VA Benefits and Denials News & Guide | TortAdvisor

<div class="fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling" style="--link_hover_color: var(--awb-color4);--link_color: var(--awb-color1);--awb-border-sizes-bottom:1px;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:8vh;--awb-padding-bottom:6vh;--awb-background-image:radial-gradient(circle at center center, hsla(var(--awb-custom_color_1-h),var(--awb-custom_color_1-s),var(--awb-custom_color_1-l),calc(var(--awb-custom_color_1-a) - 50%)) 0%,hsla(var(--awb-custom_color_1-h),var(--awb-custom_color_1-s),var(--awb-custom_color_1-l),calc(var(--awb-custom_color_1-a) - 10%)) 80%);--awb-flex-wrap:wrap;" id="form" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-content-wrap" style="max-width:1456px;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:62%;--awb-spacing-right-large:3.0967741935484%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.0967741935484%;--awb-width-medium:62%;--awb-order-medium:0;--awb-spacing-right-medium:3.0967741935484%;--awb-spacing-left-medium:3.0967741935484%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-1 fusion-sep-none fusion-title-text fusion-title-size-two" style="--awb-text-color:var(--awb-color1);--awb-margin-top:0px;--awb-margin-bottom:0px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;"><h2 class="fusion-title-heading title-heading-left fusion-responsive-typography-calculated" style="margin:0;text-transform:uppercase;--fontSize:40;line-height:1.1;">VA Benefits and Denials</h2></div><div class="fusion-title title fusion-title-2 fusion-sep-none fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-color1);--awb-margin-top:20px;--awb-margin-right:5%;--awb-margin-bottom:0px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:22px;"><p class="fusion-title-heading title-heading-left title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:500;margin:0;text-transform:capitalize;font-size:1em;--fontSize:22;--minFontSize:22;line-height:1.25;"></p></div></div></div></div></div> </section> <main id="main" class="clearfix "> <div class="fusion-row" style=""> <section id="content" style=""> <div class="post-content"> <div class="fusion-fullwidth fullwidth-box fusion-builder-row-4 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling" style="--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:8vh;--awb-padding-bottom:8vh;--awb-flex-wrap:wrap;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap" style="max-width:1456px;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_2_3 2_3 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.88%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-text fusion-text-2"><p>News, guidance, and appeal strategies for veterans dealing with VA disability benefit claims and denials, including TDIU, ratings, and the appeals process.</p> </div><div class="fusion-title title fusion-title-3 fusion-sep-none fusion-title-text fusion-title-size-three" style="--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;"><h3 class="fusion-title-heading title-heading-left fusion-responsive-typography-calculated" style="margin:0;--fontSize:30;line-height:var(--awb-typography2-line-height);">Updates on VA Benefits and Denials</h3></div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: auto;margin-top:40px;width:100%;"></div><div class="fusion-post-cards-archives-tb" data-instance="1" data-infinite-post-class="post" ><div class="fusion-post-cards fusion-post-cards-1 fusion-grid-archive fusion-grid-columns-1" style="--awb-column-spacing:0px;--awb-dots-align:center;--awb-columns:1;--awb-columns-small:100%;" data-post-type-label="posts"><ul class="fusion-grid fusion-grid-1 fusion-flex-align-items-flex-start fusion-grid-posts-cards"><li class="fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion-flex-column post-card fusion-grid-column fusion-post-cards-grid-column" style="--awb-bg-blend:overlay;--awb-bg-size:cover;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-flex-grow-small:;--awb-flex-shrink-small:;"><div class="fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap" style="--awb-flex-grow:0;--awb-flex-grow-medium:0;--awb-flex-grow-small:0;--awb-flex-shrink:0;--awb-flex-shrink-medium:0;--awb-flex-shrink-small:0;width:104% !important;max-width:104% !important;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-0 fusion_builder_column_inner_1_3 1_3 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-classic-product-image-wrapper fusion-woo-product-image fusion-post-card-image fusion-post-card-image-1 has-aspect-ratio" data-layout="static" style="--awb-border-radius-top-left:8px;--awb-border-radius-top-right:8px;--awb-border-radius-bottom-right:8px;--awb-border-radius-bottom-left:8px;--awb-aspect-ratio:3 / 2;"><div class="fusion-image-wrapper" aria-haspopup="true"> <a href="https://tortadvisor.com/va-disability-claim-denial-workers-compensation-2026/" aria-label="VA Disability Claim Denial & Workers’ Comp News 2026"> <img decoding="async" width="800" height="420" src="data:image/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27800%27%20height%3D%27420%27%20viewBox%3D%270%200%20800%20420%27%3E%3Crect%20width%3D%27800%27%20height%3D%27420%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E" class="attachment-full size-full lazyload wp-post-image" alt="va disability claim denial - Veteran and construction worker beside denied VA disability and workers’ compensation claim documents in a TortAdvisor legal guide" data-orig-src="https://tortadvisor.com/wp-content/uploads/2026/07/va-disability-claim-denial-workers-compensation-guide-tortadvisor.webp" /> </a> </div> </div></div></div><div class="fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-1 fusion_builder_column_inner_2_3 2_3 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.88%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-4 fusion-sep-none fusion-title-text fusion-title-size-five" style="--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-link-color:var(--awb-color8);--awb-link-hover-color:var(--awb-color5);--awb-font-size:30px;"><h5 class="fusion-title-heading title-heading-left fusion-responsive-typography-calculated" style="margin:0;font-size:1em;--fontSize:30;line-height:var(--awb-typography1-line-height);"><a href="https://tortadvisor.com/va-disability-claim-denial-workers-compensation-2026/" class="awb-custom-text-color awb-custom-text-hover-color" target="_self">VA Disability Claim Denial & Workers’ Comp News 2026</a></h5></div><div class="fusion-meta-tb fusion-meta-tb-1 stacked" style="--awb-border-bottom:0px;--awb-height:30px;--awb-padding-bottom:10px;--awb-padding-top:10px;--awb-text-color:var(--awb-color7);--awb-alignment-medium:flex-start;--awb-alignment-small:flex-start;"><span class="fusion-tb-published-date">Published On: July 3, 2026</span><span class="fusion-meta-tb-sep"></span><span class="fusion-tb-categories">Categories: <a href="https://tortadvisor.com/va-benefits-and-denials/" rel="category tag">VA Benefits and Denials</a></span><span class="fusion-meta-tb-sep"></span><span class="fusion-tb-author">By <span><a href="https://tortadvisor.com/author/editorial-team/" title="Posts by The TortAdvisor Editorial Team" rel="author">The TortAdvisor Editorial Team</a></span></span><span class="fusion-meta-tb-sep"></span></div><div class="fusion-content-tb