# Disability Legal Agreement
**THIS DISABILITY LEGAL AGREEMENT** (hereinafter referred to as the "Agreement") is made and entered into this ___ day of __________, 20__, by and between:
**[Client's Full Name]**
Address: [Client's Address]
City, State, Zip: [City, State, Zip]
Email: [Client's Email]
Phone: [Client's Phone]
(hereinafter referred to as the "Client")
AND
**[Law Firm's Name or Attorney's Full Name]**
Address: [Law Firm's Address]
City, State, Zip: [City, State, Zip]
Email: [Law Firm's Email]
Phone: [Law Firm's Phone]
(hereinafter referred to as the "Attorney")
**RECITALS**
WHEREAS, the Client has requested legal representation concerning disability benefits;
WHEREAS, the Attorney represents that they have the expertise and willingness to provide such legal services;
NOW, THEREFORE, for and in consideration of the mutual covenants and promises contained herein, the parties hereby agree as follows:
## 1. Scope of Representation
The Attorney agrees to provide legal services to the Client regarding the application for, appeal for, or ongoing issues related to disability benefits from federal or state agencies.
## 2. Fees and Costs
- The Client agrees to pay the Attorney a contingency fee of ___% of any back pay received as a result of the Attorney's services.
- The Attorney shall provide the Client with an itemized statement of all costs incurred in the representation. The Client shall be responsible for costs, including but not limited to filing fees, medical record fees, and other related expenses.
- All fees and expenses are due upon receipt of any back pay or other benefits awarded to the Client.
## 3. Client’s Responsibilities
The Client agrees to:
- Provide the Attorney with all necessary information and documentation related to their disability claim.
- Communicate promptly and fully with the Attorney regarding any issues or changes related to their case.
- Cooperate fully with the Attorney in all matters pertaining to the representation.
## 4. Termination
Either party may terminate this Agreement by providing written notice to the other party. In the event of termination:
- The Client will pay for all legal services rendered and costs incurred up until the date of termination.
- The Attorney will provide the Client with their case file and any necessary documentation.
## 5. Governing Law
This Agreement shall be governed by and construed in accordance with the laws of the State of [State].
## 6. Entire Agreement
This Agreement constitutes the entire understanding between the parties and supersedes all prior discussions, agreements, or understandings, whether written or oral, regarding the subject matter hereof.
## 7. Amendments
This Agreement may only be amended or modified in writing, signed by both parties.
## IN WITNESS WHEREOF,
The parties hereto have executed this Disability Legal Agreement as of the day and year first above written.
**CLIENT:**
_____________________________
[Client's Full Name]
**ATTORNEY:**
_____________________________
[Attorney's Full Name]
[Law Firm's Name]
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**Note:** This document is a template and should be tailored to fit specific needs and comply with local laws. It is advisable to seek legal counsel before finalizing any legal document.