West Virginia Surrogate Decision Maker Lookup

Who can make medical and money decisions for an adult in West Virginia who cannot decide: an agent, a guardian, or West Virginia's default surrogate order. Runs in your browser; nothing is stored.

West Virginia law checked against official sources on October 26, 2026.

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What needs deciding?
Can the person understand this decision and make it, with help if needed?
Which of these exist? (tick all that apply)

Who has authority in West Virginia

  1. With no agent and no guardian, this state's default surrogate law lets a family member or other listed person make health-care decisions, in the order below.
  2. If nobody is available or the family disagrees, a court can appoint a guardian. That is slower and costs more than documents signed in advance.

West Virginia's default surrogate order

  1. Spouse
  2. Adult children
  3. Parents
  4. Adult siblings
  5. Adult grandchildren
  6. Close friends
  7. Any other person or entity, such as a public agency or public guardian
What it covers
When there is no medical power of attorney representative or guardian able and willing to serve, the attending physician or advanced nurse practitioner selects a surrogate, who may make any and all health care decisions without a court order.
If more than one person is in the same group
No majority rule. When several people are at the same level, the attending physician or advanced nurse practitioner selects the one who appears best qualified, and may even choose someone lower on the list if that person is best qualified, documenting why.
If nobody on the list is available
The last class is any other person or entity, including public agencies and public guardians.
Who decides the person cannot decide
A physician, qualified psychologist, physician assistant or APRN who personally examined the person determines incapacity; a second opinion is needed for some mental illness, intellectual disability or addiction cases.
Limits
  • The physician or nurse practitioner may pick a lower-ranked person who is best qualified.
  • If a listed person objects to a decision to withhold or withdraw life-prolonging care, the decision waits 72 hours for a possible court order.
  • Treating providers, facility owners and operators, and their unrelated employees cannot serve.
  • The surrogate acts without a court order.

Source: W. Va. Code 16-30-8 · Checked October 26, 2026

Next steps

Who decides in West Virginia without a power of attorney?

West Virginia's default surrogate law (W. Va. Code 16-30-8) covers health-care decisions generally. Without a health-care agent or guardian, the first person in line under the statute is: Spouse.

West Virginia's default surrogate law in full

West Virginia's default surrogate order

  1. Spouse
  2. Adult children
  3. Parents
  4. Adult siblings
  5. Adult grandchildren
  6. Close friends
  7. Any other person or entity, such as a public agency or public guardian
What it covers
When there is no medical power of attorney representative or guardian able and willing to serve, the attending physician or advanced nurse practitioner selects a surrogate, who may make any and all health care decisions without a court order.
If more than one person is in the same group
No majority rule. When several people are at the same level, the attending physician or advanced nurse practitioner selects the one who appears best qualified, and may even choose someone lower on the list if that person is best qualified, documenting why.
If nobody on the list is available
The last class is any other person or entity, including public agencies and public guardians.
Who decides the person cannot decide
A physician, qualified psychologist, physician assistant or APRN who personally examined the person determines incapacity; a second opinion is needed for some mental illness, intellectual disability or addiction cases.
Limits
  • The physician or nurse practitioner may pick a lower-ranked person who is best qualified.
  • If a listed person objects to a decision to withhold or withdraw life-prolonging care, the decision waits 72 hours for a possible court order.
  • Treating providers, facility owners and operators, and their unrelated employees cannot serve.
  • The surrogate acts without a court order.

Source: W. Va. Code 16-30-8 · Checked October 26, 2026

How authority works when someone cannot decide

An adult who can understand a decision makes it, even when family disagrees. Authority passes to someone else only when the person cannot decide, and the source of that authority matters.

The strongest source is a document the person signed while able: a health-care power of attorney or advance directive naming an agent for medical decisions, and a durable power of attorney for money and property. A court appointment (a guardian, or in some states a conservator for money) comes next, and it is slower and more expensive.

For health-care decisions only, most states also have a default surrogate law, sometimes called a family consent law. It lists who may decide when there is no agent and no guardian, usually starting with a spouse, then adult children, then parents and siblings. Doctors and hospitals apply it at the bedside.

There is no "next of kin" list for money

Default surrogate laws cover health care, not bank accounts, bills or property. Being a spouse, child or next of kin does not by itself let you sign checks or sell a house for another adult. Without a durable power of attorney, managing someone else's money usually needs a court appointment.

Federal benefits follow their own rules. Social Security says a power of attorney, an authorized representative or a joint account is not the same as being a payee; SSA appoints a representative payee. VA appoints a fiduciary for a beneficiary who cannot manage VA benefits.

What this tool does not do

  • It reports what each state's statute says. It does not decide whether a person has capacity; the treating doctor does.
  • It does not decide disputes between family members or replace a court order. A guardianship order or a power of attorney can change who decides.
  • Hospitals, nursing homes and other states' laws can add steps. Ask the facility's patient-relations or legal office which law it applies.
  • It is general legal information, not legal advice for your situation.

Frequently Asked Questions

Who makes medical decisions in West Virginia if there is no power of attorney?

West Virginia's default surrogate law (W. Va. Code 16-30-8) covers health-care decisions generally. Without a health-care agent or guardian, the first person in line under the statute is: Spouse. The full order, tie rule and limits are in W. Va. Code 16-30-8.

Does next of kin in West Virginia have authority over money?

No default surrogate law covers money. In West Virginia, as everywhere, managing another adult's accounts or property takes a durable power of attorney or a court appointment.

Sources

West Virginia law checked against the official text on October 26, 2026.

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