Workers' Compensation provides wage benefits and medical care for employees injured as a result of an accident, injury, or occupational disease while "on the job."    Injured workers are entitled to compensation regardless of whether the accident, injury, or occupational disease was the injured workers' fault (with some very limited exceptions).    Additionally,  you have a right to a doctor of your own choice.  

Unfortunately, it is not unusual for an employer or its insurance company to deny wage benefits or medical care to its injured employees.      

If you have been injured on the job and your wage benefits and/or medical care, including the right to see you own doctor, is being withheld, and you are unable to return to work, please fill out the information below and an attorney will contact you within 24 to 72 hours.

Note:   The use of the internet, this website, or the form below does not create an attorney-client relationship.    Confidential or time sensitive information should not be sent through this form.


Name:                  
City:                    
State:                  
Phone Number:
Email Address:  

Date of Injury:

Did you report the accident to your employer?:

Are you currently receiving wage benefits?:

Are you seeing the doctor of your choice?:

Last date you received benefits:

Best Time to Call:

Preferred Method of Contact:

Tell Us About Your Case: