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Disability Benefit Evaluation

If we can help, we will.

Disability Benefits Evaluation Request

The form below contains eleven (11) parts.  It will take at least twenty (20) minutes to complete. Depending on your unique situation, completing this form may be a lengthy process.  The information requested in this form is the same kind of information we would request from you on your initial consultation to our office.  Completing this form does not obligate you in any way, nor does it obligate our firm to represent you.  This form is simply a tool for helping us evaluate your potential for acquiring disability benefits from the Social Security Administration.

Completing this Form

You will need some fair amount of information on hand to complete this form.  You might find it easier to print our paper-based form and use it. If you would like to complete the questionnaire offline on paper, click on the print button below.  If you have not already done so, call our office to schedule a consultation and be sure to bring the completed forms with you then.

Completing this form online does not replace a consultation with our attorneys.  Consultations are cost and risk-free.  Completing this form online will save you time at your initial consultation, and you will not have to provide this information again.  The more thorough you are in responding, the fewer questions our paralegals will have to adequately prepare for your consultation with your attorney.

If you have not already contacted our office, we will use your preferred method of contact to setup your consultation.

Disability Benefit Evaluation Questionnaire

Disability Benefit Evaluation Request
I understand this is a request for an evaluation for Social Security Disability Benefits, and that I am not forming an obligatory relationship with David Gantt Law Office by completing this evaluation request form. *
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~ What Our Clients Say ~

2019 Martindale Hubble Review

October 29, 2019

David is clear, precise, and delivers as promises.

2019 Google Review

August 7, 2019

The entire staff were welcoming, knowledgeable, helpful, and nice people! David was professional. He knew exactly what he was talking about and did what he said he was going to do. I have had a wonderful experience with this firm and will not hesitate to use them in the future.

2019 AVVO Review “Get ‘er done Gantt!”

July 10, 2019

I was very satisfied with David Gantt’s expertise and knowledge in all aspects handling my case. He dealt with all the paperwork and contacted all necessary providers to get my medical history – it was extremely hassle free! He communicated and counseled me on what to expect – being very forthcoming (he’s a straight shooter)!…

2019 Facebook review

June 5, 2019

I highly recommend Mr. Gantt. He is very kind and always professional. He prepared me for my disability hearing and calmed my nerves. Everything happened exactly as he said it would. I honestly do not think that I would have been approved for disability without his help. Also, his office staff were always ready to…

2019 Google Review

May 28, 2019

Mr. Gantt took good care of me. I will be forever grateful for him getting me the social security payments I need for a disability due to military service. He seems like a genuine compassionate good man. I highly recommend! ~C.M.

2019 Google Review

May 10, 2019

David and his entire staff are so nice and show compassion to everybody. He was there when I had any questions. David Gantt is the best attorney in his field, he goes above and beyond. I am extremely grateful to him and his staff. ~M.H.

2019 Google Review

May 9, 2019

Very nice and friendly service. They always answered any of my questions. Had a great experience working with them on my disability case. I highly recommend there services! After trying for 6 years and 2 unfavorable decisions, David and his team did a great job representing my case and won. I appreciate there time and…

2019 Google Review

May 9, 2019

The whole office is very respectful. Answered all my questions. So Glad they were there cause I had no clue after fighting for 2 years. Thank you guys soo much. ~K.H.

2019 Google Review

May 9, 2019

I am very grateful to David Gantt & his staff! They were wonderful and made the confusing process much easier to understand. I wish I had contacted them sooner. They were super to work with and such nice people! Thank you so much! ~K.S.

Avvo Review 2019

May 7, 2019

Mr. Gantt is a highly compassionate and professional lawyer. He worked hard for me to show my disabilities. Always pleasant and supportive, while being very much on top of his cases. I recommend David Gantt to anyone. Great Attorney! 5 Stars. ~ Dakota

Google Review 2019

April 10, 2019

Wonderful client services..very friendly and willing to go the extra mile to help clients. highly recommend him for anyone needing assistance for the Disability SSI. ~T.D.

2019 Google Review

April 9, 2019

I am so grateful to Mr. Gantt & his staff. They have been so professional and knowledgeable. They’ve answered all of my questions and made a very stressful situation, bearable. I would not hesitate to recommend Mr. Gantt. He is knowledgeable, professional & caring. ~J.H.

Avvo Review 2019

April 8, 2019

Linda Calloway Mundy David Gantt is an outstanding Lawyer. I highly recommend him. He was beside me all the way and I would like to thank him. ~Linda 5 Stars

2019 Google Review

March 9, 2019

David Gantt and his staff are very professional, upfront, honest and nice. They made me feel at ease discussing my case. They helped me with every step of the way towards my disability approval. I would recommend them to anyone. They kept me updated on everything. Just wish I had contacted them sooner. ~D.P.S.

2019 Google Review

February 10, 2019

When I applied for Social Security Disability I saw no reason that I would need a lawyer since my case seemed clear. It wasn’t until the second rejection that I realized that I had no idea how the system worked. A couple of local lawyers I had contacted suggested that I talked to David Gantt…

2019 Google Review

February 10, 2019

This office is fantastic. The staff is helpful and friendly. He is honest with you about the pros and cons of your case. He works hard to get a positive result. ~S.G.

Martindale Review 2019

January 21, 2019

5.0/5.0 in Social Security. David was very professional, pleasant and focused on me and my situation while I was in his office. He did not allow interruptions. His office staff was helpful and readily available when I had questions.

Martindale Review 2018

October 8, 2018

Recommended 5.0/5.0 in Social Security. I highly recommended David Gantt. He is a kind and generous person. He puts you at ease from the minute that you meat him. Very efficient and does what he says he’ll do. His staff is awesome too. Trust me… You can’t go wrong with David Gantt.