Workers Comp 2023 English
Date of injury:
Next of kin:
The Client suffered injuries as a result of a work-related accident that occurred on or about , in County, Georgia. The Client wishes file a claim with the Georgia State Board of Worker’s Compensation against the responsible party (the “Services”).
The Fees for the Services outlined shall be Contingent. IF THERE IS NO RECOVERY, THERE IS NO FEE.
This contract for legal services may be terminated at will at any time by either party upon written notification subject to the provisions below. In the event Client terminates this contract, all unpaid costs and expenses shall immediately become due and payable.
The Firm shall be entitled to payment for Services rendered before the date of termination:
In any event, Client grants the Firm a lien and security interest against any proceeds for all unpaid costs, expenses and fees.
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Document Name: Workers Comp 2023 English
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