fusion-content-tb-1" style="--awb-text-color:var(--awb-color6);--awb-margin-bottom:0px;--awb-margin-top:5px;--awb-text-transform:none;"><p> </p></div></div></div></div></div></li> </ul></div></div></div></div><div class="fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_3 1_3 fusion-flex-column" 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defer></script> <div class="fusion-title title fusion-title-8 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:18px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:18;--minFontSize:18;line-height:1.1;">Describe the type of accident you were in</p></div><div class="fusion-form-field fusion-form-radio-field fusion-form-label-above auto-skip" style="" data-form-id="10923"><fieldset><div class="fusion-form-radio"><input tabindex="" id="radio-_what_best_describes_the_type_of_accident_you_were_in-1-0" type="radio" value="Car Accident" name="_what_best_describes_the_type_of_accident_you_were_in" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-_what_best_describes_the_type_of_accident_you_were_in-1-0">Car Accident</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-_what_best_describes_the_type_of_accident_you_were_in-1-1" type="radio" value="Pedestrian or Bicycle Accident" name="_what_best_describes_the_type_of_accident_you_were_in" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-_what_best_describes_the_type_of_accident_you_were_in-1-1">Pedestrian or Bicycle Accident</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-_what_best_describes_the_type_of_accident_you_were_in-1-2" type="radio" value="Motorcycle Accident" name="_what_best_describes_the_type_of_accident_you_were_in" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-_what_best_describes_the_type_of_accident_you_were_in-1-2">Motorcycle Accident</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-_what_best_describes_the_type_of_accident_you_were_in-1-3" type="radio" value="Ride Share (Uber/Lyft) Accident" name="_what_best_describes_the_type_of_accident_you_were_in" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-_what_best_describes_the_type_of_accident_you_were_in-1-3">Ride Share (Uber/Lyft) Accident</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-_what_best_describes_the_type_of_accident_you_were_in-1-4" type="radio" value="Accident with Government Vehicle" name="_what_best_describes_the_type_of_accident_you_were_in" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-_what_best_describes_the_type_of_accident_you_were_in-1-4">Accident with Government Vehicle</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-_what_best_describes_the_type_of_accident_you_were_in-1-5" type="radio" value="Trucking Accident" name="_what_best_describes_the_type_of_accident_you_were_in" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-_what_best_describes_the_type_of_accident_you_were_in-1-5">Trucking Accident</label></div></fieldset></div><div class="fusion-form-field fusion-form-submit-field fusion-form-label-above" style="" data-form-id="10923"><div style="text-align:center;"><button type="submit" class="fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-2 fusion-button-span-yes button-default form-form-submit" style="--awb-margin-top:10px;--awb-margin-bottom:-10px;--awb-padding-top:20px;--awb-padding-bottom:20px;" data-form-number="10923" tabindex=""><span class="fusion-button-text awb-button__text awb-button__text--default">Continue</span><i class="fa-angle-right fas awb-button__icon awb-button__icon--default button-icon-right" aria-hidden="true"></i></button></div></div></div></div></div></div></div><div class="awb-form-step" data-final="0" data-step="2"><div class="fusion-fullwidth fullwidth-box fusion-builder-row-6-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling form_default" style="--awb-border-radius-top-left:8px;--awb-border-radius-top-right:8px;--awb-border-radius-bottom-right:8px;--awb-border-radius-bottom-left:8px;--awb-overflow:hidden;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-justify-content-center fusion-flex-content-wrap" style="width:104% !important;max-width:104% !important;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-12 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-9 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-custom_color_3);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:35px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:700;margin:0;text-transform:uppercase;font-size:1em;--fontSize:35;line-height:1.1;">Speak to a motor vehicle accident expert immediately</p></div><div class="fusion-title title fusion-title-10 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-color8);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:200;margin:0;text-transform:capitalize;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Please complete intake survey for free review</p></div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:30px;width:100%;"><div class="fusion-separator-border sep-single sep-solid" style="--awb-height:20px;--awb-amount:20px;border-color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));border-top-width:1px;"></div></div></div></div> <div class="fusion-layout-column fusion_builder_column fusion-builder-column-13 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch" style="--awb-padding-bottom:30px;--awb-bg-position:left center;--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column"><div class="fusion-title title fusion-title-11 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:19px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:19;--minFontSize:19;line-height:1.1;">Where did the accident or injury occur?</p></div><div class="fusion-form-field fusion-form-select-field fusion-form-label-above state" style="" data-form-id="10923"><div class="fusion-select-wrapper"><select autocomplete="off" tabindex="" id="state" name="state" class="fusion-form-input" data-holds-private-data="false"><option value="" disabled selected>Select State</option><option value="AL" >Alabama</option><option value="AK" >Alaska</option><option value="AZ" >Arizona</option><option value="AR" >Arkansas</option><option value="CA" >California</option><option value="CO" >Colorado</option><option value="CT" >Connecticut</option><option value="DE" >Delaware</option><option value="DC" >District Of Columbia</option><option value="FL" >Florida</option><option value="GA" >Georgia</option><option value="HI" >Hawaii</option><option value="ID" >Idaho</option><option value="IL" >Illinois</option><option value="IN" >Indiana</option><option value="IA" >Iowa</option><option value="KS" >Kansas</option><option value="KY" >Kentucky</option><option value="LA" >Louisiana</option><option value="ME" >Maine</option><option value="MD" >Maryland</option><option value="MA" >Massachusetts</option><option value="MI" >Michigan</option><option value="MN" >Minnesota</option><option value="MS" >Mississippi</option><option value="MO" >Missouri</option><option value="MT" >Montana</option><option value="NE" >Nebraska</option><option value="NV" >Nevada</option><option value="NH" >New Hampshire</option><option value="NJ" >New Jersey</option><option value="NM" >New Mexico</option><option value="NY" >New York</option><option value="NC" >North Carolina</option><option value="ND" >North Dakota</option><option value="OH" >Ohio</option><option