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                                    <h2 class="main-title"><strong>Understanding Social Security Disability (SSDI)</strong></h2>
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                                        Stay informed about the complex world of Social Security Disability, from program funding to eligibility requirements.
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                                        <a href="https://www.advocator.com/blog/social-security-adds-five-conditions-to-the-compassionate-allowance-cal-list/">Social Security adds five conditions to the Compassionate Allowance (CAL) list</a>
                                        <span class="date">September 3, 2020</span>
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    <div class="row">
        <div class="col s6 field-col col-required">
            <input class="block iconned log-class-footer" placeholder="First Name" type="text" name="firstname" id="txt-first-name" title="First Name" aria-label="First Name" aria-required="true">
            <i class="fa fa-info"></i>
        </div>
        <div class="col s6 field-col col-required">
            <input class="block iconned log-class-footer" data-required placeholder="Last Name" type="text" name="lastname" id="txt-last-name"  title="Last Name" aria-label="Last Name" aria-required="true">
            <i class="fa fa-info"></i>
        </div>
    </div>
    <div class="row">
        <div class="col s12 field-col col-required">
            <input class="iconned log-class-footer block" placeholder="Your Email: username@domain.extension" type="email" name="youremail" id="txt-your-email" pattern="^([^\x00-\x20\x22\x28\x29\x2c\x2e\x3a-\x3c\x3e\x40\x5b-\x5d\x7f-\xff]+|\x22([^\x0d\x22\x5c\x80-\xff]|\x5c[\x00-\x7f])*\x22)(\x2e([^\x00-\x20\x22\x28\x29\x2c\x2e\x3a-\x3c\x3e\x40\x5b-\x5d\x7f-\xff]+|\x22([^\x0d\x22\x5c\x80-\xff]|\x5c[\x00-\x7f])*\x22))*\x40([^\x00-\x20\x22\x28\x29\x2c\x2e\x3a-\x3c\x3e\x40\x5b-\x5d\x7f-\xff]+|\x5b([^\x0d\x5b-\x5d\x80-\xff]|\x5c[\x00-\x7f])*\x5d)(\x2e([^\x00-\x20\x22\x28\x29\x2c\x2e\x3a-\x3c\x3e\x40\x5b-\x5d\x7f-\xff]+|\x5b([^\x0d\x5b-\x5d\x80-\xff]|\x5c[\x00-\x7f])*\x5d))*$" title="Your Email" aria-label="Your Email" aria-required="true">
            <i class="fa fa-envelope"></i>
        </div>
    </div>
    <div class="row">
        <div class="col s12 field-col col-required">
            <input class="block iconned log-class-footer" data-required placeholder="Your Phone: 7815551212" name="yourphone" id="yourphone" data-required pattern="[1-9]{1}[0-9]{9}" title="Your Phone" aria-label="Your Phone" aria-required="true"></textarea>
            <i class="fa fa-phone"></i>
        </div>
    </div>

 <!--<div class="row">
        <button class="cta-btn bg-orange white">Submit<i style="margin-left: 10px" class="fa fa-chevron-right"></i></button>
    </div>-->
           <div class="row">
        <div class="col s12 field-col col-required">
            <input type="text" class="block iconned log-class-footer" name="yourage" id="txt-your-age-footer" placeholder="Date of Birth" onfocus="(this.type='date')" title="Date of Birth" aria-label="Date of Birth" aria-required="true">
            <i class="fa fa-birthday-cake"></i>
            <p id='dobError' class='error-message'>We are unable to assist you. Please contact your local Social Security office to discuss Social Security Insurance or Social Security Retirement.<a href='https://www.advocator.com/ssdi-qualifications/'> Click here</a> for more information on SSDI eligibility.</p>
        </div>
    </div>
    <div class="row">
        <div class="col s12 field-col col-required">
            <input class="block iconned log-class-footer" data-required name="yourzip" placeholder="Zip Code" type="text" data-pattern="[0-9]*" id="contactZip" title="Zip Code" aria-label="Zip Code" aria-required="true" pattern="[0-9]{5}" >
            <i class="fa fa-bolt"></i>
        </div>
    </div>
    <div class="row">
            <!--<input type="checkbox" checked name="unable_to_work" value="unable-to-work" id="unable_to_work123" />-->
            <div class="col s12 field-col col-required">
            <fieldset style="border:0;">
            <!--<label for="SSDI_benefits">--><legend>I am currently receiving SSDI benefits.</legend><!--</label>--><br>
            <input type="radio" name="SSDI_footer" id="ssdiYes" value="true" aria-required="true" required> Yes<br>

