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ENGLISH ESPAÑOL
  • About Us
    • Our Mission
    • Our Core Values
    • Celebrating Our 25th Anniversary in 2025!
    • Ramiro Rodriguez, Jr. – Owner
    • John Paul LaBouff – Attorney
    • Ivette Sanchez – Legal Assistant
    • Karen Rodriguez – Office Administrator
    • Roxana Matute – Bilingual Legal Intake Specialist
    • Matthew Kuzio – Social Media Specialist and Video Marketing
  • Auto Injuries
    • Auto Injury Attorney
    • Auto Accident Blog
    • What to Do After a Car Accident
    • Truck Injury Attorney
    • Types of Injury Damages Due to Auto Injuries
    • Most Common Car Accident Injuries
    • Types of Medical Complications Due to Car Accidents
    • Injured Passenger in Car Crash [Free Report]
    • Key Steps if Injured as a Passenger in a Car Crash
    • Auto Accident Videos FAQs
  • Workers’ Comp
    • Workers’ Compensation Attorney
    • Workers’ Comp Blog
    • Download our Free eBook on Workers Comp
    • Download our Free Workers Comp Report
    • Workers’ Comp Videos FAQs
  • Locations We Serve
    • Accident Attorneys in Cobb County
      • Marietta Personal Injury Attorneys
      • Smyrna Personal Injury Attorneys
      • Acworth Personal Injury Attorneys
      • Kennesaw Personal Injury Attorneys
      • Austell Personal Injury Attorneys
      • Powder Springs Personal Injury Attorneys
    • Accident Attorneys in Gwinnett County
      • Lawrenceville Personal Injury Attorneys
      • Lilburn Personal Injury Attorneys
      • Norcross Personal Injury Attorneys
      • Duluth Personal Injury Attorneys
      • Snellville Personal Injury Attorneys
      • Dacula Personal Injury Attorneys
      • Buford Personal Injury Attorneys
      • Loganville Personal Injury Attorneys
    • Accident Attorneys in Fulton County
      • Alpharetta Personal Injury Attorneys
      • Roswell Personal Injury Attorneys
      • Sandy Springs Personal Injury Attorneys
      • East Point Personal Injury Attorneys
      • Union City Personal Injury Attorneys
      • Johns Creek Personal Injury Attorneys
      • Fairburn Personal Injury Attorneys
    • Accident Attorneys in Dekalb County
      • Doraville Personal Injury Attorneys
      • Chamblee Personal Injury Attorneys
      • Decatur Personal Injury Attorneys
      • Lithonia Personal Injury Attorneys
      • Tucker Personal Injury Attorneys
      • Stone Mountain Personal Injury Attorneys
    • Accident Attorneys in Cherokee County
      • Canton Personal Injury Attorneys
      • Woodstock Personal Injury Attorneys
      • Holly Springs Personal Injury Attorneys
      • Accident Attorneys in Rockdale County
      • Conyers Personal Injury Attorneys
      • Lakeview Estates Personal Injury Attorneys
  • Injury Blog
    • Auto Accident Blog
      • Focus on the Road: Don’t Text and Drive
      • About Increasing Speed Limits
      • Tax Implications of Settlements
      • Positive Client Reviews in Georgia
      • Government Vehicles Involved In An Accident
    • Workers’ Comp Blog
      • Drug Tested Positive After a Work Injury
      • Fired If Drug Tested Positive After a Work Injury?
      • Insurance Company Denies Your Workers’ Compensation
      • Drug Test and Workers Compensation Benefits
      • Do You Have Medical Bills from a Work Injury?
    • Getting to Know Cobb County
      • Don’t Own a Gun in Kennesaw?
      • Full Steam Ahead
      • The Marietta Diner: The Best Diner in Georgia
      • A True Appreciation of History and Art
      • Celebrating Heroes
    • A Tour of Marietta
      • Honoring the Fallen at Marietta Confederate Cemetery
      • Fancy a Drink?
      • 700 Ghosts of Kennesaw House
      • The View from Stone Mountain
      • A Tour of Marietta
    • Local Flavor Recipes
      • Green Goddess Smoothie
      • When Life Gives You Lemons…
      • Zucchini Noodles With Turkey Bolognese
      • Birthday Cake Baked Oatmeal for One
      • Boost Your Immune System Like a Celebrity
  • Resources
    • Google Reviews – Client Testimonials
    • Free eBook on Workers Comp
    • Ask the Expert
    • Videos F.A.Q.s
    • Blog
    • Infographics
    • Marietta Auto Accidents Statistics
  • Free Case Evaluation
Call Now • Open 24/7(770) 766-0555
GA Injury Advocates
Home » Loss of Enjoyment of Life Index

Loss of Enjoyment of Life Index

This form is to determine whether you have lost the enjoyment of certain activities in your life, or lost status or skills in these activities as a result of your injuries from this accident. This information is called “general damage’s” and is important part of your case. These details will be given to the insurance company to access how the accident affected your life and give value to your case.

Step 1 of 4

25%

Personal information

1. Pain & Suffering

a. What was the Date of the Incident?
MM slash DD slash YYYY
b. Progression of pain:
1/10 - Very little pain. 5/10 - Fair amount of pain. 10/10 - Worst pain imaginable.
1/10 - Very little pain. 5/10 - Fair amount of pain. 10/10 - Worst pain imaginable.
This field is hidden when viewing the form
MM slash DD slash YYYY
c. Regarding day-to-day changes after the accident occurred:
d. Describe the accident’s impact on your leisure and hobbies:
1/5 - Can do it perfectly fine. 3/5 - Can do it with difficulty. 5/5 - Cannot do it at all.
1/5 - Can do it perfectly fine. 3/5 - Can do it with difficulty. 5/5 - Cannot do it at all.
1/5 - Can do it perfectly fine. 3/5 - Can do it with difficulty. 5/5 - Cannot do it at all.

2. Work Related Activities

c. My employment status at the time of the accident:

Per:
g. What happened to your employment after the accident? (Check all that apply)
h. How did the injuries sustained from the accident affect your work? (Check all that apply)
i. How did the injuries sustained from the accident affect your work? (Check all that apply)
j. Did you experience any period of a total loss of income after the accident?
MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY
[2] I have not returned to work since the accident but may be able to return to work...
k. Did you experience any partial loss of earning potential after the accident?
[3] I have returned to work, but I earned less due to:
MM slash DD slash YYYY
MM slash DD slash YYYY
1/10 - I have faced little change in the enjoyment of performing my job. 5/10 - I have lost a fair amount of enjoyment in performing my job. 10/10 - I no longer enjoy performing the job.
Max. file size: 49 MB.

3. Household Activities

a. Which of the following household activities were disrupted? (Check all that apply)

b. Which of the following outdoor activities were disrupted?

d. Due to your injuries, have you brought in any of the following assistance?
g. How long has your contribution to household services been impaired?

4. Out-of-pocket Expenses

a. List all out-of-pocket expenses that you incurred as a result of the injuries you sustained that you would not have incurred otherwise?
Expense Type
Cost
Type of Supporting Documentation
 
Max. file size: 49 MB.

5. Personal Statement

This field is for validation purposes and should be left unchanged.

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332 North Marietta Pkwy
Marietta, GA 30060

(770) 766-0555 

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