Application For Lump Sum Payment Of Attorney Fees {IC-32-A}

IC-32-A - APPLICATION FOR LUMP SUM PAYMENT OF ATTORNEY FEES. This form from the Ohio Industrial Commission is used by an applicant (typically an injured worker or beneficiary) to request a lump sum advancement specifically to cover attorney fees related to their workers' compensation claim. The form allows the applicant’s attorney to certify the legal services provided and confirm that no additional fees will be owed for continuing compensation unless a new dispute arises in the future. It also permits the applicant to request that any approved payment be sent directly to the attorney or other party owed fees, and that the payment will reduce future benefits from permanent total disability, permanent partial disability, or a death award. If reimbursement of legal expenses is included (up to $1,500), supporting documentation must be attached. www.FormsWorkflow.com