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The form below allows you to request a Free disability benefits evaluation. Complete the form below and a disability advocate will review your case and call you to let you know if you may be eligible for benefits.

Free Evaluation
Applicant's Information
First Name MI Last Name
* Name:
* City:  
* State:
  * Zip Code:  
* Phone and time to call:
- -
 
* Email Address:
   
* Date of birth:
       
* Does applicant expect to be out of work for at least 12 months?
 
* Does applicant already receive Social Security benefits?
 
* Is an attorney helping applicant with this case?
 
* Is applicant currently under the care of a doctor?
 
* Is applicant an armed forces veteran?
 
* How many years has applicant worked in the last 10 years?
 
* What is the medical condition that prevents applicant from working?
 
By clicking the “I CONSENT” button, you give permission for GAR Disability Advocates, LLC and/or CBC Settlement Funding, LLC to call or email you regarding our services at the phone number that you have provided in the form above, even if that phone number is a wireless number and even if you have previously registered that phone number on a “do not call” list. You agree that GAR Disability Advocates, LLC may use an automatic telephone dialing system or artificial or prerecorded voice to contact you at the phone number you provided. You understand that giving permission to being contacted is not a condition of purchase or acceptance of property, goods or services of any kind.

Privacy and Security Notice: Your personal information is strictly confidential and secure.

Upon submitting this form, you will receive an email and/or a phone call shortly during regular business hours. A disability advocate will give you a free evaluation of your disability claim.


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This website provides a free disability case evaluation by an experienced disability advocate at GAR Disability Advocates, LLC. Global Leads Solutions, Inc., GAR Disability Advocates, LLC, and their respective parent companies, affiliates and subsidiaries are in no way connected to, or affiliated with, the Social Security Administration. If you wish to find or get help at the social security administration website, please click here.
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