates may apply. I further understand that this request, initiated by me, is an unscheduled contact request and is my affirmative consent to be contacted which is in compliance with all federal and state telemarketing and Do-Not-Call laws, and I agree to the Terms and Conditions and Privacy Policy.

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