Gruhin & Gruhin
Certified Workers' Compensation
Specialist Attorney

WORKERS' COMPENSATION INQUIRY FORM
If you would like to be contacted
please complete the entire form

           

           

            Your name:
           

            Your email address:
           

            Your Telephone Number & Area Code:
             

            Ohio County in which the
          work injury took place:
             

             Ohio County in which you live:
             

            Date of accident:
     
 

            Time of accident:
     
:   

            Was anyone injured in the accident  ?
 

    I was injured
    My Co-Workers were Injured
    More People Were Injured

            As a result of my work injury, I had a:

    Head Injury
    Neck Injury
    Back Injury
    Knee Injury
    Hand Injury
    Wrist Injury
    Elbow Injury
    Carpal Tunnel Syndrome Injury
    Reflex Sympathetic Dystrophy Syndrome Injury
    Loss of Hand Injury
    Loss of Finger Injury
    Loss of Foot Injury
    Loss of Toe
    Crushed Hand Injury
    Crushed Finger Injury
    Crushed Foot Injury
    Crushed Leg Injury
    Crushed Body Injury
    It's Much More Complicated than anything listed
     

            Please describe the accident & injuries in as
         much detail as possible:

                         
           

                                   

         Please note:  You must be a resident of The State of
                       Ohio
or you must have been involved in
                       a work accident in the State of Ohio in
                       order for us to respond to this inquiry.

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Please note that this transmission does not create an attorney-client
relationship. Pursuant to Ohio Law, Gruhin & Gruhin does not represent
anyone in a contingency matter without a signed contract for legal services.

Answers provided to any *email legal inquiries* are provided as 
general information only.

 If you need legal advice for a specific legal problem, dealing with an 
Ohio injury claim, an in depth consultation is necessary.

Please call or email to schedule a free initial consultation so that we
can discuss the complete event & review any relevant papers.
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