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2a06:98c1:3121::3  Public Scan

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URL: https://usbenefitsguide.com/
Submission Tags: @ecarlesi possiblethreat #phishing Search All
Submission: On October 28 via api from FR — Scanned from NL

Form analysis 1 forms found in the DOM

Name: form1 — POST thankyou.php

<form action="thankyou.php" name="form1" id="form1" method="post">
  <input type="hidden" name="subid1" id="subid1" value="2150">
  <input type="hidden" name="subid2" id="subid2" value="">
  <input type="hidden" name="oid" value="92">
  <input type="hidden" value="" name="form_step1" id="form_step1">
  <input type="hidden" value="" name="form_step2" id="form_step2">
  <input type="hidden" value="" name="form_step3" id="form_step3">
  <input type="hidden" value="" name="form_step4" id="form_step4">
  <input type="hidden" value="" name="form_step5" id="form_step5">
  <input type="hidden" value="50" name="form_step6" id="form_step6">
  <input type="hidden" id="fbclid" name="fbclid" value="">
  <input type="hidden" name="submitted" id="submitted" value="0">
  <input id="leadid_token" name="universal_leadid" type="hidden" value="F3F5978E-C45F-AE74-A5B1-91F36A0CB27E">
  <input type="hidden" name="uid" id="uid" value="TW96aWxsYS81LjAgKFdpbmRvd3MgTlQgMTAuMDsgV2luNjQ7IHg2NCkgQXBwbGVXZWJLaXQvNTM3LjM2IChLSFRNTCwgbGlrZSBHZWNrbykgQ2hyb21lLzExOC4wLjU5OTMuMTE3IFNhZmFyaS81MzcuMzYyMDAxOjFhZjg6NDAyMDphMDM0Ojk4NzY6OjEy">
  <div class="form-step1" id="step11" style="height:auto;">
    <div class="formmiddle">
      <p style="margin-bottom: 40px;">What is your zip code?<br>
        <font style="font-size:12px;color:#898989;font-weight:normal;line-height:20px;">*your location may have an impact on your eligibility</font>
      </p>
      <div style="display: table;margin: auto;padding-bottom: 100px;">
        <input type="tel" name="zip" id="zip" placeholder="Zip Code" class="gobox" value="" maxlength="5" minlength="5" style="width:180px; border: 1px solid #b9b9b9; padding: 10px 40px;display:inline-block;font-size: 18px;" required="">
        <input type="button" value="GO" class="gobtn">
        <label id="zip-error" class="error leftpart" for="zip" style="margin-top: 20px;"></label>
      </div>
    </div>
  </div>
  <div class="form-step1" id="step1">
    <div class="formmiddle">
      <div class="w3-light-grey">
        <div class="w3-container w3-red w3-center" style="width:13%">13%</div>
      </div>
      <p>Do you expect to be out of work for at least a year due to your health?</p>
      <div class="button">
        <button id="Yes" type="button" class="btn left">YES</button>
        <button id="No" type="button" class="btn right">NO</button>
      </div>
    </div>
    <div class="backbtn"><a href="#" id="backfrm1">Back</a></div>
  </div>
  <div class="form-step1" id="step2">
    <div class="formmiddle">
      <div class="w3-light-grey">
        <div class="w3-container w3-red w3-center" style="width:25%">25%</div>
      </div>
      <p>Have you been treated by a doctor, hospital, or clinic in the last year?</p>
      <div class="button">
        <button id="Yes" type="button" class="btn left">YES</button>
        <button id="No" type="button" class="btn right">NO</button>
      </div>
    </div>
    <div class="backbtn"><a href="#" id="backfrm2">Back</a></div>
  </div>
  <div class="form-step1" id="step3">
    <div class="formmiddle">
      <div class="w3-light-grey">
        <div class="w3-container w3-red w3-center" style="width:38%">38%</div>
      </div>
      <p>Have you had a full time job within the past 5 years?</p>
      <div class="button">
        <button id="Yes" type="button" class="btn left">YES</button>
        <button id="No" type="button" class="btn right">NO</button>
      </div>
    </div>
    <div class="backbtn"><a href="#" id="backfrm3">Back</a></div>
  </div>
  <div class="form-step1" id="step4">
    <div class="formmiddle">
      <div class="w3-light-grey">
        <div class="w3-container w3-red w3-center" style="width:50%">50%</div>
      </div>
      <p>Do you currently receive Social Security benefits?</p>
      <div class="button">
        <button id="Yes" type="button" class="btn left">YES</button>
        <button id="No" type="button" class="btn right">NO</button>
      </div>
    </div>
    <div class="backbtn"><a href="#" id="backfrm4">Back</a></div>
  </div>
  <div class="form-step1" id="step5">
    <div class="formmiddle">
      <div class="w3-light-grey">
        <div class="w3-container w3-red w3-center" style="width:63%">63%</div>
      </div>
      <p>Have you hired an advocate or attorney to help get benefits?</p>
      <div class="button">
        <button id="Yes" type="button" class="btn left">YES</button>
        <button id="No" type="button" class="btn right">NO</button>
      </div>
    </div>
    <div class="backbtn"><a href="#" id="backfrm5">Back</a></div>
  </div>
  <div class="form-step1" id="step6">
    <div class="formmiddle">
      <div class="w3-light-grey">
        <div class="w3-container w3-red w3-center" style="width:75%">75%</div>
      </div>
      <p style="margin-bottom:20px;">How old are you?</p>
      <div class="select">
        <select class="selectbox" style="margin-bottom: 30px;">
          <option value="18">18</option>
          <option value="19">19</option>
          <option value="20">20</option>
          <option value="21">21</option>
          <option value="22">22</option>
          <option value="23">23</option>
          <option value="24">24</option>
          <option value="25">25</option>
          <option value="26">26</option>
          <option value="27">27</option>
          <option value="28">28</option>
          <option value="29">29</option>
          <option value="30">30</option>
