Client Information

Client Intake

At Gonzalez & Kochmann, we value your time and convenience. To streamline the process of working with us and to provide you with efficient legal assistance, we offer a collection of forms for various purposes. Whether you’re seeking representation for a Workers’ Compensation claim, initiating a Social Security Disability application, or need specific legal documents, our forms are designed to simplify the process for you.

Social Security Disability Intake Form

This form is for individuals who are seeking to apply for Social Security Disability benefits. It includes necessary information and documentation requirements for a successful application.

To better assist you in your Social Security Disability case, we’ll request the following information and any relevant documents during our consultation.
● Documents from your employer
● Social Security earnings statements or W-2 forms
● Social Security Documents:
      ○ Social Security card
      ○ Social Security Disability application
      ○ Correspondence with the Social Security Administration (SSA)
● Educational Records
● Any legal documents related to your disability, such as workers’ compensation records
● Medical reports concerning your current injury
     ○ If you don’t have medical records, please provide a list of doctors who have treated you for the injury, along with their addresses
● Letters of Support:
     ○ Letters from healthcare professionals supporting your disability claim
     ○ Letters from employers or colleagues detailing your work-related challenges
● Appeal Records (if applicable):
     ○ If you have already applied and been denied, include any records related to the appeals process

Workers' Compensation Initial Intake Form

Use this form if you’ve suffered a workplace injury or illness and want to schedule an initial consultation with our Workers’ Compensation attorneys.

To better assist you in your Workers’ Compensation case, we’ll request the following information and any relevant documents during our consultation.
● Documents from your employer
● Pay stubs around the time of your injury
● Information from your insurance carrier
● Correspondence from the Workers’ Compensation Board
● Any documentation related to prior Workers’ Compensation injuries
● Medical reports concerning your current injury
● If you don’t have medical records, please provide a list of doctors who have treated you for the injury, along with their addresses

General Intake Form

If you have a general inquiry or need assistance with a legal matter not covered by the above forms, please use this form to get in touch with us.

Free Consultation

Your Legal Journey Begins Here with a Free Consultation:

When you choose Gonzalez & Kochmann, you’re choosing a team of dedicated legal
professionals who are committed to helping you secure your future. Our mission is to provide you with the knowledge, advocacy, and legal expertise you need to overcome the challenges associated with Social Security and Workers’ Compensation issues.

Don’t face these legal hurdles alone. Let Gonzalez & Kochmann be your trusted partner on the path to justice and financial security. Contact us today at 212-419-4886 to schedule a consultation, and let’s begin working toward a brighter future, together.

This website constitutes attorney advertising. Communication with Hoffman, Wachtell & Rao or any individual member of the firm by Internet email or through this site, does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form. Past results do not guarantee future outcomes. Please verify that you have read the disclaimer.