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Request for Award of Claimants Attorney Fees and Expenses - West Virginia

Request for Award of Claimants Attorney Fees and Expenses - West Virginia 2025

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The document is a request form for the award of attorney fees and expenses for a claimant, as per West Virginia Code §23-2C-21(c). It includes sections for the claimant's personal information, details about the employer, and information regarding an 'unreasonable' order from a claim administrator that has been reversed. The form requires submission by an attorney with their Bar ID and address.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Claimant’s Name in the designated field at the top of the form. Ensure that this is accurate as it identifies the individual requesting fees.
Next, fill in the Social Security Number (SSN) and Claim Number (Cl.#). This information is crucial for processing your request.
Indicate the Date of Injury (DOI) and Employer's name. These details help establish context for your claim.
In the section regarding the Administrator’s 'unreasonable' order, check the appropriate box to indicate whether it was reversed by the Office of Judges, Board of Review, or Supreme Court. Attach any necessary documentation.
Complete the submission details by printing your name, Bar ID#, and address. Finally, enter the date you are submitting this form.

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