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TALK TO A LAWYER TODAY |
(312) 967-0295
Justice Legal Counsel
Home
About
Practice Areas
Sexual Harassment in the Workplace
Sexual Harassment in Education
Housing Discrimination
Consumer Rights
Fee Structure
Blog
Human Rights
Housing Discrimination
Sexual Harassment
Sexual Harassment in Education
Contact
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E.g. High school
Employer Information
Employer complaint is against
*
Position at employer at issue
*
E.g. Sales Director
Approximate date of hire (if applicable)
Date of Termination (if applicable)
What county is the employer is located in?
*
Approximate number of employees?
*
Name and title of individuals complaint is against?
*
E.g. Jon Doe, CEO
Position at new employer (if applicable)
Salary/gross income at current position
*
I.e. current salary; or, I have obtained new employment making x amount.
Salary/gross income at position you were terminated from/denied/demoted from (If applicable)
What type of employment contract do you have?
*
For cause termination only
At-will
Union contract
Not sure
Please summarize the issue you are contacting us about, including any adverse actions the employer has taken. Note: you will be asked for more details in other questions.
*
E.g. I am contacting you because I believed I was not hired for a position because of my race; I have been harassed, disciplined, demoted, and retaliated against because of my race and for filing a complaint of discrimination.
Legal Liability
What employment issues are you contacting us about? Please note that additional questions will populate based on your response. Please check all that apply.
*
Discrimination
Harassment/hostile work environment
Retaliation/whistleblower
Sexual harassment
Disability: failure to accommodate
FMLA interference
Other wrongful termination (including breach of contract)
Other
Discrimination
The discrimination was based on my (please select a protected class)
*
Race
Sex/Gender
Disability
Age
Religion
National Origin
Pregnancy
Sexual Orientation/Gender Identity
Weight
Personality conflict/other
What is the protected class you believe you are being discriminated against for? (e.g. race, sex, age, disability etc.)
*
E.g. race, Black; sex/gender, female; age, 55
When did the adverse actions occur?
*
E.g. I was terminated on; I was denied a promotion on.
Name and title of decisionmaker
*
Has the decisionmaker made any discriminatory statements?
*
E.g. the decisionmaker stated they would not hire me because of my race; the decisionmaker made the following comments about my race.
Has anyone else in management or otherwise made any discriminatory statements?
*
If you were passed over for a position or promotion, or terminated, do you know who replaced you? If so, was this person of a different protected group (race, sex, religion etc.)? How do your qualifications compare to your replacement?
E.g. I am a female. I was replaced by a male. I was much more qualified for the position based on ...
Have you been treated differently than others of a different protected group in similar circumstances? If so, please describe the circumstances and disparate treatment.
*
E.g. the males are not disciplined for certain conduct while the females are.
Is there a pattern of discrimination?
*
E.g. Yes, this has happened to five other females. Their names are ...
Does the employer have any discriminatory policies?
*
E.g. the employer policy states that there can only be so many employees that are (race, sex, age, etc.)
What reason will the employer give for taking the adverse action?
*
E.g. the employer will say I was late too many times.
What facts demonstrate that this reason is a pretext (lie) for discrimination?
*
E.g. my timecard demonstrates I was never late.
Any other evidence that the employer's motive for taking the adverse action was discriminatory?
*
Harassment
The harassment was based on my (please select a protected class)
*
Race
Sex/Gender
Disability
Age
Religion
National Origin
Pregnancy
Sexual Orientation/Gender Identity
Weight
Personality conflict/other
What is your protected class for which you are being harassed for? (e.g. race, sex, age, etc.)
*
E.g. race, Black; sex/gender, female, etc.
How often are you being harassed?
*
Daily
Weekly
Monthly
Occasionally
Please describe the harassment. Include all incidents of derogatory names or comments.
*
E.g. I am called derogatory names based on my (race, sex/gender, etc.) such as .... on a daily basis.
Who is harassing you? Please include job title
*
E.g. my co-workers, names ..., and my supervisors, names ...
Have you made it known the harassment is unwelcome?
*
E.g. yes, I told them to stop many times.
Was the employer ever made aware of the harassment?
*
E.g. yes, I reported it to supervisors and HR.
If the employer was aware, did the employer ever take any steps to stop the harassment? If so, what actions did the employer take to stop the harassment?
*
E.g. no, nothing was ever done.
Retaliation
Why have you been retaliated against?
*
Opposing discrimination, harassment, or a violation of the law
Reporting discrimination, harassment, or a violation of the law
Participating in an investigation related to discrimination, harassment, or a violation of the law
Exercising my disability or FMLA rights
Personality conflict/other
Please elaborate on why you have been retaliated against
*
E.g. I was retaliated against for filing a complaint of discrimination against my supervisor with HR.
What actions has the employer taken against you in retaliation for the above activity?
