Workers' Compensation : Work Related Injuries

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Workers' compensation: Work Related Injuries

Every day workers get injured on the job - injuries that may be serious, permanent, or even lead to death. OSHA estimates that 5,000 workers die each year from work-related injuries.

If you or a loved one is injured on the job, you are entitled to workers’ compensation benefits, regardless of who is at fault. The law requires employers to buy insurance and to compensate employees in case of work-related injuries.

Worker's Compensation Benefits

Workers’ compensation benefits usually cover your medical expenses and a percentage (usually one half to two thirds) of your wages while you are unable to work. In exchange for these guaranteed payments you will not be able to sue your employer. You may, however, still sue any third party who may have negligently contributed to, or caused, your injury.

To contact us, please fill out the form below or call us at 1-800-275-0192.

If you or a loved one has been injured in a work-related accident, you may be entitled to compensation to pay for treatment and for pain and suffering. Complete the form below for a free evaluation of your claim.

The law limits the amount of time after a patient incurs an injury to file suit. The amount of time varies based on the theory of liability and the state in which the patient files the suit.

The information you provide will only be used in accordance with our terms and conditions. By submitting this form, you certify that you agree to our terms and conditions and want us to contact you regarding your inquiry.

* denotes required fields


Title
First Name
Middle Initial
Last Name
Address
Address Cont.
City
State
Zip Code
Phone Number (day)
Phone Number (eve)
E-mail

If this inquiry is not for yourself, please tell us the name of the person.
Title
First Name
Middle Initial
Last Name
What is this person's relationship to you?
Injured's date of birth:	[None]
When did injury occur? i.e. (mm/dd/yyyy)
Where did injury occur?
How did injury occur?
What is your injury?
Are you currently receiving benefits?	Yes No
If yes, what is your weekly rate?
How long have you been out of work?
Has your physician released you to work in any capacity?	Yes No
Has your physician advised that you have sustained permanent injury?	Yes No
What is the name of the company you work for?
What is the address of the company you work for?
What is the name of your insurance carrier?
Are you currently receiving treatment?	Yes No
Do you currently have an attorney?

Please briefly describe your legal concern:

* I agree that submitting this form does not create an attorney client relationship.

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