Halcyon SSD Intake Assistant

AI-powered SSD case assessment and scoring system

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Instant Analysis

AI-powered case scoring

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Precise Scoring

0-100 evidence-based scale

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Clear Recommendations

Actionable guidance

Quick Upload PDF

Upload a document to auto-fill the form fields below

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⬆️Upload PDF to Auto-Fill Form

How it works: Upload a PDF intake document and the system will automatically extract and fill in the form fields below. Review the auto-filled data and make any necessary adjustments before submitting.

Practice Area & Form Settings

Practice Area

Select your practice area for proper case tracking and analysis

Smart Suggestions

Enabled

Show condition-related suggestions for functional limitations and medications

Client Information

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Child Disability Case (Under 18)

Enable for claimants under 18 at time of filing. Uses SSA's "functional equivalence" standard.

Full Name *

Date of Birth *

Age

Phone Number

Email Address

Gender

Alleged Onset Date

Last Worked

Already Applied for Disability?

Case Stage

Date Last Insured (DLI)

DLI unknown

Work Status

SSDI Eligibility

SSI Eligibility

Medical & Other Information

Assistive Devices

Requires Dialysis

Requires Supplemental Oxygen

Highest Level of Education

Mental Health Hospitalization

History of Incarceration

Obesity (BMI >30)

Medical Conditions

Add medical conditions one at a time. Each condition will trigger smart suggestions for limitations and medications.

Medical Conditions

No conditions added yet. Click "Add Condition" to get started.

Functional Limitations

Describe how medical conditions limit daily activities and work ability.

Functional Limitations

Separate multiple limitations with commas. Auto-populated from your medical conditions. Edit or delete as needed.

Current Medications

List current medications with dosages if known.

Medications

Separate multiple medications with commas. Auto-populated from your medical conditions. Edit or delete as needed.

Work History

Describe previous jobs and work duties.

Work History

Include job titles, main duties, physical requirements, and dates if known.

Treatment History

Treatment consistency significantly impacts SSA disability determination.

Has client received consistent medical treatment for their conditions in the last 12 months?

Consistent treatment can add up to +5 points. Gaps may reduce score by up to -9 points.

Complete assessment will provide case scoring and recommendations