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WC108a ATTORNEY FEE APPROVALGEORGIA STATE BOARD OF WORKERS COMPENSATION ATTORNEY FEE APPROVALBoard Claim No. Employee Last Name. I. Date of Injury. IDENTIFYING INFORMATIONCounty of InjuryEMPLOYEEEmployee
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How to fill out attorney fee approval wc-108a
How to fill out attorney fee approval wc-108a
01
To fill out the attorney fee approval wc-108a form, follow these steps:
02
Start by entering your personal information, including your name, address, phone number, and email.
03
Provide the name of the workers' compensation insurance carrier and their mailing address.
04
Indicate the date of the workers' compensation injury or illness.
05
Enter the WCAB case number, if available.
06
Specify the attorney information, including their name, State Bar number, address, phone number, and email.
07
Describe the legal services provided by the attorney, the date range when the services were provided, and the total number of hours spent.
08
Enter the hourly rate or agreed-upon fee for the attorney's services.
09
Calculate the total attorney's fees by multiplying the number of hours with the rate.
10
Indicate any costs or expenses incurred by the attorney, if applicable.
11
Summarize the reason for the requested attorney's fees and explain the basis for the calculation.
12
Sign and date the form.
13
Make a copy of the completed form for your records.
14
Submit the form to the appropriate authority.
Who needs attorney fee approval wc-108a?
01
Attorney fee approval wc-108a is needed by individuals who have received legal representation in a workers' compensation case and want to request approval for the attorney's fees. This form is required to seek authorization for the payment of attorney's fees and to justify the amount requested.
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