my.disability-approval.org
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https://my.disability-approval.org/
Submission Tags: @ecarlesi possiblethreat #phishing Search All
Submission: On November 12 via api from AU — Scanned from AU
Submission Tags: @ecarlesi possiblethreat #phishing Search All
Submission: On November 12 via api from AU — Scanned from AU
Form analysis 1 forms found in the DOM
POST /fsg?pageId=907c9751-09f8-43f4-8e33-87109bad3434&variant=ak
<form action="/fsg?pageId=907c9751-09f8-43f4-8e33-87109bad3434&variant=ak" method="POST" id="fields"><input type="hidden" name="pageId" value="907c9751-09f8-43f4-8e33-87109bad3434"><input type="hidden" name="pageVariant" value="ak">
<div class="fields"><input id="utm_source" name="utm_source" type="hidden" class="hidden" value=""><input id="network" name="network" type="hidden" class="hidden" value=""><input id="keyword" name="keyword" type="hidden" class="hidden"
value=""><input id="matchtype" name="matchtype" type="hidden" class="hidden" value=""><input id="targetid" name="targetid" type="hidden" class="hidden" value=""><input id="campaignid" name="campaignid" type="hidden" class="hidden"
value=""><input id="campaignname" name="campaignname" type="hidden" class="hidden" value=""><input id="adgroupid" name="adgroupid" type="hidden" class="hidden" value=""><input id="adgroupname" name="adgroupname" type="hidden" class="hidden"
value=""><input id="creative" name="creative" type="hidden" class="hidden" value=""><input id="creativeid" name="creativeid" type="hidden" class="hidden" value=""><input id="creativename" name="creativename" type="hidden" class="hidden"
value=""><input id="feeditemid" name="feeditemid" type="hidden" class="hidden" value=""><input id="device" name="device" type="hidden" class="hidden" value=""><input id="devicemodel" name="devicemodel" type="hidden" class="hidden"
value=""><input id="loc_interest_ms" name="loc_interest_ms" type="hidden" class="hidden" value=""><input id="loc_physical_ms" name="loc_physical_ms" type="hidden" class="hidden" value=""><input id="gclid" name="gclid" type="hidden"
class="hidden" value=""><input id="msclkid" name="msclkid" type="hidden" class="hidden" value=""><input id="fbclid" name="fbclid" type="hidden" class="hidden" value=""><input id="placement" name="placement" type="hidden" class="hidden"
value=""><input id="lpurl" name="lpurl" type="hidden" class="hidden" value=""><input id="querystring" name="querystring" type="hidden" class="hidden" value=""><input id="getemails" name="getemails" type="hidden" class="hidden" value=""><input
id="wbraid" name="wbraid" type="hidden" class="hidden" value=""><input id="gbraid" name="gbraid" type="hidden" class="hidden" value="">
<fieldset class="step active" style="display: block;">
<div class="lp-pom-form-field radio-group multi-group" id="container_months_12" style="margin-bottom: -98px;"><label class="main lp-form-label" for="months_12" id="label_months_12" style="height: auto;"><span class="label-style">Are you out of
work for a health issue? *</span></label>
<div class="ub-input-item input-wrap optionsList" id="group_months_12">
<div class="option" id="ub-option-months_12-item-0"><input type="radio" id="months_12_yes" name="months_12" value="Yes" class="radio form-builder-radio-input form_elem_months_12" checked="checked" required=""><label for="months_12_yes"
class="opt-label form-builder-radio-label"><span class="label-style">Yes</span></label></div>
<div class="option" id="ub-option-months_12-item-1"><input type="radio" id="months_12_no" name="months_12" value="No" class="radio form-builder-radio-input form_elem_months_12" required=""><label for="months_12_no"
class="opt-label form-builder-radio-label"><span class="label-style">No</span></label></div>
</div>
</div>
</fieldset>
<fieldset class="step">
<div class="lp-pom-form-field radio-group multi-group" id="container_last_10" style="margin-bottom: -98px;"><label class="main lp-form-label" for="last_10" id="label_last_10" style="height: auto;"><span class="label-style">Did you work 5 of the
last 10 years? *</span></label>
<div class="ub-input-item input-wrap optionsList" id="group_last_10">
<div class="option" id="ub-option-last_10-item-0"><input type="radio" id="last_10_yes" name="last_10" value="Yes" class="radio form-builder-radio-input form_elem_last_10" checked="checked" required=""><label for="last_10_yes"