value="OK" >Oklahoma</option><option value="OR" >Oregon</option><option value="PA" >Pennsylvania</option><option value="RI" >Rhode Island</option><option value="SC" >South Carolina</option><option value="SD" >South Dakota</option><option value="TN" >Tennessee</option><option value="TX" >Texas</option><option value="UT" >Utah</option><option value="VT" >Vermont</option><option value="VA" >Virginia</option><option value="WA" >Washington</option><option value="WV" >West Virginia</option><option value="WI" >Wisconsin</option><option value="WY" >Wyoming</option></select><div class="select-arrow"><svg width="12" height="8" viewBox="0 0 12 8" fill="none" xmlns="http://www.w3.org/2000/svg"> <path d="M1.5 1.75L6 6.25L10.5 1.75" stroke="#6D6D6D" stroke-width="2" stroke-linecap="round" stroke-linejoin="round"/> </svg></div></div></div><div class="fusion-form-field fusion-form-phone-number-field fusion-form-label-above" style="" data-form-id="10923"><input type="tel" autocomplete="off" pattern="\d{5}" data-invalid-notice="Enter a 5-digit ZIP code (e.g., 90210)" name="zip" id="zip" value="" class="fusion-form-input" required="true" aria-required="true" placeholder="Zip Code *" data-holds-private-data="false"/></div> <div class="fusion-title title fusion-title-12 fusion-no-small-visibility fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-top:20px;--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">City where the injury occurred</p></div><div class="fusion-form-field fusion-form-text-field fusion-form-label-above" style="" data-form-id="10923"><input type="text" autocomplete="off" name="city_where_the_injury_occurred" id="city_where_the_injury_occurred" value="" class="fusion-form-input" placeholder="eg: New York City " data-holds-private-data="false" minlength="0"/></div><div class="fusion-form-field fusion-form-submit-field fusion-form-label-above" style="" data-form-id="10923"><div style="text-align:center;"><button type="submit" class="fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-3 fusion-button-span-yes button-default form-form-submit" style="--awb-margin-top:10px;--awb-padding-top:20px;--awb-padding-bottom:20px;" data-form-number="10923" tabindex=""><span class="fusion-button-text awb-button__text awb-button__text--default">Next Step</span><i class="fa-angle-right fas awb-button__icon awb-button__icon--default button-icon-right" aria-hidden="true"></i></button></div></div> <div style="text-align:center;"><a class="fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-4 fusion-button-default-span fusion-button-default-type" style="--awb-padding-top:10px;--awb-padding-right:0px;--awb-padding-bottom:10px;--awb-padding-left:0px;--button_accent_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_border_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_accent_hover_color:var(--awb-color7);--button_border_hover_color:var(--awb-color7);--button_gradient_top_color:rgba(255,255,255,0);--button_gradient_bottom_color:rgba(255,255,255,0);--button_gradient_top_color_hover:rgba(255,255,255,0);--button_gradient_bottom_color_hover:rgba(255,255,255,0);--button_font_size:14px;" target="_self" href="#previousStep"><span class="fusion-button-text awb-button__text awb-button__text--default">Previous Step</span></a></div> </div></div></div></div></div><div class="awb-form-step" data-final="0" data-step="3"><div class="fusion-fullwidth fullwidth-box fusion-builder-row-6-3 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling form_default" style="--awb-border-radius-top-left:8px;--awb-border-radius-top-right:8px;--awb-border-radius-bottom-right:8px;--awb-border-radius-bottom-left:8px;--awb-overflow:hidden;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-justify-content-center fusion-flex-content-wrap" style="width:104% !important;max-width:104% !important;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-14 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-13 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-custom_color_3);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:35px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:700;margin:0;text-transform:uppercase;font-size:1em;--fontSize:35;line-height:1.1;">Speak to a motor vehicle accident expert immediately</p></div><div class="fusion-title title fusion-title-14 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-color8);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:200;margin:0;text-transform:capitalize;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Please complete intake survey for free review</p></div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:30px;width:100%;"><div class="fusion-separator-border sep-single sep-solid" style="--awb-height:20px;--awb-amount:20px;border-color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));border-top-width:1px;"></div></div></div></div> <div class="fusion-layout-column fusion_builder_column fusion-builder-column-15 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch" style="--awb-padding-bottom:30px;--awb-bg-position:left center;--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column"><div class="fusion-title title fusion-title-15 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Who was hurt in the accident?</p></div><div class="fusion-form-field fusion-form-radio-field fusion-form-label-above auto-skip" style="" data-form-id="10923"><fieldset><div class="fusion-form-radio"><input tabindex="" id="radio-who_was_hurt_in_the_accident-2-0" type="radio" value="I was hurt" name="who_was_hurt_in_the_accident" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-who_was_hurt_in_the_accident-2-0">I was hurt</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-who_was_hurt_in_the_accident-2-1" type="radio" value="A loved one was hurt" name="who_was_hurt_in_the_accident" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-who_was_hurt_in_the_accident-2-1">A loved one was hurt</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-who_was_hurt_in_the_accident-2-2" type="radio" value="We were both hurt" name="who_was_hurt_in_the_accident" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-who_was_hurt_in_the_accident-2-2">We were both hurt</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-who_was_hurt_in_the_accident-2-3" type="radio" value="No one was hurt" name="who_was_hurt_in_the_accident" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-who_was_hurt_in_the_accident-2-3">No one was hurt</label></div></fieldset></div><div class="fusion-form-field fusion-form-submit-field fusion-form-label-above" style="" data-form-id="10923"><div style="text-align:center;"><button type="submit" class="fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-5 fusion-button-span-yes button-default form-form-submit" style="--awb-margin-top:10px;--awb-padding-top:20px;--awb-padding-bottom:20px;" data-form-number="10923" tabindex=""><span class="fusion-button-text awb-button__text awb-button__text--default">Next Step</span><i class="fa-angle-right fas awb-button__icon awb-button__icon--default button-icon-right" aria-hidden="true"></i></button></div></div> <div style="text-align:center;"><a class="fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-6 fusion-button-default-span