          <option value="31">31</option>
          <option value="32">32</option>
          <option value="33">33</option>
          <option value="34">34</option>
          <option value="35">35</option>
          <option value="36">36</option>
          <option value="37">37</option>
          <option value="38">38</option>
          <option value="39">39</option>
          <option value="40">40</option>
          <option value="41">41</option>
          <option value="42">42</option>
          <option value="43">43</option>
          <option value="44">44</option>
          <option value="45">45</option>
          <option value="46">46</option>
          <option value="47">47</option>
          <option value="48">48</option>
          <option value="49">49</option>
          <option value="50" selected="">50</option>
          <option value="51">51</option>
          <option value="52">52</option>
          <option value="53">53</option>
          <option value="54">54</option>
          <option value="55">55</option>
          <option value="56">56</option>
          <option value="57">57</option>
          <option value="58">58</option>
          <option value="59">59</option>
          <option value="60">60</option>
          <option value="61">61</option>
          <option value="62">62</option>
          <option value="63">63</option>
          <option value="64">64</option>
          <option value="65">65</option>
          <option value="Over 65">Over 65</option>
        </select>
      </div>
      <button type="submit" id="age_button" name="age_button" class="btnfinal" style="min-width:180px;width:300px;margin-top:15px;">CONTINUE</button>
    </div>
    <div class="backbtn"><a href="#" id="backfrm6">Back</a></div>
  </div>
  <div class="form-step1" id="step7" style="height:auto;">
    <div class="formmiddle" style="text-align:center;">
      <div class="w3-light-grey">
        <div class="w3-container w3-red w3-center" style="width:88%">88%</div>
      </div>
      <p style="margin: 35px auto 15px auto;">Briefly describe your case</p>
      <textarea type="text" name="description_step7" value="" id="description_step7" placeholder="Briefly describe what happened" class="intextarea" title=""
        style="width:80%;min-height:100px;border-color:#999;font-size: 20px;border-radius: 10px;margin-bottom:20px;font-family: 'AvenirRoman',sans-serif;padding: 10px;color: #999;"></textarea>
      <br>
      <label id="descerror" class="error" for="description_step7" style="display:contents;"></label>
      <button type="submit" id="desc_button" name="desc_button" class="btnfinal" style="min-width:180px;width:300px;margin-top:15px;">CONTINUE</button>
    </div>
    <div class="backbtn" style="padding-bottom: 50px;"><a href="#" id="backfrm7">Back</a></div>
  </div>
  <div class="form-step1" id="step8" style="height:auto;">
    <div class="formmiddle" style="text-align:center;">
      <div class="w3-light-grey">
        <div class="w3-container w3-red w3-center" style="width:92%">92% - FINAL STEP</div>
      </div>
      <p>Enter your contact information</p>
      <div class="select">
        <input type="text" name="firstname" id="firstname" placeholder="First Name" class="marginright" value="">
        <label id="firstname-error" class="error leftpart" for="firstname"></label>
        <input type="text" name="lastname" id="lastname" placeholder="Last Name" value="">
        <label id="lastname-error" class="error rightpart" for="lastname"></label>
      </div>
      <div class="select">
        <input type="text" name="email" id="email" placeholder="Email Address" class="marginright" value="">
        <label id="email-error" class="error leftpart" for="email"></label>
        <input type="text" name="phone" id="phone" placeholder="Phone Number" maxlength="14" value="">
        <label id="phone-error" class="error rightpart" for="phone"></label>
      </div>
      <button type="submit" class="btnfinal" id="bsubmit" name="bsubmit">SEE IF I QUALIFY</button>
      <button class="btnfinal" id="loading" name="loading" style="display:none;"><img src="images/loading.gif" alt=""> Processing!</button>
      <br>
      <div style="padding: 0px 10% 20px 10%;color:#9c9c9c;font-size: 12px;"><label><input type="hidden" id="leadid_tcpa_disclosure">By clicking the "See If I Qualify" button, I consent by electronic signature to: receive autodialed and/or
          pre-recorded telemarketing calls, emails and/or SMS text (standard cellular rates may apply) from usdisabilitypartners.com and its <a target="_blank" href="../partners.php" style="color:#9c9c9c;text-decoration: underline;">clients</a> in
          order to provide me with lawsuit information and other products or services at the telephone number I provided. I also consent to the usdisabilitypartners.com
          <a target="_blank" href="../privacy.php" style="color:#9c9c9c;text-decoration: underline;">Privacy Policy</a> and <a target="_blank" href="../terms.php" style="color:#9c9c9c;text-decoration: underline;">Terms of Use</a>. I understand that I
          may receive a call even if my telephone number is listed on a Do Not Call list and that my consent is not a requirement of purchase.</label></div>
    </div>
  </div>
  <input type="hidden" name="xxTrustedFormToken" id="xxTrustedFormToken_0" value="https://cert.trustedform.com/169eaa0849545fba9c6a2be6509f90241c3b109b"><input type="hidden" name="xxTrustedFormCertUrl" id="xxTrustedFormCertUrl_0"
    value="https://cert.trustedform.com/169eaa0849545fba9c6a2be6509f90241c3b109b"><input type="hidden" name="xxTrustedFormPingUrl" id="xxTrustedFormPingUrl_0"
    value="https://ping.trustedform.com/0.gpA4cztVfRxOuI9lsO7-qyCT2_kkjO6v9ZgZLhWGd8Bc1Dh1r6FjgBNXrsDbyP9YLe2P804P.OLj0s_wdRbUXu_QRb_KVGA.TZGzf2ozpt9FTNJEM9NcKA">
</form>

