Now you can contact our office at any time.
Simply fill out the following Social Security Disability Questionnaire.

Your Full Name (required)

Date of Birth:

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Your Street Address

Your City

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Your Zip Code

Are you currently working? YesNo

Date you last worked?

What is your job description?

When did you become disabled (onset date)?

Have you applied for Social Security Disability? YesNo
     If Yes, at what stage is your claim?

Are you currently under the care of a doctor?
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Please give a detailed description of your disability:




Transmission of an e-mail itself does not create an attorney-client relationship. Jeffrey Freedman Attorneys PLLC cannot serve you as your counsel in any matter unless you and our firm expressly agree in writing that we serve as your attorney.

Serving clients for
over 30 years

We have helped over 50,000 people thoughout New York since our firm was founded in 1980.

As a client, you can be assured that your case will receive special care and consideration. That means providing you with the most up-to-date legal advice. It also means taking time to fully explain the legal procedures we recommend, including all the options available to you.

At our firm, clients come first. We offer convenient appointment times at any of our 12 offices. We look forward to serving you and offering you the best solutions available.

– Jeffrey M. Freedman

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