Apply for Disability Benefits Assistance

We are able to assist when applying for benefits, such as SSI/SSDI, if you are struggling with paperwork, finding necessary information or tracking down records. Fill out the form on this page to be referred to one of our disability benefits team members.

Request for Initial Social Security Benefits Assistance

Items marked with an * are required.

Name of person or agency making this referral:

Center for Independence will not disclose the status of a submitted request without a HIPAA compliant signed Release of Information.

This is not an Application for Social Security Benefits. We will ask questions to see if we think you might be eligible to apply for Social Security benefits.

For us to help you, the following must be true:

1) You do not have an active application for Social Security. This means that you are not working with anyone else and that you are not applying for Social Security on your own.

2) You have a disability that stops you from working full-time.

3) You think you will be disabled for at least 12 months in a row, OR

Your doctors have told you that you have less than a year to live.

Are all of the items above true for you?

Initial Screening Questions, NO Active App, Not FTE, 12+ Months or Death

Yes

Center for Independence

Empowering Individuals with Disabilities since 1982

Apply for Disability Benefits Assistance

Request for Initial Social Security Benefits Assistance