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My total medical expenses have been
The cost to repair my vehicle/property is:
The amount of money I lost from work is:
The amount of future income I will lose is:
I will have future medical bills of:
Find Out How Much Your Case Is Worth
I was a victim in a(n):
This was a work related injury
The incident occurred:
I have taken the following action regarding my case
I was at fault less than 50%:
My total medical expenses have been
(including money you paid and paid by insurance)
The cost to repair my vehicle/property is:
Cost to repair car damage or, if the car was a total loss, the cost reimbursed by insurance for the car.
The amount of money I lost from work is:
(If you missed work because of your injuries, the total amount of your lost income.)
The amount of future income I will lose is:
(If you will be missing work in the future because of your injuries, the projected amount of your future income loss.)
I will have future medical bills of:
(If you will require medical care in the future, the projected cost for such care.)
My Injuries are:
I have broken bones:
I need surgery:
I need Medical Treatment
My "pain and suffering" is:
My recovery will take 6 months or longer:
My diagnosis and treatment is from:
My suffering will remain permanent:
My physician has clearly indicated I will have future problems:
I am looking to consult with an attorney:
Thank you but at the moment we are not accepting these types of cases
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INSTANT case value?
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