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Which of these best describes your employment law issue?
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Wrongful Termination
Failure to Pay Wages
Bullying / Harassment
Other
What are you looking for?
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See if I have a case
Want information
Get advice
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... and your last name:
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In case we need to reach you for clarification, please give us the best phone number at which to reach you.
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Please enter the best email address to use:
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Please enter the company name:
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Are you a federal employee?
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Yes
No
Please enter the city you worked out of:
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Please select the state where you worked from the list below:
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How many employees worked at the company?
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0 - 15
16 - 100
100+
What was your job title?
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Are you still employed with them?
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Yes
No
Were you let go, did you resign, or were you not hired?
Let go
Resigned
Not hired
Other
Dates of employment, month and year? (00/0000 - 00/0000)
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It's ok to put in the date if you remember it (i.e. Sept 15, 2014), or something like "8 years ago in Sept", or "haven't started yet"...
Did the company offer you a Severance Agreement?
Yes
No
When was the severance given, and when is your deadline?
How were you paid?
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Hourly
Salaried
Please enter your hourly pay rate. How many hours per week do you think you worked?
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Please enter your annual salary.
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Were you classified as exempt from overtime pay?
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Yes
No
Not sure
Regarding overtime, how were you paid overtime wages?
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I did not work overtime wages
I worked overtime but did not receive overtime pay
Time-and-a-half
Straight time (or the same as my regular hourly rate)
My overtime rate fluctuated
Do you receive your lunch breaks?
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Yes
No
Are lunches being deducted from your daily hours?
Yes
No
Did you receive your rest breaks?
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Yes
No
How often do you receive them?
Are you part of a union?
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Yes
No
Is the union currently assisting you?
Yes
No
If yes, how is the union assisting you?
Would you like to share your gender identity and your pronouns?
Race:
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Age:
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Spanish Speaking Only?
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Yes
No
Do you think your age, race, disability, or gender played a factor in your employment issue?
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Yes
No
Tell us why you think you got fired for wrongful termination:
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Be as detailed as you would like - there is plenty of space
Tell us why you do not believe you were fairly paid.
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Tell us about the bullying / harassment:
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Please enter as much detail as possible.
Why do you think your age, race, disability, or gender played a role in your employment issue?
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Do you believe the bullying/harassment is as a result of your age, gender or race?
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Yes
No
Why?
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Please enter as much detail as possible.
Tell us what happened:
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Please enter as much detail as possible.
Any additional notes?
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