fusion-button-default-type" style="--awb-padding-top:10px;--awb-padding-right:0px;--awb-padding-bottom:10px;--awb-padding-left:0px;--button_accent_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_border_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_accent_hover_color:var(--awb-color7);--button_border_hover_color:var(--awb-color7);--button_gradient_top_color:rgba(255,255,255,0);--button_gradient_bottom_color:rgba(255,255,255,0);--button_gradient_top_color_hover:rgba(255,255,255,0);--button_gradient_bottom_color_hover:rgba(255,255,255,0);--button_font_size:14px;" target="_self" href="#previousStep"><span class="fusion-button-text awb-button__text awb-button__text--default">Previous Step</span></a></div> </div></div></div></div></div><div class="awb-form-step" data-final="0" data-step="4"><div class="fusion-fullwidth fullwidth-box fusion-builder-row-6-4 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling form_default" style="--awb-border-radius-top-left:8px;--awb-border-radius-top-right:8px;--awb-border-radius-bottom-right:8px;--awb-border-radius-bottom-left:8px;--awb-overflow:hidden;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-justify-content-center fusion-flex-content-wrap" style="width:104% !important;max-width:104% !important;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-16 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-16 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-custom_color_3);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:35px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:700;margin:0;text-transform:uppercase;font-size:1em;--fontSize:35;line-height:1.1;">Speak to a motor vehicle accident expert immediately</p></div><div class="fusion-title title fusion-title-17 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-color8);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:200;margin:0;text-transform:capitalize;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Please complete intake survey for free review</p></div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:30px;width:100%;"><div class="fusion-separator-border sep-single sep-solid" style="--awb-height:20px;--awb-amount:20px;border-color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));border-top-width:1px;"></div></div></div></div> <div class="fusion-layout-column fusion_builder_column fusion-builder-column-17 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch" style="--awb-padding-bottom:30px;--awb-bg-position:left center;--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column"><div class="fusion-title title fusion-title-18 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:18px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:18;--minFontSize:18;line-height:1.1;">Did the injured person receive treatment?</p></div><div class="fusion-form-field fusion-form-radio-field fusion-form-label-above auto-skip" style="" data-form-id="10923"><fieldset><div class="fusion-form-radio"><input tabindex="" id="radio-did_the_injured_person_receive_treatment-3-0" type="radio" value="Treated at a hospital" name="did_the_injured_person_receive_treatment" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-did_the_injured_person_receive_treatment-3-0">Treated at a hospital</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-did_the_injured_person_receive_treatment-3-1" type="radio" value="Treated at a doctors' office" name="did_the_injured_person_receive_treatment" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-did_the_injured_person_receive_treatment-3-1">Treated at a doctors' office</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-did_the_injured_person_receive_treatment-3-2" type="radio" value="Was not treated" name="did_the_injured_person_receive_treatment" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-did_the_injured_person_receive_treatment-3-2">Was not treated</label></div></fieldset></div><div class="fusion-form-field fusion-form-submit-field fusion-form-label-above" style="" data-form-id="10923"><div style="text-align:center;"><button type="submit" class="fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-7 fusion-button-span-yes button-default form-form-submit" style="--awb-margin-top:10px;--awb-padding-top:20px;--awb-padding-bottom:20px;" data-form-number="10923" tabindex=""><span class="fusion-button-text awb-button__text awb-button__text--default">Next Step</span><i class="fa-angle-right fas awb-button__icon awb-button__icon--default button-icon-right" aria-hidden="true"></i></button></div></div> <div style="text-align:center;"><a class="fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-8 fusion-button-default-span fusion-button-default-type" style="--awb-padding-top:10px;--awb-padding-right:0px;--awb-padding-bottom:10px;--awb-padding-left:0px;--button_accent_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_border_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_accent_hover_color:var(--awb-color7);--button_border_hover_color:var(--awb-color7);--button_gradient_top_color:rgba(255,255,255,0);--button_gradient_bottom_color:rgba(255,255,255,0);--button_gradient_top_color_hover:rgba(255,255,255,0);--button_gradient_bottom_color_hover:rgba(255,255,255,0);--button_font_size:14px;" target="_self" href="#previousStep"><span class="fusion-button-text awb-button__text awb-button__text--default">Previous Step</span></a></div> </div></div></div></div></div><div class="awb-form-step" data-final="0" data-step="5"><div class="fusion-fullwidth fullwidth-box fusion-builder-row-6-5 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling form_default" style="--awb-border-radius-top-left:8px;--awb-border-radius-top-right:8px;--awb-border-radius-bottom-right:8px;--awb-border-radius-bottom-left:8px;--awb-overflow:hidden;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-justify-content-center fusion-flex-content-wrap" style="width:104% !important;max-width:104% !important;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-18 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-19 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-custom_color_3);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:35px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:700;margin:0;text-transform:uppercase;font-size:1em;--fontSize:35;line-height:1.1;">Speak to a motor vehicle accident expert immediately</p></div><div class="fusion-title title fusion-title-20 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-color8);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:200;margin:0;text-transform:capitalize;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Please complete intake survey for free review</p></div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:30px;width:100%;"><div class="fusion-separator-border sep-single sep-solid" style="--awb-height:20px;--awb-amount:20px;border-color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));border-top-width:1px;"></div></div></div></div> <div class="fusion-layout-column fusion_builder_column fusion-builder-column-19 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch" style="--awb-padding-bottom:30px;--awb-bg-position:left center;--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column"><div class="fusion-title title fusion-title-21 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Estimated Medical Bills</p></div><div