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Home > Help with Unemployment Insurance (Unemployment Compensation) Denials

Help with Unemployment Insurance (Unemployment Compensation) Denials

To apply for free legal help because the you have been denied Unemployment Benefits, please complete the form below.

If your problem is in some other area of the law, please use your browser’s back button to return to the prior page and make a different selection.

LARC will assess your application to determine what services migh be available to you. If LARC can refer your case to another agency for further assistance, we will do so.

Be sure to check any notice of decision you have received for appeal deadline information. You should file an appeal before your deadline in order to preserve your rights. If you decide you do not want to pursue an appeal, you can always withdraw your request.

Your Email Address:

First Name: *

Middle Name:

Last Name: *

Date of Birth: *

Street Address:

Address Line 2:

City:

Zip Code:

Home Phone#:

Work Phone#:

Cell Phone#:

What is the best phone number for us to call?: *

Home

Work

Cell

Is it safe for us to call at these numbers?: *

Yes

No

Best time to reach you Monday-Friday between 9am and 4pm?: *

Please provide us several dates and times between 9am – 4pm, Monday – Friday , that you will be available for us to call you.

Is it safe for us to leave a message at these numbers?: *

Yes

No

Please describe any special instructions or information concerning how to contact the person applying for services:

If you are submitting this application for another person, please tell us who you are and your relationship to the applicant:

When did you apply for benefits?:

In which office did you apply? :

What is the name of the company you worked for?:

How long did you work for them?:

What is the last day you worked?:

How did you end up losing your job?:

I quit

I was laid off

I was fired

Why did you quit, get laid off or fired?:

When did you apply for Unemployment?:

What is the date of the denial letter?:

What is the reason for denial?:

Have you filed for an appeal?:

Yes

No

If you have a hearing date, what is it?:

Have you continued to file claims?:

Yes

|No

IMPORTANT: you will not get benefits for any week for which you do not file. Keep filing while you wait for the appeal.

Are you looking for work?:

Yes

No

You must continue to meet the job search requirements while you wait for the appeal.

The number of people who live with you under the age of 18, including yourself:

The number of people who live with you over the age of 18, including yourself:

Are you a U.S. citizen?:

Yes

No

Non-citizens may still be eligible for services, but we might need more information about your status. No information we gather here is shared outside of the legal services agencies without your permission.

Are you or is a member of your household a veteran?:

Yes

No

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