DAVID Y. IGE GOVERNOR SHAN S. TSUTSUI LIEUTENANT GOVERNOR L EONARD HOSHIJO ACTING DIRECTOR JOANN VIDINHAR ADMINISTRATOR STATE OF HAWAII002 DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS002 DISABILITY COMPENSATION DIVISION002 830 PUNCHBOWL STREET, ROOM 209 P.O. BOX 3769002 HONOLULU, HAWAII 96812-3769002 http://labor.hawaii.gov002 Phone: (808) 586-9151 / Fax: (808) 586-9219002 Section 386-94 HRS relating to attorney fees states: s, the director, appeals board, or court may consider factors such as and effort required by the complexity of the case, the novelty and difficulty of issues involved, the amount of fees awarded in similar cases, benefits obtained for the claimants, and the hourly rate customarily awarded attorneys possessing similar skills and experience. In all cases reasonable Please complete the information below which will assist us in determining your authorized hourly rate as required under section 386-94, HRS. REQUEST FOR INCREASE IN HOURLY RATE Name: Address: License No.: Date Licensed: Number of years practicing law in Hawaii: cases (Claimant, Case Number, and Date of Accident): 1. 2. 3. : Rate being requested : Current RateSignature: : DateYour approved hourly rate is: APPROVED BY: DATE: COMPENSATION dlir.workcomp@hawaii.gov TEMPORARY DISABILITY INSURANCE dlir.tempdisabilityins@hawaii.gov PREPAID HEALTHCARE dlir.prepaidhealthcare@hawaii.gov American LegalNet, Inc. www.FormsWorkFlow.com