            <p id='ssdiError' class="error-message">We are unable to assist you because you are already receiving Social Security Disability benefits.</p>
            <input type="radio" name="SSDI_footer" id="ssdiNo" value="false"> No<br>
            </fieldset>
        </div>
    </div>
    <div class="row">
            <!--<input type="checkbox" checked name="unable_to_work" value="unable-to-work" id="unable_to_work123" />-->
            <div class="col s12 field-col col-required">
            <fieldset style="border:0;">
            <!--<label for="unable_to_work123">--><legend>I am unable to work due to a disabling medical condition.</legend><!--</label>--><br>
            <input type="radio" name="unable_to_work_footer" id="unableworkYes" value="true" aria-required="true" required> <label for="unableworkYes">Yes</label><br>
            <input type="radio" name="unable_to_work_footer" id="unableworkNo" value="false"> <label for="unableworkNo">No</label><br>
            </fieldset>
        </div>
    </div>
    <!--<div class="row">
        <div class="col s12 field-col col-required">
            <input type="checkbox" checked name="citizen-of-usa" value="citizen-of-usa" id="citizen_of_usa" />
            <label for="citizen_of_usa">I am a U.S. citizen</label>
        </div>
    </div>-->
    <div class="row">
                <div class="col s12 field-col">
                     <input type="hidden" name="form" value="Landing free evaluation" />

                     <input type="hidden" name="id" class="log-class-footer" value="map">
                     <input type="hidden" name="file" class="log-class-footer" value="form.dtc-apply-for-disability-map-primary.twig">
                </div>
            </div>
    <div class="row">
        <div class="col s12 field-col col-required">
          <!--  <input type="checkbox" checked name="worked-paid-taxes" value="worked-paid-taxes" id="worked_paid_taxes" />-->
          <fieldset style="border:0;">
            <!--<label for="worked_paid_taxes">--><legend>I worked at least 5 of the last 10 years and paid taxes.</legend><!--</label>--><br>
            <input type="radio" id="yes" name="worked-paid-taxes-footer" value="true" aria-required="true" required> <label for="yes">Yes</label><br>
            <input type="radio" id="no" name="worked-paid-taxes-footer" value="false"> <label for="no">No</label><br>
            <p id='noError' class="error-message">We are unable to assist you because you must have paid taxes for at least 5 out of the last 10 years to be eligible for Social Security Disability.</p>
            <input type="radio" id="notsure" name="worked-paid-taxes-footer" value="notsure"> <label for="notsure">Not sure</label><br>
            <p id="notsureError" class="error-message">Please call Social Security at 1-800-772-1213 and ask for your work credits and your date last insured.</p>
            </fieldset>

        </div>
    </div>
    <div class="row">
        <div class="col s12 field-col">
            <div style="max-width: 614px; display: block; margin: auto;">
<input type="checkbox" id="consent" name="consent_granted" checked value=true><input type="hidden" name="consent_granted_date" value="2021-03-30"><label for="consent">
    <span style="font-size: 0.75rem" class="permission-consent-to-contact-language">I consent to receive text messages from The Advocator Group, LLC at the telephone number above. The number of messages you receive may vary. Reply HELP for help, STOP to cancel. Message and data rates may apply. All communication policies can be reviewed at <a href="https://www.advocator.com/sms/" target="_blank">www.advocator.com/sms/</a>.</span>

    <br /><br />
    <span style="font-size: 0.75rem" class="permission-consent-to-contact-language">By clicking “send” below, I consent to receive emails and phone calls (via automatic telephone dialing system and artificial/pre-recorded message) from The Advocator Group, LLC or a third party vendor at the telephone number above. I have read and agree to the terms of the <a href="/sms/" target="_blank">Communication Policy</a>. By submitting your personal data, you consent to handling of the data consistent with our <a href="https://www.bbinsurance.com/privacy-statement/" target="_blank">Privacy Policy</a>.</span></label>
</div>        </div>
    </div>
    <div class="row">
        <button id="submitButton" class="cta-btn bg-orange white">Send to The Advocator Group<i style="margin-left: 10px" class="fa fa-chevron-right"></i></button>
    </div>
        <div class="row">
        <div class="col s12 field-col">
            <input type="hidden" name="utm_source" value="">
        </div>
    </div>
    <div class="row">
        <div class="col s12 field-col">
            <input type="hidden" id="utm_campaign" name="utm_campaign" value="June Test">
        </div>
    </div>
        <div class="row">
        <div class="col s12 field-col">
            <input type="hidden" id="form" name="form" value="apply for disability">
        </div>
    </div>
    <div class="row">
        <div class="col s12 field-col">
            <input class="ohnohoney" autocomplete="off" type="email" id="spamemail" name="spamemail" aria-label="Your Email Here" placeholder="Your e-mail here">
        </div>
    </div>
</form>
<style>

