If you can’t work–We want to help!
We help people get the Social Security and VRS Disability Retirement benefits
they need to improve their lives.
Terms and Conditions
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Thanks for filling out the form."><!-- [et_pb_line_break_holder] --><input type="hidden" id="_agile_form_id_tags" name="tags" value="Filled Out Contact Form"><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><input type="hidden" id="_agile_form_id" name="_agile_form_id" value="5652383656837120"><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- Text input--><!-- [et_pb_line_break_holder] --><div class="agile-group required-control"><!-- [et_pb_line_break_holder] --> <label class="agile-label" for="agilefield-3">First Name<span class="agile-span-asterisk"> *</span></label><!-- [et_pb_line_break_holder] --> <div class="agile-field-xlarge agile-field"><!-- [et_pb_line_break_holder] --> <input maxlength="250" id="agilefield-3" name="first_name" type="text" placeholder="" class="agile-height-default" required=""><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div class="agile-custom-clear"></div><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- Text input--><!-- [et_pb_line_break_holder] --><div class="agile-group required-control"><!-- [et_pb_line_break_holder] --> <label class="agile-label" for="agilefield-4">Last Name<span class="agile-span-asterisk"> *</span></label><!-- [et_pb_line_break_holder] --> <div class="agile-field-xlarge agile-field"><!-- [et_pb_line_break_holder] --> <input maxlength="250" id="agilefield-4" name="last_name" type="text" placeholder="" class="agile-height-default" required=""><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div class="agile-custom-clear"></div><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- Text input--><!-- [et_pb_line_break_holder] --><div class="agile-group required-control"><!-- [et_pb_line_break_holder] --> <label class="agile-label" for="agilefield-5">Phone Number<span class="agile-span-asterisk"> *</span></label><!-- [et_pb_line_break_holder] --> <div class="agile-field-xlarge agile-field"><!-- [et_pb_line_break_holder] --> <input maxlength="250" id="agilefield-5" name="phone" type="text" placeholder="" class="agile-height-default" required=""><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div class="agile-custom-clear"></div><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- Text input--><!-- [et_pb_line_break_holder] --><div class="agile-group required-control"><!-- [et_pb_line_break_holder] --> <label class="agile-label" for="agilefield-2">Enter Email<span class="agile-span-asterisk"> *</span></label><!-- [et_pb_line_break_holder] --> <div class="agile-field-xlarge agile-field"><!-- [et_pb_line_break_holder] --> <input maxlength="250" id="agilefield-2" name="email" type="email" placeholder="" class="agile-height-default" required=""><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div class="agile-custom-clear"></div><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- Text input--><!-- [et_pb_line_break_holder] --><div class="agile-group required-control"><!-- [et_pb_line_break_holder] --> <label class="agile-label" for="agilefield-6">Tell Us More<span class="agile-span-asterisk"> *</span></label><!-- [et_pb_line_break_holder] --> <div class="agile-field-xlarge agile-field"><!-- [et_pb_line_break_holder] --> <input maxlength="250" id="agilefield-6" name="note" type="text" placeholder="Enter a brief description of your legal situation." class="agile-height-default" required=""><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div class="agile-custom-clear"></div><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- Multiple Checkboxes (inline) --><!-- [et_pb_line_break_holder] --><div class="agile-group agile-form-multicheckboxes"><!-- [et_pb_line_break_holder] --> <label class="agile-label" for="inline_checkboxes_1516231257268">Disclaimer: I agree that by contacting you that no client-lawyer relationship has been created. Please do not send any confidential information to us until such time as an attorney-client relationship has been officially established.<span class="agile-span-asterisk"> *</span></label><!-- [et_pb_line_break_holder] --> <div class="agile-field agile-field-xlarge agile-height-default"><!-- [et_pb_line_break_holder] --> <label for="inline_checkboxes_1516231257268-0" class="i-checks"><!-- [et_pb_line_break_holder] --> <input type="checkbox" name="note" id="inline_checkboxes_1516231257268-0" value="Yes, I Agree"><i></i><!-- [et_pb_line_break_holder] --> Yes, I Agree<!-- [et_pb_line_break_holder] --> </label><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--recaptcha aglignment--><!-- [et_pb_line_break_holder] --><!-- Button --><!-- [et_pb_line_break_holder] --><div class="agile-group"><!-- [et_pb_line_break_holder] --> <div class="agile-field agile-button-field"><!-- [et_pb_line_break_holder] --> <button type="submit" class="agile-button" style="margin:0;">Send</button><!-- [et_pb_line_break_holder] --> <br><span id="agile-error-msg"></span><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></fieldset><!-- [et_pb_line_break_holder] --></form><!-- [et_pb_line_break_holder] --><script type="text/javascript"><!-- [et_pb_line_break_holder] -->(function(a){var b=a.onload,p=true;isCaptcha=false;if(p){a.onload="function"!=typeof b?function(){try{_agile_load_form_fields()}catch(a){}}:function(){b();try{_agile_load_form_fields()}catch(a){}}};var formLen=document.forms.length;for(i=0;i<formLen;i++){if(document.forms.item(i).getAttribute("id")== "agile-form"){a.document.forms.item(i).onsubmit=function(a){a.preventDefault();try{_agile_synch_form_v5(this)}catch(b){this.submit()}}}}})(window);<!-- [et_pb_line_break_holder] --></script>