Veterans Disability Consultation

We’re here to help you get the highest veterans disability compensation rating possible! Our 90+ years of combined experience means that you will benefit from a veterans disability consultation regardless of if you decide to work with us or not.

We represent veterans in all 50 states so in-person interviews are not necessary. Please complete the form below to get a and a member of our staff will be in touch with you very soon. Please also include when you would like to be contacted. We understand this is in depth, but it will help us be prepared to ask the best questions when speaking with you.

Mr/Ms.

Full Name *

First

Last

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Preferred Phone Number *

Date & Year of Birth

Secondary Phone

Email *

Character of Discharge from Service? *

To be eligible for our services, your character of discharge must not be a bar to VA benefits. We do not assist with discharge upgrades.

Do you have a Fee Agreement in place with another VA Accredited attorney or agent? *

Select one of the following
No, I've have never worked with one. Only free services or handled it myself.
Yes, but I disconinued their service and they waived the fees
Yes, but I'm not satisfied and am looking for a more aggressive and experienced advocate

Our advocates enter into a 20% of the retroactive benefit contingent upon favorable outcome agreements. Reasonable fees generally can't exceed 20%. Each advocate is individually accredited by the VA OGC and all fee agreements and awards are subject to review by the VA OGC. If you are satisfied with your current representative, even if its through a free service, we recommend that you stay with them. We assume anyone completing this form is looking for our help to get the most in VA compensation benefits.

Name of person who referred you?

Comment or Message *

Please tell us about your case. Recommend that you include Branch of Service, approximate dates of service, list any disabilities related to your service. If you are trying to get the VA to acknowledge service connection, provide a brief description on how you relate it. Please include your employment history. If not currently working, provide the last date you worked and the type of work you performed.

VA Claim # or Social Security #

VA claim # is an 8 digit number used for claims generally submitted by veterans of the Vietnam era and before. If you don't know or served more recently, your VA claim # is your SSN. You have the option of providing this on this form or directly to our staff over the phone.

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