Text Content

YOU COULD RECEIVE UP TO $3,345 / MONTH
IN DISABILITY BENEFITS!




ARE YOU ELIGIBLE?
COMPLETE THIS SHORT SURVEY TO FIND OUT.

What is your zip code?
*your location may have an impact on your eligibility


13%

Do you expect to be out of work for at least a year due to your health?

YES NO
Back
25%

Have you been treated by a doctor, hospital, or clinic in the last year?

YES NO
Back
38%

Have you had a full time job within the past 5 years?

YES NO
Back
50%

Do you currently receive Social Security benefits?

YES NO
Back
63%

Have you hired an advocate or attorney to help get benefits?

YES NO
Back
75%

How old are you?

18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 Over 65
CONTINUE
Back
88%

Briefly describe your case


CONTINUE
Back
92% - FINAL STEP

Enter your contact information



SEE IF I QUALIFY Processing!

By clicking the "See If I Qualify" button, I consent by electronic signature to:
receive autodialed and/or pre-recorded telemarketing calls, emails and/or SMS
text (standard cellular rates may apply) from usdisabilitypartners.com and its
clients in order to provide me with lawsuit information and other products or
services at the telephone number I provided. I also consent to the
usdisabilitypartners.com Privacy Policy and Terms of Use. I understand that I
may receive a call even if my telephone number is listed on a Do Not Call list
and that my consent is not a requirement of purchase.

If you have a diagnosed medical disability that is expected to last longer than
12 months you may qualify for disability benefits.


ABOUT SSDI



The Social Security Disability Insurance (SSDI) and Supplemental Security Income
(SSI) programs provide assistance to people with disabilities.

The SSDI program pays benefits to you and certain family members if you are
“insured.” This means that you worked long enough – and recently enough - and
paid Social Security taxes on your earnings.

The Supplemental Security Income (SSI) program pays benefits to adults and
children with disabilities who have limited income and resources.

While these two programs are different, the medical requirements are the same.
If you meet the non-medical requirements, monthly benefits are paid if you have
a medical condition expected to last at least one year or result in death.

Up to 70% of all initial SSDI applications are denied after their initial
application. If you’ve already applied and been denied don’t worry – we can help
with your appeal. The process should be fast and easy with a Social Security
attorney on your side.

GET THE BENEFITS YOU DESERVE
*This program is not affiliated with the US government

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