Start My Social Security Disability Application

Disability Specialists strives to make the Social Security Disability application as simple and straightforward as possible.

Please call us toll-free at 1-800-642-6393 to request an intake interview, or simply complete the questionnaire below and we will contact you.

We work in 120 different languages. When your call is answered, state the language you prefer, then wait a moment while we get someone on the line to help.

    Have you started an application for Social Security benefits?

    Are you currently working and earning more than $1,470 per month?

    Are you able to perform any full time job that you have done in the past 15 years?

    Do you have severe physical and/or mental condition?

    Have you received treatment from a doctor for your condition?

    Will you miss at least 12 months of work because of your condition or have you already missed 12 months of work because of your condition?

    Your Name:                        


    Preferred Language:        
    (If other than English)

    Last Four of Your
    Social Security Number:  


    Street Address:                  

    Address Line 2:                  




    Date of Birth (mm/dd/yyyy) :  


    Best time of day to contact you?  

    Are you completing this form for someone else?

    If so, your name:

    What is your relationship
    to the individual?

    What is your phone number?

    What agency are you associated with, if any?

    May we contact you?