Current through Register Vol. XLI, No. 50, December 13, 2024
Section 85-4-4 - Payment of awards4.1. An award of reasonable attorneys= fees and costs actually incurred in reversing an unreasonable denial decision shall be paid by a private carrier or self-insured employer.4.2. Reasonable attorneys= fees incurred in reversing an unreasonable denial of compensability or an initial award of temporary total disability shall be the attorney's fees allowed pursuant to W. Va. Code '23-5-16. Attorney's fees shall be payable only upon the conclusion of all litigation and appeals if the denial decision has been reversed and if the Office of Judges has determined that the denial decision is unreasonable.a. Attorneys shall not be entitle to receive attorney fees under both the provisions of W. Va. Code '23-5-16 and this rule. Any amounts received in excess of the statutory amount shall be reimbursed to the claimant for incurred attorney's fees.4.3. Reasonable attorneys= fees incurred in reversing an unreasonable denial of an authorization of medical benefits will be calculated at a rate of $110 per each hour worked through a final decision by the Office of Judges, up to a maximum of $1,500. The attorney will be paid $110 per hour worked for any appellate work at the Board of Review and West Virginia Supreme Court of Appeals, up to a maximum additional $1,500. Attorney's fees shall be payable only upon the conclusion of all litigation and appeals if the denial decision has been reversed and if the Office of Judges has determined that the denial decision is unreasonable. The hours worked shall begin to accrue upon the injured workers= receipt of the denial of medical authorization.4.4. Costs actually incurred in the process of obtaining a reversal of the unreasonable denial is limited to the following items incurred after the date of the denial decision: b. Service of process costs;d. Costs of preparation of medical reports; ande. Costs of testimony of expert witnesses.4.5. In no event shall the costs of the preparation of a medical reports or the testimony of expert witnesses exceed the normal and customary fee schedule of the Commission, Insurance Commissioner, private carrier or self-insured employer, whichever is applicable.4.6. The attorney's fees and actual costs shall be paid upon petition presented to the private carrier or self-insured employer. The fee petition shall provide the contract of representation, an itemization of all legal services provided and the amount of time (expressed in tenths of an hour) expended in providing them, and an itemized listing of the actual costs incurred in the litigation of the matter.4.7. In no event shall attorney's fees and costs be awarded for disputes regarding the amount contained within the fee petition presented to the private carrier or self-insured employer.