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workers’ compensation contact form

Please feel free to contact us by using the form below. You also may contact us via phone, fax or at the address listed below.

Disclaimer:Submitting information to Boxer & Gerson, LLP via this contact page does not mean that Boxer & Gerson, LLP agrees to accept your case or that you have entered into an attorney-client relationship with Boxer & Gerson, LLP.

Law has many important deadlines. These deadlines could bar you from pursuing your case or affect your rights in other ways. If you are concerned about time deadlines, we urge you to contact us by phone at (510) 835-8870. We are not responsible for time deadlines in your case unless and until we have a specific written agreement to represent you.

If you are an existing client of the firm, please call the office to reach the attorney assigned to your case.

First Name Last Name  
Your Address
City State
 
Zip
    
E-mail Address
 Telephone
  


Do you already have a workers' compensation attorney?  Yes  No 

The date(s) of your work injury/illness:


A brief description of how your injury occurred:


Are you receiving weekly comp benefits?  YesNo

A brief description of the current status of your claim:


Have you chosen a QME to evaluate you? YesNo

A brief description of benefits you are being denied:
     

How did you find us?


Do you belong to a union?  Yes  No 

If so, which union and local?


Would you like to be added to our mailing list?  Yes  No 

By submitting this form, you agree that this matter may be sent to an attorney(s) who may contact you. You also agree that you have read and understand the disclaimer at the top of this form and that by submitting this form you are not creating a formal attorney-client relationship.



 

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