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Tulsa, OK

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918.388.7752

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Oklahoma City, OK

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405.606.7440

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Bartlesville, OK

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918.335.3100

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    • Teresa M. Grasso-Herlan
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  • Home
  • Attorneys
    • Teresa M. Grasso-Herlan
    • Michael Clay
  • SSDI
    • Are You Eligible?
    • Benefits
    • Applications
    • Steps in the Claim Process
    • Denied Claims and Appeals
  • Supplemental Security Income (SSI)
  • Testimonials
  • Resources
    • FAQs
    • Download Our E-Book!
    • Blog
  • Locations
    • Tulsa
    • Bartlesville

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NOTE: When answering this question exclude the home you live in and the car you drive to get to and from your doctor appointments?
NOTE: Exclude the home you live in and the car you use to get to and from your doctor's appointments
Are you or anyone in your household currently receiving any state assistance (i.e., food stamps, Medicaid/SoonerCare, TANIF)?(Required)
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Have you submitted an application for disability benefits with the Social Security Administration?(Required)
Have you been denied for disability benefits within the last 60 days?(Required)
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    Do you have a copy of your physician’s statement he/she completed putting you on FMLA?(Required)
    Are you currently on Short Term Disability (STD) or Long Term Disability (LTD) benefits through your company?(Required)

    PAST RELEVENT WORK

    In order to help us determine if we can help you prove you cannot do the work you have done in the last 15 years, answer the questions below
    List each employer you have worked at in the last 15 years being sure to answer each question fully:(Required)
    COMPANY NAME
    DATE EMPLOYMENT BEGAN
    DATE EMPLOYMENT ENDED
    JOB TITLE
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    HOW MANY TOTAL HOURS DID YOU WORK A WEEK
    HEAVIEST WEIGHT LIFTED IN POUNDS(I.E., 10 POUNDS, 20 POUNDS, 50 POUNDS)
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    (i.e., cane, walker, wheelchair, crutches, etc.)?(Required)
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    Do you have a handicapped placard you hang in the window of your car (BLUE OR RED)?(Required)
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    Are you currently using medical marijuana?(Required)
    Do you have a criminal history?(Required)
    Since you became disabled have you applied for any Unemployment benefits through the state?(Required)
    Have you ever been injured on the job and filed a worker's compensation claim?(Required)
    Are you currently drawing any worker's compensation payments?(Required)
    Has your worker's compensation claim been settled or resolved?(Required)

    About Us

    Since 1990, the Social Security Law Center has been the leading social security law firm for Oklahoma City, Tulsa, and the surrounding areas.

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    Tulsa Area

    Tulsa, OK
    918-388-7752

    OKC Area

    Oklahoma City, OK
    405-606-7440

    Bartlesville Area

    Bartlesville, OK
    918-335-3100

    Phone: (918) 388-7752

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