  input[type="date"]:before {
    content: attr(placeholder) !important;
    color: #aaa;
    margin-right: 0.5em;
  }
  input[type="date"]:focus:before,
  input[type="date"]:valid:before {
    content: "";
  }

#ssdiError{
    display: none;
}
#notsureError{
    display: none;
}
#noError{
    display: none;
}
#dobError{
    display: none;
}


#spamemail{
        opacity: 0;
        position: absolute;
        top: 0;
        left: 0;
        height: 0;
        width: 0;
        z-index: -1;
}





</style>




<script>
function replaceValidationUI( form ){

form.addEventListener('invalid', (function () {
  return function (e) {
    e.preventDefault();
  };
})(), true);

//safari
form.addEventListener( "submit", function( event ) {
        if ( !this.checkValidity() ) {
            event.preventDefault();
        }
    });


var submitButton = form.querySelector( "button:not([type=button]), input[type=submit]" );
    submitButton.addEventListener( "click", function( event ) {
        var invalidFields = form.querySelectorAll( ":invalid" ),
            errorMessages = form.querySelectorAll( ".error-message" ),
            parent;

        // Remove any existing messages
        // for ( var i = 0; i < errorMessages.length; i++ ) {

        //     errorMessages[ i ].parentNode.removeChild( errorMessages[ i ] );
        // }

        // for ( var i = 0; i < invalidFields.length; i++ ) {
        //     parent = invalidFields[ i ].parentNode;
        //     if(invalidFields[i].id == 'txt-your-age-footer'){
        //         if(invalidFields[i].value <= 18 || invalidFields[i].value >= 66){
        //         parent.insertAdjacentHTML( "beforeend", "<div class='error-message'>We are unable to assist you. Please contact Social Security to discuss Social Security Insurance or Social Security Retirement. Click here for more information on SSDI eligibility.</div>" )
        //         }
        //     }
        //     else{
        //     parent.insertAdjacentHTML( "beforeend", "<div class='error-message'>" +
        //         invalidFields[ i ].validationMessage +
        //         "</div>" );
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        // // If there are errors, give focus to the first invalid field
        // if ( invalidFields.length > 0 ) {
        //     invalidFields[ 0 ].focus();
        // }
    });
}

// Replace the validation UI for all forms
var forms = document.querySelectorAll( "form" );
for ( var i = 0; i < forms.length; i++ ) {
    replaceValidationUI( forms[ i ] );

}
</script>
<script>


function calculate_age(dob) { 
    console.log(dob);
    currentDate = new Date();
    var diff = currentDate.getTime() - dob.getTime();
    return Math.floor(diff / (1000 * 60 * 60 * 24 * 365.25));
}

function validating() {

    var values = {};
    $.each($(".log-class-footer").serializeArray(), function (i, field) {
      var name = field.name;
      values[name] = field.value;
    });

    var disabled = false;
    var today = new Date();
    var yyyy = today.getFullYear();
    var iYYYY = parseInt(yyyy, 10);    
    var DOBvalue = values['yourage'];
    var DOBarr = DOBvalue.split('-');

    var year = DOBarr[0];
    var month = DOBarr[1];
    var monthAdjust = parseInt(month) - 1;
    var day = DOBarr[2];

    var age = calculate_age(new Date(year, monthAdjust, day));

    if(age < 18 || age > 66){
        disabled = true;
        $('p#dobError').css('display','block');
    }
    else{
        $('p#dobError').css('display','none');
    }

    // //SSDI

    var ssdiCheck = $("input[name$='SSDI_footer']:checked").val();
    console.log(ssdiCheck);
    if(ssdiCheck == 'true'){
        disabled = true;
    }

    //worked-paid
    var workedpaidCheck = $("input[name$='worked-paid-taxes-footer']:checked").val();
    if(workedpaidCheck == "false"){
        disabled = true;
    }

    console.log(disabled);
    if (disabled == true){
        $('button#submitButton').prop("disabled", true);
        $('button#submitButton').css('background-color','gray');
        $('button').hide();
    }
    else{
        $('button#submitButton').css('background-color','#EC570C')
        $('button#submitButton').prop("disabled", false);
        $('button').show();
    }
}


