Were you injured while in the course and scope of your work?
(“Course and scope” means carrying out the business of your employer)
—Please choose an option—YesNo

Good. You have to have an on-the-job injury to have a workers’ compensation case.

You have to have an on-the-job injury to have a workers’ compensation case.

Were you driving a motor vehicle when the accident occurred?
—Please choose an option—YesNo

Your case could be stronger if you were driving while your injury occurred.

In what state did the accident occur?
—Please choose an option—NVALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Is your employer based in Nevada?
—Please choose an option—YesNoUnknown

Were there any witnesses to the injury?
—Please choose an option—YesNoVideo surveillanceUnknown

Having a witness or video surveillance strengthens your case.

Did you report the incident to your supervisor in 7 days?
—Please choose an option—Yes - in writingYes - verballyYes - both verbally and in writingYes, after 7 daysNo

Did you seek medical attention?
—Please choose an option—Yes, I went to an ER/clinic and was seen by a medical professionalNo, I have not

Do you believe you still need medical attention?
—Please choose an option—YesNo

Treatment for an injury is an essential part of a workers’ compensation case.

Treatment for an injury is an essential part of a workers’ compensation case.

What body part(s) were injured due to your work-related accident?
Injured body part:
HeadNeckShoulderArmHandBackElbowKneeHipGroinCoreUpper legLower legFootAnkle
Advanced symptoms:
Radiating painNumbness/tinglingWeakness in arms and/or legsUnusual headachesLoss of consciousness during the accident

Have you filled out a C4 form at the medical facility?
—Please choose an option—YesNo
Click here to view what C4 form looks like.

What is your age?
—Please choose an option—Under 3030-4041-5051-60Over 60

Your young age strengthens your case.

How much do you make per hour?
—Please choose an option—Under $10$10-$20$21-$30Over $30

Your higher hourly wage increases the value of your case.

How many hours do you work on average?
—Please choose an option—Under 30Over 30

Have you been off of work due to your injury?
—Please choose an option—NoYes- less than 4 daysYes- 5 days or more

Are there any other issues or difficulties you have experienced because of your industrial accident?
Termination/layoffSuspensionUnpaid wages from hours workedUnsafe working conditionLight duty position not offeredLight duty position changed your pay rateHarassmentDiscriminationCriminal matterTraffic citationUnpaid medical expensesPain and sufferingOtherNone of the above

Every case is unique. If you would like to discuss your case with one of our experience Work Injury attorneys, please fill out the info below:

or call 702-333-0000