Questionnaire

Review this website and its resource links to determine what type of claim you may have and fill out the intake form for a free claim review.

The clients for whom we can provide effective counsel are:

  • Employees and individuals who have been denied disability and pension benefits.
  • Employees and individuals who have been denied continued health coverage during periods of family caregiving or following termination of employment.
  • Partners, managers, administrators, and others who need to negotiate executive compensation or severance arrangements, or reasonable exit and non-competition agreements.
  • Former employees who are sued over unreasonable non-competition or “non-compete” agreements.
  • Employees and individuals who have been discriminated against.
  • Reasonable people who have serious problems in the workplace.
  • Whistleblowers (Sarbanes-Oxley, health & safety, and others).


Items marked with an asterisk (*) are required.


Note: Please do not use an email provided by your employer
If you have difficulty explaining and you have a letter or other document you think will help us, please send a copy to us
(Specify the date you filed your appeal)
(Specify the date you received a response to your appeal)
(Specify the date your appeal is due)

For Disability Claims

(From which are you are seeking benefits)
(list all medical conditions involved)

Please read the following carefully.

I am submitting this questionnaire and attachments for review by Clark Law Group, PLLC. I understand the following:

  1. That the submission of information is for review only and that there will be no charge for this review.
  2. Clark Law Group, PLLC and I have not entered into an attorney-client relationship and are not acting as my attorney unless and until a formal, written Retainer Agreement has been signed both by me and by a representative of Clark Law Group, PLLC. No decision has yet been made on whether Clark Law Group, PLLC will take my case and there is no guarantee that the firm will accept my case.
  3. Further information may be requested in order for Clark Law Group, PLLC to reach a decision.
  4. It takes time to review the material submitted and to make any reply or decision. Because no attorney-client relationship has yet been established, I will be responsible until I am notified otherwise to meet all necessary deadlines and time frames applicable to my claim; and I acknowledge that I have not received any representations or legal opinions with respect to any time frames or deadlines that may be applicable to my claim.

Contact Our Office

Clark Law Group, PLLC
1100 Connecticut Avenue, NW
Suite 920
Washington, DC 20036
Phone: (202) 293-0015
Fax: (202) 293-0115
Google+
Map/Directions

Contact Us


Clark Law Group, PLLC
Washington, DC
1100 Connecticut Ave, NW
Suite 920
Washington, DC 20036
Phone: (202) 293-0015
Fax: (202) 293-0115
Toll Free: 855-202-0011

Clark Law Group, PLLC
Chicago, IL
150 N. Wacker Drive
Suite 1925
Chicago, IL 60606
Phone: (312) 574-3420
Toll Free: 855-769-7500

Clark Weekly

Topic of the Week

Military Leave

As a member of the United States Uniformed Services, you are entitled to special workplace protections under federal law. The Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA) seeks to ensure that those who serve their country can

Read more...

Blog of the Week

Trade war drives up unemployment in key 2020 battleground states

Unemployment remains low nationwide, but it’s starting to tick up in a some key places—places dependent on the industries hit hard by Donald Trump’s trade war, and places that just happen to be in battleground states.

Thought for the Week

"This year, we celebrate the 25th anniversary of the Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA), a fundamental support to our all-volunteer force. With roots dating back to World War II, USERRA became law on Oct. 13, 1994, and has helped to build a more robust reserve component, enabling the world’s strongest military to be economically efficient and deeply woven into the fabric of American community life. USERRA strengthened and formalized economic protections that enable all service members’ careers to progress, without pause, while serving our nation."

–Jonathan VanderPlas; Military Times

List of the Week

from DOL: Veterans' Employment & Training Service

Employment Situation of Veterans

  • The jobless rate for all veterans fell to an 18-year low of 3.5% in 2018, from its peak at 9.9% in 2011
  • The unemployment rate for women veterans fell to 3.0 percent in 2018
  • October 2019, the veteran unemployment rate remained at 3.2 percent, the same rate as last month

Top Five News Headlines

  1. Black Facebook Workers Write Open Letter to Company: We Are Treated Every Day 'as If We Do Not Belong Here'
  2. LinkedIn CEO Wants to Curb Sexual Harassment Hidden in Private Messages
  3. EEOC sues Sprint retailer over alleged sexual assault in Sacramento
  4. Marciano Art Foundation is accused of unfair labor practices
  5. Union Decries VA Response to Lynched Doll Found in Staff Area of Louisiana Facility