$('input#txt-your-age-footer').on('blur', function(){
    validating();
});

// SSDI
$('input#ssdiYes').on('click', function(){
    $('p#ssdiError').css('display','block');
    validating();
});
$('input#ssdiNo').on('click', function(){
    $('p#ssdiError').css('display','none');
    validating();
});

//CALL YOUR PEOPLES ABOUT SSN
$('input#notsure').on('click', function(){
    $('p#notsureError').css('display','block');
    $('p#noError').css('display','none');
    //pull value out of the modal
    var modalzip = document.querySelectorAll( "#contactZip" );
    var zip = modalzip[1].value;
    //call our file with 
    $.getJSON("/SSA.json", function(data)
    {
        $.each(data, function(key,value){
            if(value.MailingPostalCode == zip){
                // we always want to append the default text so we can replace the same string every time
                var defaultText = " Please call Social Security at 1-800-772-1213 and ask for your work credits and your date last insured. ";
                $("#notsureError").text(defaultText);
                var text = $("#notsureError").text();
                //replace that with the correct value;
                var new_text = text.replace('1-800-772-1213', value.Phone);
                $("p#notsureError").text(new_text);
            } 
        });
    }); 
    validating();
});

$('input#no').on('click', function(){
    $('p#notsureError').css('display','none');
    $('p#noError').css('display','block');
    validating();
});

$('input#yes').on('click', function(){
    $('p#notsureError').css('display','none');
    $('p#noError').css('display','none');
    validating();
});

</script>

<script>
    $("#map").submit(function (e) {
        $('button').prop("disabled", true);
        $('button').css('background-color', 'gray');
        //disable a normal button
        $("button").prop("disabled", true);

        return true;
    });

    $(document).ready(function(){  
        function autoSave(){  
          //Serialize the Form
          var values = {};
          $.each($(".log-class-footer").serializeArray(), function (i, field) {
              var name = field.name;
              values[name] = field.value;
          });

          //true or false for ssdi, CHECK TO SEE IF IT EXISTS BEFOREHAND???
          var ssdiRadio = document.getElementsByName('SSDI_footer');
          if(ssdiRadio.length > 0){
          for (var i = 0, length = ssdiRadio.length; i < length; i++)
            {
                if (ssdiRadio[i].checked)
                {
                    values['SSDI'] = ssdiRadio[i].value;
                    // only one radio can be logically checked, don't check the rest
                    break;
                }
                else{
                    values['SSDI'] = "";                 
                }
            }
          }

          //true or false for unable to work
          var unableToWork = document.getElementsByName('unable_to_work_footer');
          if(unableToWork.length > 0){
            for (var i = 0, length = unableToWork.length; i < length; i++)
            {
                if (unableToWork[i].checked)
                {
                    values['unable'] = unableToWork[i].value;
                    // only one radio can be logically checked, don't check the rest
                    break;
                }
                else{
                    values['unable'] = "";                 
                }
            }
          }
                
          //true or false (or not sure) for unable to work
          var workPaid = document.getElementsByName('worked-paid-taxes-footer');
          if(workPaid.length > 0){
            for (var i = 0, length = workPaid.length; i < length; i++)
            {
                if (workPaid[i].checked)
                {
                    values['paid'] = workPaid[i].value;
                    // only one radio can be logically checked, don't check the rest
                    break;
                }
                else{
                    values['paid'] = "";                 
                }
            }
          }

          var emptyArray = "true";
          for (var key in values) {
              if (key == 'id' || key == 'file'){
                //do nothing
              }
              else{
                if (values[key] != ""){
                    emptyArray = "false";
                }
              }
          }

          var currentUrl = new URL(window.location.href);
          values['url'] = currentUrl['href'];

          // console.log(values);

          if (emptyArray == "true") {
              // do nothing
              // console.log("empty array!");
          }
          else{
              // console.log("its not empty!");
              $.ajax({  
                   url:"../../FormLogger.php",  
                   type:"POST",  
                   data:{"values":values},  
                   success:function(data)  
                   {  
                      // console.log("it worked!");
                   }  
              });  
          }            
        }  
          setInterval(function(){   
          autoSave();   
          }, 10000);  
    });
</script>                  </div>
</div>

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