Massachusetts Attorneys >> Welding Rod Massachusetts Attorneys.com provides a directory of Massachusetts lawyers who offer free case evaluations. To contact an attorney reviewing welding rod cases, please fill out the free welding rod evaluation form below.
Once you submit your form, your contact information will be sent to the sponsored Massachusetts attorney or law firm listed below. That lawyer will review your form in accordance with the site terms and conditions and may contact you to discuss your case. There is no cost or obligation for this service. This form will be sent to:
Attorney Attorney Justin R. Cook
10 Tremont Street, 7th Floor Boston, MA 02108 (617) 227-7000
Free Welding Fumes Consultation
Personal Information:
Date of Birth / Age:
(ex. mm/dd/yyyy or 54)
Are you inquiring for yourself?
Yes No
If not, who are you
inquiring on behalf of?
If you are NOT inquiring on your own behalf,
what is your relationship to the injured person?
Is the person deceased?
Yes No
If deceased, what is the cause of death
as stated on the death certificate:
Date of Death:
(ex. mm/dd/yyyy)
Was an autopsy performed?
Yes No
If not deceased, does the
injury prevent you or the
victim from working?
Yes No
If yes, when did you/victim stop working?
What is the approximate lost wages
due to the injury?
Symptom Information:
How long were you a welder for? years
What were the
dates of exposure?*
Begin:
End:
City where you worked:
*
State where you worked:
*
What types of welding have you done before?
(Ex. MIG, TIG, Steel, Alloy, Other)
What BRANDS and TYPES of welding rods do you remember using?
Have you experienced any of the following symptoms?
Please check all that apply:
Tremors in any extremity?
Yes No
If yes, please explain:
Rigidity in hands, arms,
legs, or upper body?
Yes No
If yes, please explain:
Gait (Walking) Disturbances?
Yes No
If yes, please explain:
Facial Effects?
Yes No
If yes, please explain:
Speech Disorders?
Yes No
If yes, please explain:
Sexual Dysfunction?
Yes No
If yes, please explain:
Other Symptoms?
Yes No
If you have any medical problems that you feel
may be related, please explain:
Have you ever had an
MRI of the brain?
Yes No
Have you ever received medical
care for any of your symptoms?
Yes No
Have you been diagnosed with any of the following conditions?
Manganism
Manganese Toxicity
Parkinson's Disease
Parkinsons-Like Syndrome
Parkinsonism
Other Neurological Disease
What was the date of diagnosis?
Case Description*
Please explain exactly what happened, trying to state
as thoroughly as possible who you believe was responsible
and why you believe that person was negligent:
Please explain the full extent of the victims injuries:
Comments / Additional Information
Is there anything else that would assist us in
understanding the facts of your case?
To Better Serve You:
Please tell us how you found us? If "other" please specify.
Please specify how you found us (if other than above):
If you found us using a search engine,
please tell us which search engine?
Please tell us exactly what terms you typed into the
search engine to find us? (i.e. Personal Injury Lawyers)
I understand that by filling out this free consultation form I am not forming an attorney client relationship. I understand that I may only retain an attorney by entering into a fee agreement and that by submitting this form I am not entering into a fee agreement. I understand that not all submissions may receive a response.
Yes
No
I agree that the above does not constitute a request for legal advice. I agree that any information that I will receive in response to the above question is general information and I will not be charged for the response to this e-mail question. I further understand that the law for each state may vary, and therefore, I will not rely upon this information as legal advice. I agree that if this matter requires advice regarding my home state, local counsel may be contacted for referral of this matter. I understand that email is not secure and thus I am not forming a confidential relationship.
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