claimpros.ai

Demo · Sample Call

This is what your
claimants hear.

A purpose-built SSDI intake call — not a phone tree, not a script. The AI traverses Blue Book logic, evaluates work history against SGA thresholds, applies grid rules, and delivers a qualification decision in under eight minutes.

2 min 54 sec
Degenerative disc disease · §1.15
Grid Rules triggered
Score: 84 · Pursue
0:38 / 2:54

Audio

Available to clients

Alex

0:04

Hi, is this James? This is Alex calling from Meridian Disability Law. You recently submitted a question about Social Security disability benefits. I have a few questions that should take about seven minutes — is now a good time?

TCPA consent captured before this call was placed.

James

0:18

Yeah, go ahead.

Alex

0:20

Thanks, James. Let's start with your medical situation. What's the main reason you're not able to work right now?

James

0:28

My back. Degenerative disc disease. I had surgery two years ago and it didn't fix it — still have constant pain, can't lift anything, can't sit for more than twenty minutes.

Alex

0:42

I understand — that's a debilitating condition. Has a doctor confirmed the diagnosis in writing? Things like an MRI report, surgical records, or chart notes.

Blue Book §1.15 (Disorders of the skeletal spine) — confirming documented evidence.

James

0:54

Yes, I've got all of it. Two MRIs, the surgical report, everything.

Alex

0:58

That documentation is exactly what matters for an evaluation. Let me ask about your work history. When did you last work, and what kind of work were you doing?

James

1:08

I stopped about eighteen months ago. I was a construction foreman — physical work, on site every day.

Alex

1:17

And since you stopped, have you done any work at all — even part-time or occasional jobs?

SGA threshold check: $1,550/month (2025). UWA flag if under threshold.

James

1:25

I tried a desk job for two weeks. Sitting made it worse, I had to quit.

Alex

1:31

That actually helps your case — it demonstrates you tried to return to work and your condition prevented it. Have you ever applied for SSDI or SSI benefits before?

Unsuccessful Work Attempt documented. Prior application fork triggered.

James

1:44

Once, about three years ago. They denied me at the first level and I just gave up.

Alex

1:52

That's more common than you'd think, and it doesn't hurt you now. A new application is evaluated fresh — and with surgical records, your work background as a foreman, and the time that's passed, the picture is different. How old are you, James?

Initial denial confirmed. No active appeal window. Fresh application path.

James

2:04

Fifty-one.

Alex

2:06

That's relevant. Under Social Security's grid rules, your age, your physical work background, and an inability to perform light or sedentary work all factor into the evaluation. Do you have a primary care physician or specialist you've been seeing for this condition?

Grid Rules §404.1563 — age 50–54 with heavy work history, limited to light/sedentary. Strong grid flag.

James

2:19

Yeah, Dr. Patel. She's been treating me since before the surgery.

Alex

2:24

Ongoing treating relationship — that's important. Based on everything you've shared, James, this looks like a case our attorneys will want to review. The documented diagnosis, the failed surgery, the work history, your age — these align well with what disability law is designed to cover. I'll flag this for attorney review today. Someone from the firm will reach out within one business day. Do you have any questions for me right now?

Score: 84 · Pursue — Attorney Review. Structured intake record generated.

James

2:48

No, I just — I didn't think I had a real shot, honestly.

Alex

2:54

You may have a stronger case than you realize. I'll make sure the file is ready when the attorney calls. Thanks for your time today, James.

Adaptive Logic

Every answer changes the path.

A human intake coordinator makes these judgment calls manually, inconsistently, and only during business hours. This logic runs on every call, every time.

Decision fork · Prior application history

"Have you ever applied for SSDI or SSI before?"

Never applied

Standard Blue Book traversal. DLI calculation from last insured date.

Initial denied

Confirm no active appeal. Fresh application path — prior denial has no bearing.

Reconsideration denied

Calculate appeal window (65-day deadline). Dual-track: reconsideration appeal vs. new filing.

ALJ hearing denied

Capture ALJ name. Calculate Appeals Council window (60 days). ALJ reversal rate surfaced for attorney.

Currently appealing

Stage and hearing office captured. Flag for immediate attorney escalation — no intake decision pending.

Decision fork · Work activity since onset

"Since you stopped, have you done any work at all?"

No work at all

DLI calculated from onset date. Insured status confirmed against quarters earned.

Under $1,550/month

Unsuccessful Work Attempt documented. Below SGA — does not break disability period.

Over $1,550/month

SGA threshold exceeded. Non-medical eligibility flag. Attorney review required before intake decision.

Self-employed / gig

Net earnings test applies, not gross. Countable hours and services evaluated separately.

Decision fork · Medical evidence on file

"Has a doctor confirmed the diagnosis in writing?"

Confirmed, records on hand

Evidence flag set: treating source documentation confirmed. Proceed to functional limits.

Confirmed, records not located

Record retrieval noted in intake file. Treating physician name captured for subpoena if needed.

Diagnosis not confirmed

Explain documentation importance. Condition category preserved — RFC assessment may still support claim.

Mental health only

Psychiatric Review Technique (PRT) criteria activated. Four functional area evaluation begins.

What's happening

Two conversations at once.

The claimant experiences a natural conversation. Underneath, every response triggers structured evaluation logic — in real time, invisibly.

What the claimant hears

What the system is doing

Natural greeting, permission to proceed

TCPA consent record created with timestamp and session ID

Condition and severity questions

Blue Book category mapped · Primary impairment code assigned

Work history conversation

SGA threshold evaluated · DLI calculated · UWA flag set if applicable

Prior application discussion

Application stage classified · Appeal window calculated · ALJ name captured if relevant

Age and treating physician

Grid Rules applied · Treating source relationship documented

Qualification decision delivered

Confidence score generated · Evidence flags set · Intake record created · Attorney notified

Built for compliance from the first second.

TCPA consent is captured before any call is placed. Every session generates a timestamped consent record. Claimants are offered a legal aid referral when they do not qualify. The attorney review interface enforces a 60-second read window and typed attestation before any case decision is confirmed.

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Full recordings shared during the onboarding conversation. Available to clients.

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claimpros.ai · SSDI intelligence platform · Transcript is illustrative — call logic runs live