class="opt-label form-builder-radio-label"><span class="label-style">Yes</span></label></div>
<div class="option" id="ub-option-last_10-item-1"><input type="radio" id="last_10_no" name="last_10" value="No" class="radio form-builder-radio-input form_elem_last_10" required=""><label for="last_10_no"
class="opt-label form-builder-radio-label"><span class="label-style">No</span></label></div>
</div>
</div>
</fieldset>
<fieldset class="step">
<div class="lp-pom-form-field radio-group multi-group" id="container_doctor_care" style="margin-bottom: -98px;"><label class="main lp-form-label" for="doctor_care" id="label_doctor_care" style="height: auto;"><span class="label-style">Have you
seen a doctor in the last 6 months? *</span></label>
<div class="ub-input-item input-wrap optionsList" id="group_doctor_care">
<div class="option" id="ub-option-doctor_care-item-0"><input type="radio" id="doctor_care_yes" name="doctor_care" value="Yes" class="radio form-builder-radio-input form_elem_doctor_care" checked="checked" required=""><label
for="doctor_care_yes" class="opt-label form-builder-radio-label"><span class="label-style">Yes</span></label></div>
<div class="option" id="ub-option-doctor_care-item-1"><input type="radio" id="doctor_care_no" name="doctor_care" value="No" class="radio form-builder-radio-input form_elem_doctor_care" required=""><label for="doctor_care_no"
class="opt-label form-builder-radio-label"><span class="label-style">No</span></label></div>
</div>
</div>
</fieldset>
<fieldset class="step">
<div class="lp-pom-form-field radio-group multi-group" id="container_current_benefits" style="margin-bottom: -98px;"><label class="main lp-form-label" for="current_benefits" id="label_current_benefits" style="height: auto;"><span
class="label-style">Do you currently receive Social Security Benefits? *</span></label>
<div class="ub-input-item input-wrap optionsList" id="group_current_benefits">
<div class="option" id="ub-option-current_benefits-item-0"><input type="radio" id="current_benefits_yes" name="current_benefits" value="Yes" class="radio form-builder-radio-input form_elem_current_benefits" required=""><label
for="current_benefits_yes" class="opt-label form-builder-radio-label"><span class="label-style">Yes</span></label></div>
<div class="option" id="ub-option-current_benefits-item-1"><input type="radio" id="current_benefits_no" name="current_benefits" value="No" class="radio form-builder-radio-input form_elem_current_benefits" checked="checked"
required=""><label for="current_benefits_no" class="opt-label form-builder-radio-label"><span class="label-style">No</span></label></div>
</div>
</div>
</fieldset>
<fieldset class="step">
<div class="lp-pom-form-field radio-group multi-group" id="container_age" style="margin-bottom: -98px;"><label class="main lp-form-label" for="age" id="label_age" style="height: auto;"><span class="label-style">What is your
age? *</span></label>
<div class="ub-input-item input-wrap optionsList" id="group_age">
<div class="option" id="ub-option-age-item-0"><input type="radio" id="age_18_49" name="age" value="18-49" class="radio form-builder-radio-input form_elem_age" required=""><label for="age_18_49"
class="opt-label form-builder-radio-label"><span class="label-style">18-49</span></label></div>
<div class="option" id="ub-option-age-item-1"><input type="radio" id="age_50_64" name="age" value="50-64" class="radio form-builder-radio-input form_elem_age" checked="checked" required=""><label for="age_50_64"
class="opt-label form-builder-radio-label"><span class="label-style">50-64</span></label></div>
<div class="option" id="ub-option-age-item-2"><input type="radio" id="age_65" name="age" value="65+" class="radio form-builder-radio-input form_elem_age" required=""><label for="age_65" class="opt-label form-builder-radio-label"><span
class="label-style">65+</span></label></div>
</div>
</div>
</fieldset>
<fieldset class="step">
<div class="lp-pom-form-field single-line-text" id="container_first_name" style="margin-bottom: -98px;"><label class="main lp-form-label" for="first_name" id="label_first_name" style="height: auto;"><span class="label-style">First