class="fusion-form-field fusion-form-radio-field fusion-form-label-above auto-skip" style="" data-form-id="10923"><fieldset><div class="fusion-form-radio"><input tabindex="" id="radio-estimated_medical_bills-4-0" type="radio" value="Less than $1,000" name="estimated_medical_bills" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-estimated_medical_bills-4-0">Less than $1,000</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-estimated_medical_bills-4-1" type="radio" value="$,1000 - $5,000" name="estimated_medical_bills" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-estimated_medical_bills-4-1">$,1000 - $5,000</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-estimated_medical_bills-4-2" type="radio" value="$5,000 - $25,000" name="estimated_medical_bills" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-estimated_medical_bills-4-2">$5,000 - $25,000</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-estimated_medical_bills-4-3" type="radio" value="$25,000 - $100,000" name="estimated_medical_bills" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-estimated_medical_bills-4-3">$25,000 - $100,000</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-estimated_medical_bills-4-4" type="radio" value="More than $100,000" name="estimated_medical_bills" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-estimated_medical_bills-4-4">More than $100,000</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-estimated_medical_bills-4-5" type="radio" value="Don't know yet" name="estimated_medical_bills" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-estimated_medical_bills-4-5">Don't know yet</label></div></fieldset></div><div class="fusion-form-field fusion-form-submit-field fusion-form-label-above" style="" data-form-id="10923"><div style="text-align:center;"><button type="submit" class="fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-9 fusion-button-span-yes button-default form-form-submit" style="--awb-margin-top:10px;--awb-padding-top:20px;--awb-padding-bottom:20px;" data-form-number="10923" tabindex=""><span class="fusion-button-text awb-button__text awb-button__text--default">Next Step</span><i class="fa-angle-right fas awb-button__icon awb-button__icon--default button-icon-right" aria-hidden="true"></i></button></div></div> <div style="text-align:center;"><a class="fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-10 fusion-button-default-span fusion-button-default-type" style="--awb-padding-top:10px;--awb-padding-right:0px;--awb-padding-bottom:10px;--awb-padding-left:0px;--button_accent_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_border_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_accent_hover_color:var(--awb-color7);--button_border_hover_color:var(--awb-color7);--button_gradient_top_color:rgba(255,255,255,0);--button_gradient_bottom_color:rgba(255,255,255,0);--button_gradient_top_color_hover:rgba(255,255,255,0);--button_gradient_bottom_color_hover:rgba(255,255,255,0);--button_font_size:14px;" target="_self" href="#previousStep"><span class="fusion-button-text awb-button__text awb-button__text--default">Previous Step</span></a></div> </div></div></div></div></div><div class="awb-form-step" data-final="0" data-step="6"><div class="fusion-fullwidth fullwidth-box fusion-builder-row-6-6 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling form_default" style="--awb-border-radius-top-left:8px;--awb-border-radius-top-right:8px;--awb-border-radius-bottom-right:8px;--awb-border-radius-bottom-left:8px;--awb-overflow:hidden;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-justify-content-center fusion-flex-content-wrap" style="width:104% !important;max-width:104% !important;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-20 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-22 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-custom_color_3);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:35px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:700;margin:0;text-transform:uppercase;font-size:1em;--fontSize:35;line-height:1.1;">Speak to a motor vehicle accident expert immediately</p></div><div class="fusion-title title fusion-title-23 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-color8);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:200;margin:0;text-transform:capitalize;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Please complete intake survey for free review</p></div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:30px;width:100%;"><div class="fusion-separator-border sep-single sep-solid" style="--awb-height:20px;--awb-amount:20px;border-color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));border-top-width:1px;"></div></div></div></div> <div class="fusion-layout-column fusion_builder_column fusion-builder-column-21 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch" style="--awb-padding-bottom:30px;--awb-bg-position:left center;--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column"><div class="fusion-title title fusion-title-24 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Was a police report filed?</p></div><div class="fusion-form-field fusion-form-radio-field fusion-form-label-above auto-skip" style="" data-form-id="10923"><fieldset><div class="fusion-form-radio"><input tabindex="" id="radio-was_a_police_report_filed-5-0" type="radio" value="Yes" name="was_a_police_report_filed" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-was_a_police_report_filed-5-0">Yes</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-was_a_police_report_filed-5-1" type="radio" value="No" name="was_a_police_report_filed" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-was_a_police_report_filed-5-1">No</label></div></fieldset></div><div class="fusion-form-field fusion-form-submit-field fusion-form-label-above" style="" data-form-id="10923"><div style="text-align:center;"><button type="submit" class="fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-11 fusion-button-span-yes button-default form-form-submit" style="--awb-margin-top:10px;--awb-padding-top:20px;--awb-padding-bottom:20px;" data-form-number="10923" tabindex=""><span class="fusion-button-text awb-button__text awb-button__text--default">Next Step</span><i class="fa-angle-right fas awb-button__icon awb-button__icon--default button-icon-right" aria-hidden="true"></i></button></div></div> <div style="text-align:center;"><a class="fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-12 fusion-button-default-span fusion-button-default-type" style="--awb-padding-top:10px;--awb-padding-right:0px;--awb-padding-bottom:10px;--awb-padding-left:0px;--button_accent_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_border_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_accent_hover_color:var(--awb-color7);--button_border_hover_color:var(--awb-color7);--button_gradient_top_color:rgba(255,255,255,0);--button_gradient_bottom_color:rgba(255,255,255,0);--button_gradient_top_color_hover:rgba(255,255,255,0);--button_gradient_bottom_color_hover:rgba(255,255,255,0);--button_font_size:14px;" target="_self" href="#previousStep"><span class="fusion-button-text awb-button__text awb-button__text--default">Previous Step</span></a></div> </div></div></div></div></div><div class="awb-form-step" data-final="0" data-step="7"><div