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Injured in a work accident? Fill out the free workers’ compensation evaluation form below and we’ll help you find out how much your claim may be worth!

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– Step 1 of 3

Date of your accident? (your best guess is fine) *

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Did you need at least a week off work to recover? *

• Yes
• No

Do you already have a lawyer handling your case? *

• Yes
• No

Next

Briefly describe the injury and the incident that caused it. *

Next

First Name *

Last Name *

Email *

Phone Number *

Zip Code *

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