Name *</span></label><input id="first_name" name="first_name" type="text" class="ub-input-item single text form_elem_first_name" placeholder="First Name" required=""></div>
<div class="lp-pom-form-field single-line-text" id="container_last_name" style="margin-bottom: -98px;"><label class="main lp-form-label" for="last_name" id="label_last_name" style="height: auto;"><span class="label-style">Last
Name *</span></label><input id="last_name" name="last_name" type="text" class="ub-input-item single text form_elem_last_name" placeholder="Last Name" required=""></div>
<div class="lp-pom-form-field email" id="container_email" style="margin-bottom: -98px;"><label class="main lp-form-label" for="email" id="label_email" style="height: auto;"><span class="label-style">Email *</span></label><input id="email"
name="email" type="email" class="ub-input-item single text form_elem_email" placeholder="Email" required="" pattern="^[a-zA-Z0-9._%+-]+@[a-zA-Z0-9_-]+\.[a-zA-Z0-9-.]{2,61}$"></div>
<div class="lp-pom-form-field single-line-text" id="container_phone_number" style="margin-bottom: -98px;"><label class="main lp-form-label" for="phone_number" id="label_phone_number" style="height: auto;"><span class="label-style">Phone
Number *</span></label><input id="phone_number" name="phone_number" type="tel" class="ub-input-item single text form_elem_phone_number" placeholder="Phone Number" required=""
pattern="^(\+?1[ -]?)?\(?[2-9]\d\d\)?[ -]?[2-9]\d\d[ -]?\d{4}$"></div>
</fieldset>
</div><button class="lp-element lp-pom-button hidee" id="lp-pom-button-311" type="submit"><span class="label">CONTINUE »</span></button>
</form>Text Content
Disclaimer: This is a paid attorney/advocate advertisement. This website is a group advertisement and a fee is paid for by participating attorneys and advocates. The site is not an attorney referral service or prepaid legal services plan. The site is privately owned and is not affiliated with or endorsed by the Social Security Administration, Department of Education, or any other Government agency. The promotion of this website is sponsored exclusively by attorneys and advocacy groups who provide services applicable to this website for the public. Your information will remain confidential, be stored according to our Privacy Policy/Terms of Use, and it will not be sold to third parties under any circumstances. The information on this page is provided for informational purposes only and is not intended to provide specific legal, financial, or medical advice. Submitting your information on this form does not create an attorney/client relationship. The law firms may contact you and may retain you as a client depending on several factors. To see a list of advertisers, Check Your Benefits Eligibility Now Get free help with your Social Security Disability application, denial, or appeal. GET QUALIFIED UP TO $3,345/MONTH IN SSDI BENEFITS Copyright © Disability-Approval.org All rights reserved. Privacy Policy - Accessibility Statement Check Eligibility Now Copyright © MB Legal Group PLLC. All rights reserved. Get assistance with your Social Security Disability application, denial, or appeal. Copyright © Disability-Approval.org All rights reserved. Privacy Policy - Accessibility Statement click here. By clicking “Submit” and/or using the chat box on this page, I hereby consent to receive autodialed and/or pre-recorded phone calls from a disability advocate or attorney at the telephone number(s) provided above, even if that phone number is a wireless number and even if you have previously registered that phone number on a “do not call” list. I understand that consent is not a condition of purchase. SOCIAL SECURITY DISABILITY ADVOCATES SOCIAL SECURITY DISABILITY ADVOCATES Are you out of work for a health issue? * Yes No Did you work 5 of the last 10 years? * Yes No Have you seen a doctor in the last 6 months? * Yes No Do you currently receive Social Security Benefits? * Yes No What is your age? * 18-49 50-64 65+ First Name * Last Name * Email * Phone Number * CONTINUE » word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word word mmMwWLliI0fiflO&1 mmMwWLliI0fiflO&1 mmMwWLliI0fiflO&1 mmMwWLliI0fiflO&1 mmMwWLliI0fiflO&1 mmMwWLliI0fiflO&1 mmMwWLliI0fiflO&1 👋🏼 See If You Qualify! 👋🏼 See If You Qualify! 👋🏼 See If You Qualify! Social Security Disability Scroll