Online Case Assessment

Do I have a case?

Complete this free online case assessment form and a disability lawyer from Yazdani Law Office will contact you within 12 hours to discuss your case. No obligations. Just answers.

    First Name:*

    Last Name:*

    Street Address:



    Home Phone:*

    Cell Phone:

    Email Address:


    Case Details

    Name of Insurance Company:

    Type of Insurance Policy:

    Amount of Monthly Benefits:

    Provide details about the medical condition and any symptoms that you are experiencing:

    Provide details about the reason the Insurance Company or CPP denied your disability claim:

    I acknowledge and agree that no lawyer-client relationship is established by submitting this online case assessment form
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    Disabled Law