*
E.g. I have been disciplined for no reason, terminated, demoted, etc.
Who was the person who decided to take the retaliatory actions against you?
*
E.g. supervisor, name
Was the decisionmaker aware of your opposition, report, participation or exercise of rights? How so?
*
E.g., yes, the supervisor knew of the report because I told them.
What evidence supports the conclusion that you were retaliated against because of the opposition, report, participation or exercise of rights?
*
E.g. the supervisor stated that I wouldn't be there long because of my report.
How will the employer justify its actions?
*
E.g. they will say my sales numbers were down.
What evidence demonstrates the employers explanation is pretext (a lie) for retaliation?
*
E.g. my sales numbers were the best in the department.
Sexual Harassment
Name and job title of person sexually harassing you
*
Is the person sexually harassing you a supervisor?
*
Yes
No
Please describe the sexual harassment, including how frequently it occurred
*
Did you make it known the sexual harassment was unwelcome? If so, how did you do this?
*
E.g. yes, I told him/her on many occasions to stop.
How has the sexual harassment impacted your ability to do your job?
*
E.g. it has made me frightened to go to work and caused a great deal of emotional distress.
Was the employer aware of the sexual harassment? If so, how so?
*
E.g. yes, it happened in front of management and I reported it.
If the employer was aware, did the employer ever take any steps to stop the harassment?
*
E.g. the person was told to stop, but nothing more was done and it continued.
Disability: Failure to Accommodate
Please describe your disability and how it affects your ability to do the job?
*
What accommodation did you request and how would this accommodation allow you to perform the job?
*
What reason did the employer give for refusing the accommodation?
*
Why is this reason insufficient to justify the denial?
*
FMLA Interference
Have you worked for the employer for at least 12 months?
*
Yes
No
Does the employer have 50 employees or more within 75 miles of your work location?
*
Yes
No
Have you worked 1,250 hours of more in the year preceding the FMLA request?
*
Yes
No
What was the reason you requested FMLA?
*
What reason was given for the denial or interference?
*
Why was this denial or interference wrongful?
*
Other Wrongful Termination
What reason did the employer give for your termination?
*
Why is this reason insufficient to justify your termination?
*
Other
Please describe in detail why you are contacting us?
*
How will the employer justify its actions?
*
Why is the employer's explanation not sufficient to justify its actions?
*
Chronology and Witnesses
Please provide a chronology of events
*
Please list any witnesses and knowledge the witnesses may have
*
Damages
Have you lost or been denied any of the following?
*
Pension
Profit Sharing
Medical Insurance
Other
No
What is the total amount of money you have or will lose as a result of the employer's actions?
*
Have you sought treatment for emotional distress as a result of the employer's actions?
*
Next
Additional Information
How did you find us? If referred by another firm, please provide the name of the firm.
*
Have you spoken with any other attorneys regarding you claim? If so, did they agree to take your case? If not, why?
*
Did you resign from your employment?
*
Are you a member of a union? If yes, did you file a grievance and what is the status?
*
Have you signed an agreement releasing your claims (a severance agreement)?
*
Have you signed an agreement to arbitrate your claims against the employer? This may be in your written employment contract.
*
Have you agreed to a shortened statute of limitations? This may be in your written employment contract.
*
Has there been an economic cutback (layoffs) at your employer?
*
Have you ever been terminated from a job prior to the issue you are raising with this firm? If yes, state the employer name and the year of the termination.
*
On any previous occasion, have you sued or have you been sued? If yes, please describe.
*
Did you make any false statements in your resume or employment application? If so, please describe.
*
Does your ex-employer have enough assets to a pay a judgment should your suit be successful?
*
Has your employer filed for bankruptcy or do you have any information indicating that youremployer has filed or may file for bankruptcy? If yes, please provide a brief summary of theinformation you possess, including, if known, any basic information about your employer’sbankruptcy action (e.g. court in which the case was filed, date of filing and case number).
*
Have you filed for bankruptcy or are you contemplating filing for bankruptcy? If you have filedfor bankruptcy, please provide basic information about your bankruptcy action (e.g. court inwhich your case was filed, date of filing and case number).
*
Have you applied for, or received, any of the following:
*
Medicare
Medicaid
Short-term disability coverage
Long-term disability coverage
Unemployment
Social security
None
Do you currently have any claims pending against the employer? If yes, where and what is the status of the complaint?
*
Do you post about your employment on Facebook or any other internet social media site?
*
Have you ever been charged with or convicted of a crime? If yes, provide details below.
*
You should understand that if we file a lawsuit on your behalf, your background will be extensivelyinvestigated by the other side. Is there anything we should know about your history prior toagreeing to represent you? Is there anything that would be damaging or embarrassing that may be revealed?
*
Do you have any relevant medical or mental health diagnosis?
*
Anything else we should know about your case?
*
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