class="fusion-fullwidth fullwidth-box fusion-builder-row-6-7 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling form_default" style="--awb-border-radius-top-left:8px;--awb-border-radius-top-right:8px;--awb-border-radius-bottom-right:8px;--awb-border-radius-bottom-left:8px;--awb-overflow:hidden;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-justify-content-center fusion-flex-content-wrap" style="width:104% !important;max-width:104% !important;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-22 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-25 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-custom_color_3);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:35px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:700;margin:0;text-transform:uppercase;font-size:1em;--fontSize:35;line-height:1.1;">Speak to a motor vehicle accident expert immediately</p></div><div class="fusion-title title fusion-title-26 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-color8);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:200;margin:0;text-transform:capitalize;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Please complete intake survey for free review</p></div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:30px;width:100%;"><div class="fusion-separator-border sep-single sep-solid" style="--awb-height:20px;--awb-amount:20px;border-color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));border-top-width:1px;"></div></div></div></div> <div class="fusion-layout-column fusion_builder_column fusion-builder-column-23 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch" style="--awb-padding-bottom:30px;--awb-bg-position:left center;--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column"><div class="fusion-title title fusion-title-27 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:17px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:17;--minFontSize:17;line-height:1.1;">Did the police report say you are at fault?</p></div><div class="fusion-form-field fusion-form-radio-field fusion-form-label-above auto-skip" style="" data-form-id="10923"><fieldset><div class="fusion-form-radio"><input tabindex="" id="radio-did_the_police_report_say_you_are_at_fault-6-0" type="radio" value="No" name="did_the_police_report_say_you_are_at_fault" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-did_the_police_report_say_you_are_at_fault-6-0">No</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-did_the_police_report_say_you_are_at_fault-6-1" type="radio" value="Yes" name="did_the_police_report_say_you_are_at_fault" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-did_the_police_report_say_you_are_at_fault-6-1">Yes</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-did_the_police_report_say_you_are_at_fault-6-2" type="radio" value="Both at fault" name="did_the_police_report_say_you_are_at_fault" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-did_the_police_report_say_you_are_at_fault-6-2">Both at fault</label></div></fieldset></div><div class="fusion-form-field fusion-form-submit-field fusion-form-label-above" style="" data-form-id="10923"><div style="text-align:center;"><button type="submit" class="fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-13 fusion-button-span-yes button-default form-form-submit" style="--awb-margin-top:10px;--awb-padding-top:20px;--awb-padding-bottom:20px;" data-form-number="10923" tabindex=""><span class="fusion-button-text awb-button__text awb-button__text--default">Next Step</span><i class="fa-angle-right fas awb-button__icon awb-button__icon--default button-icon-right" aria-hidden="true"></i></button></div></div> <div style="text-align:center;"><a class="fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-14 fusion-button-default-span fusion-button-default-type" style="--awb-padding-top:10px;--awb-padding-right:0px;--awb-padding-bottom:10px;--awb-padding-left:0px;--button_accent_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_border_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_accent_hover_color:var(--awb-color7);--button_border_hover_color:var(--awb-color7);--button_gradient_top_color:rgba(255,255,255,0);--button_gradient_bottom_color:rgba(255,255,255,0);--button_gradient_top_color_hover:rgba(255,255,255,0);--button_gradient_bottom_color_hover:rgba(255,255,255,0);--button_font_size:14px;" target="_self" href="#previousStep"><span class="fusion-button-text awb-button__text awb-button__text--default">Previous Step</span></a></div> </div></div></div></div></div><div class="awb-form-step" data-final="0" data-step="8"><div class="fusion-fullwidth fullwidth-box fusion-builder-row-6-8 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling form_default" style="--awb-border-radius-top-left:8px;--awb-border-radius-top-right:8px;--awb-border-radius-bottom-right:8px;--awb-border-radius-bottom-left:8px;--awb-overflow:hidden;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;--awb-flex-wrap-medium:nowrap;--awb-flex-wrap-small:nowrap;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-justify-content-center fusion-flex-content-wrap" style="width:104% !important;max-width:104% !important;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-24 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-28 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-custom_color_3);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:35px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:700;margin:0;text-transform:uppercase;font-size:1em;--fontSize:35;line-height:1.1;">Speak to a motor vehicle accident expert immediately</p></div><div class="fusion-title title fusion-title-29 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-color8);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:200;margin:0;text-transform:capitalize;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Please complete intake survey for free review</p></div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:30px;width:100%;"><div class="fusion-separator-border sep-single sep-solid" style="--awb-height:20px;--awb-amount:20px;border-color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));border-top-width:1px;"></div></div></div></div> <div class="fusion-layout-column fusion_builder_column fusion-builder-column-25 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch" style="--awb-padding-bottom:30px;--awb-bg-position:left center;--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column"><div class="fusion-title title fusion-title-30 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:17px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:17;--minFontSize:17;line-height:1.1;">Are you currently represented by a lawyer?