Name

Email Address

Phone Number

Area of interest Area of interest1 - Workers compensation2 - Motor Vehicle Accident Compensation3 - Asbestos and Silicosis compensation4 - Abuse Compensation5 - Medical Negligence6 - General Insurance

Has WorkCover accepted your claim? Has WorkCover accepted your claim?YesNo, WorkCover rejected my claimHaven't made oneWaiting on WorkCover

Did the case happen in the last 3 years? Did the case happen in the last 3 years?YesNo

Did the accident happen in QLD? Did the accident happen in QLD?YesNo

Were you working in QLD at the time you were exposed to silicosis/dust related disease? Were you working in QLD at the time you were exposed to silicosis/dust related disease?YesNo

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