Free Case Review | Brett Duke Employment Law

01

About you and how you found us

Your full name *

Phone number *

Email address *

How did you hear about us? *

02

Your job

Employer's full name *

Give the full name as it appears on your paycheck or W-2 — not a nickname or store number.

Your job title *

Where did you physically work — city *

If you worked remotely, give the city you worked from.

Where did you physically work — state *

Date you were hired *

Your best estimate is fine if you don't remember the exact day.

Are you still employed there? *

Yes, still working No, my employment ended On leave or suspended, but not terminated

03

Your employer

Who owns or runs the place you worked? *

Pick the one that best describes who issues your paycheck.

A private company or business A private nonprofit, hospital, clinic, or church A city, town, county, or school district A state agency, state department, or state board A public university, college, or university medical or health sciences center The federal government — a federal agency, the military, or the Postal Service I'm not sure

Did you physically work on a military base, national laboratory, or other federal property? *

Yes No Not sure

Were you hired and/or paid through a staffing or temp agency? *

Yes No Not sure

About how many employees does this employer have? *

Your rate of pay *

An hourly rate or an annual salary — whichever you were paid. For example: "$18.50 per hour" or "$62,000 per year."

Hours you normally worked per week

Your immediate supervisor's name and title

Who made the decision to fire, demote, or discipline you?

If you don't know, say so.

04

What happened

Date that happened *

If more than one thing happened, give the date of the most serious one.

What reason did the employer give you? *

Use their words, and say whether you got it in writing.

What do you believe the real reason was? *

05

Why you believe it was illegal

Did you ask for a disability accommodation, medical leave, or FMLA leave? *

Yes No Not sure

Did you file a workers' compensation claim or report a work injury? *

Yes No

Was anyone outside your group treated better for the same conduct?

Give names and job titles if you can, and say what happened to them.

06

Speaking up

Before this happened, did you complain about or report any of the following? *

Discrimination or harassment Unsafe working conditions Something I believed was illegal or fraudulent Unpaid wages, overtime, or missed breaks I refused to do something I believed was illegal I requested leave or an accommodation I filed a charge or complaint with a government agency None of these

Please check at least one — "None of these" is a valid answer.

07

Agency filings and deadlines

These dates matter more than anything else on this form. Employment deadlines are short and cannot be extended. If you are not sure of a date, say so rather than guessing.

Have you filed a charge or complaint with the EEOC, the Texas Workforce Commission Civil Rights Division, or the New Mexico Human Rights Bureau? *

Yes No Not sure

Have you received a Right to Sue notice, a Notice of Right to File a Civil Action, or an Order of Nondetermination? *

Yes No Not sure

Are you aware of any deadlines in your case?

08

Money and where you are now

Are you working now? *

Yes, full time Yes, part time No I am self-employed

Have you applied for or received unemployment benefits? *

Yes, receiving Yes, denied Applied, waiting No

About how much income have you lost so far?

Out-of-pocket costs — insurance, medical, job search

How has this affected you physically or emotionally, and have you seen a doctor or counselor about it?

09

Anything that could affect your case

Answer these honestly. None of them automatically means you have no case — but each one changes how the case has to be handled, and finding out late is far worse than finding out now.

Did you sign a severance agreement, release, or separation agreement? *

Yes No I was offered one but have not signed Not sure

Did you sign an arbitration agreement with this employer? *

Yes No Not sure — it may have been in my hiring paperwork

Have you filed for bankruptcy since this began, or is one pending? *

Yes No Not sure

10

Your story, in date order

Please write what happened in the order it happened, starting with the earliest event. Put a date at the start of each item, and where someone said something to you, use their words. A dated list is far more useful to us than a paragraph — it is the single most helpful thing you can give us.

March 3, 2026 — I emailed HR (Angela Ruiz) saying my supervisor was making comments about my age. I have the email.
March 11, 2026 — My supervisor told me "you're getting too old for this job" in front of two coworkers.
March 19, 2026 — I was written up for the first time in six years, for something I did not do.
April 2, 2026 — I was fired.

What happened, in date order *

I understand that submitting this form does not create an attorney-client relationship, that Brett Duke, P.C. has not agreed to represent me, and that submitting this form does not stop, pause, or extend any legal deadline that may apply to my claim. Employment law deadlines are short, and some are as short as 180 days. *

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About you and how you found us

Your job

Your employer

What happened

Why you believe it was illegal

Speaking up

Agency filings and deadlines

Money and where you are now

Anything that could affect your case

Your story, in date order

Call and we'll walk through it together.