</p></div><div class="fusion-form-field fusion-form-radio-field fusion-form-label-above auto-skip" style="" data-form-id="10923"><fieldset><div class="fusion-form-radio"><input tabindex="" id="radio-are_you_currently_represented_by_a_lawyer_for_this_case-7-0" type="radio" value="No" name="are_you_currently_represented_by_a_lawyer_for_this_case" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-are_you_currently_represented_by_a_lawyer_for_this_case-7-0">No</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-are_you_currently_represented_by_a_lawyer_for_this_case-7-1" type="radio" value="Yes" name="are_you_currently_represented_by_a_lawyer_for_this_case" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-are_you_currently_represented_by_a_lawyer_for_this_case-7-1">Yes</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-are_you_currently_represented_by_a_lawyer_for_this_case-7-2" type="radio" value="I was, but not anymore" name="are_you_currently_represented_by_a_lawyer_for_this_case" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-are_you_currently_represented_by_a_lawyer_for_this_case-7-2">I was, but not anymore</label></div></fieldset></div><div class="fusion-form-field fusion-form-submit-field fusion-form-label-above" style="" data-form-id="10923"><div style="text-align:center;"><button type="submit" class="fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-15 fusion-button-span-yes button-default form-form-submit" style="--awb-margin-top:10px;--awb-padding-top:20px;--awb-padding-bottom:20px;" data-form-number="10923" tabindex=""><span class="fusion-button-text awb-button__text awb-button__text--default">Next Step</span><i class="fa-angle-right fas awb-button__icon awb-button__icon--default button-icon-right" aria-hidden="true"></i></button></div></div> <div style="text-align:center;"><a class="fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-16 fusion-button-default-span fusion-button-default-type" style="--awb-padding-top:10px;--awb-padding-right:0px;--awb-padding-bottom:10px;--awb-padding-left:0px;--button_accent_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_border_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_accent_hover_color:var(--awb-color7);--button_border_hover_color:var(--awb-color7);--button_gradient_top_color:rgba(255,255,255,0);--button_gradient_bottom_color:rgba(255,255,255,0);--button_gradient_top_color_hover:rgba(255,255,255,0);--button_gradient_bottom_color_hover:rgba(255,255,255,0);--button_font_size:14px;" target="_self" href="#previousStep"><span class="fusion-button-text awb-button__text awb-button__text--default">Previous Step</span></a></div> </div></div></div></div></div><div class="awb-form-step" data-final="0" data-step="9"><div class="fusion-fullwidth fullwidth-box fusion-builder-row-6-9 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling form_default" style="--awb-border-radius-top-left:8px;--awb-border-radius-top-right:8px;--awb-border-radius-bottom-right:8px;--awb-border-radius-bottom-left:8px;--awb-overflow:hidden;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-justify-content-center fusion-flex-content-wrap" style="width:104% !important;max-width:104% !important;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-26 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-31 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-custom_color_3);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:35px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:700;margin:0;text-transform:uppercase;font-size:1em;--fontSize:35;line-height:1.1;">Speak to a motor vehicle accident expert immediately</p></div><div class="fusion-title title fusion-title-32 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-color8);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:200;margin:0;text-transform:capitalize;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Please complete intake survey for free review</p></div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:30px;width:100%;"><div class="fusion-separator-border sep-single sep-solid" style="--awb-height:20px;--awb-amount:20px;border-color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));border-top-width:1px;"></div></div></div></div> <div class="fusion-layout-column fusion_builder_column fusion-builder-column-27 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch" style="--awb-padding-bottom:30px;--awb-bg-position:left center;--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column"><div class="fusion-title title fusion-title-33 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">When did the accident happen?</p></div><div class="fusion-form-field fusion-form-radio-field fusion-form-label-above auto-skip" style="" data-form-id="10923"><fieldset><div class="fusion-form-radio"><input tabindex="" id="radio-when_did_the_accident_happen-8-0" type="radio" value="Within the last 30 days" name="when_did_the_accident_happen" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-when_did_the_accident_happen-8-0">Within the last 30 days</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-when_did_the_accident_happen-8-1" type="radio" value="Within the last year" name="when_did_the_accident_happen" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-when_did_the_accident_happen-8-1">Within the last year</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-when_did_the_accident_happen-8-2" type="radio" value="Within the last 2 years" name="when_did_the_accident_happen" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-when_did_the_accident_happen-8-2">Within the last 2 years</label></div><div class="fusion-form-radio"><input tabindex="" id="radio-when_did_the_accident_happen-8-3" type="radio" value="More than 2 years" name="when_did_the_accident_happen" class="fusion-form-input" data-holds-private-data="false"/><label for="radio-when_did_the_accident_happen-8-3">More than 2 years</label></div></fieldset></div><div class="fusion-form-field fusion-form-submit-field fusion-form-label-above" style="" data-form-id="10923"><div style="text-align:center;"><button type="submit" class="fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-17 fusion-button-span-yes button-default form-form-submit" style="--awb-margin-top:10px;--awb-padding-top:20px;--awb-padding-bottom:20px;" data-form-number="10923" tabindex=""><span class="fusion-button-text awb-button__text awb-button__text--default">Next Step</span><i class="fa-angle-right fas awb-button__icon awb-button__icon--default button-icon-right" aria-hidden="true"></i></button></div></div> <div style="text-align:center;"><a class="fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-18 fusion-button-default-span fusion-button-default-type" style="--awb-padding-top:10px;--awb-padding-right:0px;--awb-padding-bottom:10px;--awb-padding-left:0px;--button_accent_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_border_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_accent_hover_color:var(--awb-color7);--button_border_hover_color:var(--awb-color7);--button_gradient_top_color:rgba(255,255,255,0);--button_gradient_bottom_color:rgba(255,255,255,0);--button_gradient_top_color_hover:rgba(255,255,255,0);--button_gradient_bottom_color_hover:rgba(255,255,255,0);--button_font_size:14px;" target="_self" href="#previousStep"><span class="fusion-button-text awb-button__text awb-button__text--default">Previous Step</span></a></div> </div></div></div></div></div><div class="awb-form-step" data-final="0" data-step="10"><div class="fusion-fullwidth fullwidth-box fusion-builder-row-6-10 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling form_default" style="--awb-border-radius-top-left:8px;--awb-border-radius-top-right:8px;--awb-border-radius-bottom-right:8px;--awb-border-radius-bottom-left:8px;--awb-overflow:hidden;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-justify-content-center