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2020-11-06T10:57:02+00:00
Are You Already Receiving SSDI Benefits?
Yes
No
Are You Seeing a Doctor?
Have you been treated for your disability within the past year?
Yes
No
Does Applicant Expect To Be Out Of Work For At Least 12 Months?
Yes
No
Is Applicant Currently Working Full Time?
Yes
No
How Many Years Has Applicant Worked In Last 10 Years?
Less than 1 year
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
I haven't worked in the last 10 years
Have You Accumulated More Than $7,500 In Personal Loans, Medical or Credit Card Debt?
Yes
No
Want A Free Bankruptcy Relief Evaluation To Determine Your Eligibility For Bankruptcy?
Yes
No
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