West Virginia workers’ comp lawyers charge a contingency fee: a percentage of your settlement or award. You don’t pay fees upfront, and you don’t pay fees if you lose. (To learn more about how much you could receive, see our article on West Virginia workers’ comp benefits.)
West Virginia sets maximum attorneys’ fees in workers’ compensation cases. If you are awarded benefits by a workers’ comp judge or receive a settlement from the insurance company, the maximum fee is 20% of your award or settlement. However, your lawyer’s fee is limited to 20% of your payments for a maximum of 208 weeks.
For example, suppose your weekly benefit rate is $400. You appeal the insurance company’s denial, and your lawyer negotiates a $200,000 settlement. A 20% fee would be $40,000, but your lawyer is also limited by the 208-week cap. In this case, your lawyer’s fee is calculated as follows:
Unlike some states, West Virginia allows variation in how contingency fees are calculated. For example, some lawyers calculate their fee based on the highest workers’ comp benefit rate you receive, even if your rate changes during the course of your claim. This manner of calculation can result in a higher fee than 20% of your average benefit rate, but is permitted by the state agency.
Additionally, attorneys’ fees must be approved by the West Virginia Insurance Commission in each case. The Commission will review your lawyer’s fees to make sure it is reasonable given:
If your claim is very simple, the commission might award a fee of less than 20%.
If the state agency approves your medical treatment on appeal, your lawyer can receive $125 per hour, up to $2,500 for the lifetime of the claim. However, the insurance company must pay these attorneys’ fees, not you. In order to receive these fees, your lawyer must file a Request for Award of Claimant’s Fees and Expenses within 30 days of your award of medical benefits.
If the insurance company unreasonably denied your claim, the West Virginia Insurance Commission might order it to pay some of your attorneys’ fees. To be unreasonable, the insurance company must not have had any legal or factual basis for its denial. Because this is a difficult standard to meet, awards of attorneys’ fees are relatively rare.
Legal costs are expenses related to your claim, such as the cost of ordering medical records, hiring expert witnesses, and transcribing deposition testimony. If your legal costs relate to an award of medical benefits or an unreasonable denial, the insurance might have to pay some of your costs. However, this is rare. In most cases, you are financially responsible for your legal costs.
Thankfully, most workers’ comp lawyers don’t require upfront payment of legal costs. Instead, they pay costs during your case and then deduct them from your award or settlement. And, many lawyers won’t charge you for legal costs if you lose your claim. However, not all lawyers are willing to advance or waive legal costs. Make sure you understand the lawyer’s legal cost policy before you sign a fee agreement.
If your workers’ comp benefits are denied or reduced, it’s probably in your best interest to hire an experienced workers’ comp lawyer. Appealing a workers’ comp denial typically requires detailed legal, medical, and vocational analysis. Most injured workers aren’t equipped to properly develop a workers’ comp appeal and present it to a judge. (See our article on the challenges of handling your own workers’ comp claim for more information.)
Most West Virginia workers’ comp lawyers offer a free initial consultation, which means you’ll have little to no upfront costs.