The West Virginia Workers' Compensation Complaint Form is used by employees in the state of West Virginia to file a complaint against their employer related to workers' compensation issues. The form is used to report an employer's violation of the West Virginia Workers' Compensation law. The form is available in two versions: the Short Form, which is suitable for most grievances, and the Long Form, which is used for more complex complaints. Both forms require information about the injured employee, the employer, the type of injury sustained, the date of the injury, and the circumstances of the injury. The form also requires a written statement from the employee outlining the details of the complaint. Upon completion, the form must be submitted to the West Virginia Workers' Compensation Commission for review.