Workers’ Compensation Intake — Workplace Fall Injury
Client: Dylan Client
Contact: (555) 123-4567 | dylan@client.com
Employer: Southeastern Packaging Solutions – Charlotte, NC
Type of Case: Workers’ Compensation – Workplace Fall
Date of Incident: December 3, 2025, approx. 8:20 AMClient has worked for the employer for approximately 1.5 years as a warehouse line operator, responsible for loading pallets, moving materials, and stacking boxes. On December 3, client was placing boxes on a second-shelf rack while using a small step stool provided by the employer. The stool wobbled and slipped, causing client to fall roughly three feet backward onto a concrete floor, striking his back and right knee. Debris was present on the ground (broken pallet pieces, plastic wrap), and the step stool had a known history of instability. Multiple workers had previously complained. Coworker Jeremy witnessed the fall and helped client up.
Client immediately notified supervisor Mark Manager, who dismissed the injury, telling the client to “walk it off.” Supervisor did not file an incident report or send client for medical treatment. Employer has not offered light duty, stating they “don’t really do light duty.” Client is currently out of work with no return-to-work plan communicated.
Client went to Novant Health Urgent Care after leaving work early. X-rays performed on back and knee. Diagnoses include: lumbar strain, knee sprain, and possible meniscus irritation. Prescribed anti-inflammatories. Advised to avoid lifting; MRI may be needed if knee locking continues.
Back pain rated 7/10, knee pain 8/10, painful to bend, walk, or sit. Symptoms worsening.
Witness: Jeremy Witness (coworker). Safety Gear: Steel-toed boots and gloves; no harness required for the task.
Scheduled for today at 4:00 PM with Attorney Michelle Lawyer. Client instructed to have urgent-care paperwork available for the consultation.
Full Name Dylan Client Phone (555) 123-4567 dylan@client.com
Employer Southeastern Packaging Solutions (Charlotte, NC) Position Warehouse Line Operator Time Employed About 1.5 years Job Duties Loading pallets, moving materials, stacking boxes
Date December 3, 2025 Time ~8:20 AM Location Warehouse floor – at rack area Description of Incident Client was placing boxes on the second shelf while standing on a small step stool. Stool wobbled and slipped; client fell backward approx. 3 feet onto concrete. Ground had debris (broken pallet pieces, plastic wrap) contributing to hazard. Stool known to be unstable; complaints previously made by workers. Safety Gear Used Steel-toed boots, gloves Hazards Present Debris on floor; unstable equipment Height of Fall Approx. 3 feet Witness(es) Jeremy Witness (coworker)
Reported to Supervisor? Yes – to supervisor Mark immediately Supervisor Reaction Dismissive; told client to “walk it off” Incident Report Filed? No Employer-Sent Medical Care? No Light Duty Offered? No – employer said they “don’t really do light duty” Current Work Status Out of work; employer has not contacted client with plan
Primary Complaints Back pain (lumbar area), Right knee pain, locking when bending, Pain when walking, bending, or sitting Pain Levels Back 7/10; Knee 8/10 Impact Area Back and right knee Symptoms Progression Worsening
Medical Provider Novant Health Urgent Care Tests Performed X-rays (back and knee) Diagnoses Lumbar strain; knee sprain; possible meniscus irritation Medications Anti-inflammatories Restrictions No heavy lifting Future Treatment Recommended MRI if knee continues locking
Existing Workers’ Comp Attorney? No – none retained
Workplace fall with hazardous conditions (debris, unstable stool)
Employer failure to file report or provide medical care
Documented medical injuries
Client out of work with restrictions
Witness present
Strong indication for workers’ compensation representation
Date/Time Today at 4:00 PM Attorney Michelle Lawyer Method Attorney will call the client directly Client Notified To Bring Urgent-care paperwork
Dear Mr. Client,
Thank you for speaking with us today. This email is to confirm your free workers’ compensation consultation with our office.
Appointment Details:
- Date: Today
- Time: 4:00 PM
- Attorney: Michelle Lawyer
- Method: Telephone call
- Call-Back Number: (555) 123-4567
Attorney Michelle Lawyer will call you directly at the scheduled time. Please make sure your phone is available and that you are in a quiet place where you can speak freely.
For the consultation, please have the following available if possible:
- Any paperwork or discharge instructions from Novant Health Urgent Care
- Information related to your workplace accident and injuries
If your condition worsens, your work status changes, or you receive any additional medical treatment before the appointment, please let us know.
We understand this situation is stressful, and we appreciate you trusting us. We look forward to assisting you.
Kind regards,
Alex
Intake Specialist
Law Firm
(555) 123-4567
Hello Mr. Client, this is Alex from Law Firm. Just a quick reminder of your workers’ compensation consultation today at 4:00 PM with Attorney Michelle Lawyer. She will be calling you at this number. Please have your urgent care paperwork handy if available. We look forward to speaking with you.Dear Mr. Client,
This is a friendly reminder of your workers’ compensation consultation scheduled for today at 4:00 PM with Attorney Michelle Lawyer.
Appointment Details:
- Time: 4:00 PM
- Attorney: Michelle Lawyer
- Method: Telephone call
- Call-Back Number: (555) 123-4567
Attorney Lawyer will call you directly at the scheduled time. If available, please have any paperwork from Novant Health Urgent Care ready for reference during the call.
If you have any questions or if something changes before your appointment, feel free to reply to this email or contact our office.
We look forward to assisting you.
Kind regards,
Alex
Intake Specialist
Law Firm
(555) 123-4567