Home
Forms Library
West virginia form compensation

West virginia form compensation 2026

west virginia form compensation Preview on Page 1

See details

4.8 out of 5

101 votes

The document is a notice for owners, corporate officers, and board members in West Virginia to either reject or reinstate their workers' compensation coverage. It outlines the legal requirements for exclusion from coverage, the need for attestation of position within the company, and the consequences of opting out of coverage. Additionally, it requires supporting documentation to verify the individual's role and mandates filing with the workers' compensation carrier.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out West Virginia Form Compensation with Our Platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open it in the editor.
Begin by entering the 'Legal Name of Corporation, LLC or Company' in the designated field. Ensure that this matches your official registration documents.
Next, input the 'Federal Employer Identification Number (FEIN)' accurately. This is crucial for identification purposes.
If your business operates under a different name, fill in the 'Business Name (DBA)'. Otherwise, you can leave this blank.
Provide the complete 'Address of Corporation, LLC or Company' to ensure proper correspondence.
In the section for personal details, enter your 'Name', 'Position', and 'Social Security Number'. Double-check for accuracy.
Sign and date the form at the bottom. Remember that signing attests to your position and eligibility regarding workers’ compensation coverage.
Finally, attach any required documentation such as corporate filings or meeting minutes before submitting it to your workers’ compensation carrier.

Start using our platform today to fill out your West Virginia Form Compensation easily and for free!

See more west virginia form compensation versions

We've got more versions of the west virginia form compensation form. Select the right west virginia form compensation version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2010	4.8 Satisfied (101 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I sign my west virginia form compensation on a mobile?

Yes, you’ll find many different applications for this on the web. Nevertheless, if you need to eSign your west virginia form compensation without installing additional software, DocHub is the optimum choice you can make. This powerful editor works on mobile devices just as on desktops. Open our editor in any internet browser, register or sign in to your account, and start processing your forms.

Can I sign my west virginia form compensation while I edit it?

If you edit your west virginia form compensation with DocHub, you simply will not need to look for other software or services to eSign it. An electronic signature is a component of DocHub’s substantial editing toolset, which enables you to apply changes in your form without switching between websites. Simply complete your form, double-check the correctness of your data and place your electronic signature at the end to make it submission-ready within a few minutes.

Does West Virginia require workers compensation insurance?

All West Virginia employers are statutorily required to maintain workers compensation insurance coverage.

How much does workers comp pay in West Virginia?

An injured workers wage paid is 66 2/3%. The weekly payment minimum is $175.33, 33 1/3% of the West Virginia state average weekly wage and may not exceed the Federal minimum hourly wage. The weekly maximum is $526, 100% of the West Virginia state average weekly wage. Maximum period of payments is 104 weeks.

What is the first report of injury for workers comp in West Virginia?

First Report of Injury (FROI) Form OIC-WC-2. As soon as you have been notified of a work-related injury, please immediately fill out this form and submit it to EMPLOYERS and provide a copy to the employee.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more

How does workers compensation work in WV?

Workers compensation insurance in WV helps pay medical costs for employees that become hurt or sick as a result of their job. It can also help replace some of your employees missed wages or provide disability payments if theyre unable to return to work.

How much is workers comp benefit in West Virginia?

Temporary total, permanent total and vocational rehabilitation benefits: $917.08 (paid at two thirds of the claimants average weekly wage not to exceed 100% of the State average weekly wage of $917.08);

Is workers comp mandatory in WV?

All West Virginia employers are statutorily required to maintain workers compensation insurance coverage. Visit the West Virginia Offices of the Insurance Commissioner Employer Coverage Unit online to file workers compensation.

How is PPD calculated in West Virginia?

Pursuant to W. Va. Code 23-4-6(e)(1), permanent partial disability (PPD) rates are paid at 66 and 2/3% of the average weekly wage earnings, wherever earned, of the injured employee at the date of injury, not to exceed 70% of the average weekly wage in West Virginia.

How long do you have to file a workers comp claim in WV?

Claims Must Be Filed Within Six Months West Virginia requires injured workers to file an application for benefits within six months of the date of injury. Do not allow yourself or your loved one to miss out on valuable financial help to replace lost wages, cover medical expenses, and more.

West virginia form compensation 2026

Here's how it works

How to use or fill out West Virginia Form Compensation with Our Platform