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Worker's compensation questionnaire

workers compensation questionnaire

Hey there,

Are you a law firm, attorney, or lawyer handling worker's compensation cases? Then this Worker's Compensation Questionnaire is tailored for you. With it, you'll gather all the essential information about your client’s case in one go. This comprehensive tool can save you time, keep you organized, and ultimately streamline your case management process. Give it a try!

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Questions to include on your Worker's compensation questionnaire

1. Client Information

This basic information is necessary for any records and further communication.

  • What is your full legal name?
  • What is your email address?
  • What is your phone number?
  • What is your mailing address?

2. Case Details

This section is intended to gather details about the worker's compensation claim case. These details are important in understanding the nature and scope of the case.

  • Is this a new case or a continuation of an existing case? (New Case, Existing Case)
  • What is the name of the employee involved in the case?
  • What is the date of the incident?
  • Please briefly describe the incident.
  • What is the nature of the injury sustained?

3. Employer Information

This information is necessary to identify the employer involved in the case.

  • What is the name of the employer?
  • What is the employer's address?
  • What is the employer's contact number?

4. Treatment Information

This section is designed to gather information about the medical treatment received as a result of the incident.

  • Has the employee sought treatment for the injuries? (Yes, No)
  • If yes, provide the name and contact of the healthcare provider.
  • Has the injury led to any permanent disability? (Yes, No, Unknown)

The disability question is critical as it can significantly impact the amount of compensation awarded.

This information is relevant to understand any legal representation to date.

  • Has the employee engaged any legal representation? (Yes, No)
  • If yes, please provide the name and contact information of the legal representative.

The legal representation question is necessary because it can help you understand the potential complexity of the case if there are other parties involved.

6. Documentation

These questions relate to any supporting documentation for the case.

  • Can you provide copies of any medical reports relating to the case? (Yes, No)
  • Are there any witness statements or other documentation that supports the claim? (Yes, No)

The documentation questions are necessary to gather evidence supporting the worker's compensation claim. They are also critical for assessing the validity of the claim and preparing a strong case.

Things to consider

  1. Keep It User Friendly - The form should be easy to navigate and fill out. Use simple language and avoid legal jargon where possible. Make sure the form is mobile-friendly since many people might fill it out on a smartphone or tablet.
  2. Avoid Overcrowding - While getting as much information as possible is necessary, try not to overcrowd the form with too many questions. This might discourage the user from completing the form.
  3. Use Conditional Questions - Use form features that only show certain questions based on previous answers. For example, the question about the name and contact of the legal representative should only appear if the user previously selected 'Yes' for engaging legal representation.
  4. Privacy Matters - Make sure to include a privacy statement. Users should know why you need the information, how you will use it, and who will have access to it. This will increase their trust and increase the likelihood they will complete the form.
  5. Offer Assistance - Some users may need help or have questions while filling out the form. Consider including help texts, tooltips, or a customer service contact for support.
  6. Error Handling - Ensure your form has good error handling. If a user makes an error or forgets a required field, the system should clearly mark the error and explain how to correct it.
  7. Progress Indicators - If the form is long, use progress indicators. This helps users know how much of the form they have completed and how much is left, which can motivate them to finish filling it out.

How to create your Worker's compensation questionnaire

Now that you know what questions you should include, it's time to build your form!

The only problem is that traditional forms tools are inefficient.

People will forget to fill out your form. They'll get stuck halfway and not be able to finish it. Or they'll send you the wrong stuff. You end up wasting hours chasing people down over email. 

That's why you should give Content Snare a try. 

Content Snare is packed with advanced features that will have you hours:

  • Automatic reminders - Remind people to complete their form with fully customizable reminders.
  • Reject incorrect information - If a single question is filled out incorrectly, ask your client to re-do just that one item.
  • Autosaving - No progress gets lost. People can fill out forms in multiple sittings.
  • Comments and questions - If the person filling the form gets stuck, they can ask a question without having to email you.

Give it a go by signing up for your free 14-day trial

Get the information you need without chasing people

Content Snare is the stress-free way to get information from anyone. Break free of your inbox and reclaim your time. Let Content Snare chase your clients for you.