fusion-flex-content-wrap" style="width:104% !important;max-width:104% !important;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-28 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-34 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-custom_color_3);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:35px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:700;margin:0;text-transform:uppercase;font-size:1em;--fontSize:35;line-height:1.1;">Speak to a motor vehicle accident expert immediately</p></div><div class="fusion-title title fusion-title-35 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-color8);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:200;margin:0;text-transform:capitalize;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Please complete intake survey for free review</p></div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:30px;width:100%;"><div class="fusion-separator-border sep-single sep-solid" style="--awb-height:20px;--awb-amount:20px;border-color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));border-top-width:1px;"></div></div></div></div> <div class="fusion-layout-column fusion_builder_column fusion-builder-column-29 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch" style="--awb-padding-bottom:30px;--awb-bg-position:left center;--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column"><div class="fusion-title title fusion-title-36 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">What is the primary injury?</p></div><div class="fusion-form-field fusion-form-select-field fusion-form-label-above" style="" data-form-id="10923"><div class="fusion-select-wrapper"><select autocomplete="off" tabindex="" id="what_is_the_primary_injury" name="what_is_the_primary_injury" class="fusion-form-input" data-holds-private-data="false"><option value="" disabled selected>Choose One</option><option value="Anxiety and Emotional Suffering" >Anxiety and Emotional Suffering</option><option value="Back or Neck Pain" >Back or Neck Pain</option><option value="Headache" >Headache</option><option value="Broken bones" >Broken bones</option><option value="Whiplash" >Whiplash</option><option value="Memory Loss" >Memory Loss</option><option value="Brain injury" >Brain injury</option><option value="Lost of Limb" >Lost of Limb</option><option value="Paralysis" >Paralysis</option><option value="Loss of life" >Loss of life</option><option value="Other Inury" >Other Inury</option></select><div class="select-arrow"><svg width="12" height="8" viewBox="0 0 12 8" fill="none" xmlns="http://www.w3.org/2000/svg"> <path d="M1.5 1.75L6 6.25L10.5 1.75" stroke="#6D6D6D" stroke-width="2" stroke-linecap="round" stroke-linejoin="round"/> </svg></div></div></div><div class="fusion-form-field fusion-form-submit-field fusion-form-label-above" style="" data-form-id="10923"><div style="text-align:center;"><button type="submit" class="fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-19 fusion-button-span-yes button-default form-form-submit" style="--awb-margin-top:10px;--awb-padding-top:20px;--awb-padding-bottom:20px;" data-form-number="10923" tabindex=""><span class="fusion-button-text awb-button__text awb-button__text--default">Next Step</span><i class="fa-angle-right fas awb-button__icon awb-button__icon--default button-icon-right" aria-hidden="true"></i></button></div></div> <div style="text-align:center;"><a class="fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-20 fusion-button-default-span fusion-button-default-type" style="--awb-padding-top:10px;--awb-padding-right:0px;--awb-padding-bottom:10px;--awb-padding-left:0px;--button_accent_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_border_color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));--button_accent_hover_color:var(--awb-color7);--button_border_hover_color:var(--awb-color7);--button_gradient_top_color:rgba(255,255,255,0);--button_gradient_bottom_color:rgba(255,255,255,0);--button_gradient_top_color_hover:rgba(255,255,255,0);--button_gradient_bottom_color_hover:rgba(255,255,255,0);--button_font_size:14px;" target="_self" href="#previousStep"><span class="fusion-button-text awb-button__text awb-button__text--default">Previous Step</span></a></div> </div></div></div></div></div><div class="awb-form-step" data-final="0" data-step="11"><div class="fusion-fullwidth fullwidth-box fusion-builder-row-6-11 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling form_default" style="--awb-border-radius-top-left:8px;--awb-border-radius-top-right:8px;--awb-border-radius-bottom-right:8px;--awb-border-radius-bottom-left:8px;--awb-overflow:hidden;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-justify-content-center fusion-flex-content-wrap" style="width:104% !important;max-width:104% !important;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-30 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column"><div class="fusion-title title fusion-title-37 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-custom_color_3);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:35px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:700;margin:0;text-transform:uppercase;font-size:1em;--fontSize:35;line-height:1.1;">Speak to a motor vehicle accident expert immediately</p></div><div class="fusion-title title fusion-title-38 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-text-color:var(--awb-color8);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:200;margin:0;text-transform:capitalize;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Please complete intake survey for free review</p></div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:30px;width:100%;"><div class="fusion-separator-border sep-single sep-solid" style="--awb-height:20px;--awb-amount:20px;border-color:hsla(var(--awb-color3-h),var(--awb-color3-s),calc(var(--awb-color3-l) - 5%),var(--awb-color3-a));border-top-width:1px;"></div></div></div></div> <div class="fusion-layout-column fusion_builder_column fusion-builder-column-31 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch" style="--awb-padding-bottom:30px;--awb-bg-position:left center;--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;" data-scroll-devices="small-visibility,medium-visibility,large-visibility"><div class="fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column"><div class="fusion-title title fusion-title-39 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-paragraph" style="--awb-margin-bottom:10px;--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;--awb-font-size:20px;"><p class="fusion-title-heading title-heading-center title-heading-tag fusion-responsive-typography-calculated" style="font-family:"Roboto";font-style:normal;font-weight:600;margin:0;letter-spacing:-0.015em;font-size:1em;--fontSize:20;--minFontSize:20;line-height:1.1;">Describe How You Were Injured</p></div><div class="fusion-form-field fusion-form-textarea-field fusion-form-label-above message" style="" data-form-id="10923"><textarea cols="40" autocomplete="off" minlength="0" maxlength="1000" rows="5" tabindex="" id="describe_how_you_were_injured" name="describe_how_you_were_injured" class="fusion-form-input" placeholder="Describe how the accident happened, your injuries, and any medical treatment received. " data-holds-private-data="false">

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