Did you suffer an injury or illness on the job within the past three years?

Yes

Were you living or working in Texas at the time of your work injury or illness?

Yes

Were you employed by the federal government when you were injured or became ill?

Yes

If the injury or illness happened more than one month ago, did you notify your employer?

Less than a month ago

Yes - I have notified

No - I have not notified

If the injury or illness was over a month, have you filed a workers comp claim with the state?

Was less than a month

Yes - I’ve filed a claim

No - I’ve not filed a claim

If the injury or illness happened more than six months ago, have you ever received weekly workers' comp benefit checks?

Was less than 6 months

Yes

If you received an Impairment Rating, was it more than 90 days ago?

Do not have rating

No, it's less than 90 days

Yes, it was over 90 days

Is your claim related to Covid-19?

Yes

Have you ever been represented by an attorney for this work injury or illness?

Yes

We would like to talk to you about your case.

Please fill out the information below, and we will have an attorney contact you right away.

Full Name

Phone *

Email *

Address

12600 N. Featherwood Dr, Ste 200

Houston, Texas 77034

Phone & Fax

Main Office: 713-223-1234

Toll Free: 888-434-2667