Fill and Sign the Complaint for Injuries under Fela Jury Trial Demand Form

IN THE UNITED STATES DISTRICT COURT FOR THE ____________ DISTRICT OF ___________ ___________________ DIVISION NAME OF PLAINTIFF )       ) ) V. ) NO.       ) ) NAME OF DEFENDANT )       ) ) JURY TRIAL DEMANDED COMPLAINT _____________, the plaintiff, files this complaint against ________________, a corporation, the defendant, and in support thereof states the following: PARTIES, JURISDICTION AND VENUE 1. This is a Federal Employers' Liability Act case brought pursuant to 45 U.S.C., Section 51, et. seq. The defendant, __________, is a ____________ corporation which does business in ____________ County, ______________, and has done such business at all times referred to herein. The defendant, ___________, is subject to the jurisdiction of this Court, venue is proper, and it may be served with summons and complaint as allowed by law. 2. The defendant, __________, is a common carrier by railroad engaged in the business of operating a railroad in interstate commerce for hire for the purpose of carrying freight in interstate commerce. 3. ______________'s railway agent for service of process is __________, __________, __________, _________, _____. 4. The plaintiff, at all times referred to herein, was an employee of the defendant and was acting within the line and scope of his employment for the defendant. The plaintiff's duties of employment for the defendant were in furtherance of interstate commerce or directly or closely and substantially affected such interstate commerce. FACTS 5. Plaintiff avers that heretofore on, to - wit, the _______ day of ______, ____, while working as a brakeman for the defendant, ___________, at or near ___________, ___________, on Job ___, the plaintiff's train was caused to collide with the train of Job ___, and plaintiff was injured and damaged as follows: His knees were injured and damaged; his left upper extremity was injured and damaged; his back was injured and damaged and was permanently injured and permanently damaged; the nerves, muscles, discs, and ligaments of his low back were injured and damaged and were permanently injured and permanently damaged; his neck was injured and damaged and was permanently injured and permanently damaged; the nerves, muscles, discs, and ligaments of his neck were injured and damaged and were permanently injured and permanently damaged; his musculoskeletal system was injured and damaged and was permanently injured and permanently damaged; his nervous and emotional system was injured and damaged and was permanently injured and permanently damaged; he was caused to suffer great physical pain and mental anguish and will be caused to suffer great physical pain and mental anguish in the future; he was caused to lose wages from his employment and his power and capacity to work and earn money in the future was permanently impaired; he was unable to carry out his usual and normal activities of life for a long period of time and his power and capacity for carrying out and engaging in his usual and normal activities of life in the future were permanently impaired; he was caused to have radical surgery and spend money for medical providers; and he was otherwise injured. FIRST CAUSE OF ACTION 6. Plaintiff avers that all of his aforesaid injuries and damages were caused, in whole or in part, by the negligence of the defendant, its agents, servants or employees, while acting within the line and scope of their employment for the defendant, or by reason of a defect or insufficiency due to the negligence of the defendant in its communication systems, dispatcher's instructions, radio communication systems, work practices, maintenance and inspection of vegetation adjacent to railroad tracks, and safety practices at the time and place of plaintiff's aforesaid injuries. SECOND CAUSE OF ACTION 7. Plaintiff further avers that all of his aforesaid injuries and damages were caused, in whole or in part, by the negligent failure of the defendant to use reasonable care to provide to the plaintiff a reasonably safe place for plaintiff to do his work and labor for the defendant. DAMAGES 8. Plaintiff avers that as a result, in whole or in part, of the defendant's negligence, he has suffered and seeks to recover for the following special injuries and damages: (a) Past lost wages, benefits, and medical expenses; (b) Future lost wages and benefits; and (c) Permanent impairment of his ability to earn a living. 9. Plaintiff avers that as a result, in whole or in part, of the defendant's negligence, he has suffered and seeks to recover for the following general injuries and damages: (a) Past physical pain and mental anguish; (b) Future physical pain and mental anguish; (c) Permanent physical disability; and (d) Inability to carry out and enjoy the usual and normal activities of life. 10. The plaintiff seeks to recover a sum that will fully and fairly compensate him for his special and general damages. Because of the severity of his injuries, the plaintiff demands an adequate award of compensatory damages. JURY DEMAND 11. Plaintiff demands trial by jury. WHEREFORE, the plaintiff demands a trial by jury, that summons issue, that judgment be entered in favor of him and against the defendant and the following relief be granted: (a) That the plaintiff be awarded special general damages in an amount to fully fairly compensate him for his injuries; and (b) That the cost of his action be assessed against the defendant; and (c) That this Court Grant such other and further relief as it deems just and proper. Respectfully submitted, ___________________________________