How is my case resolved
- I was injured at work
- How to file a claim
- If my claim was accepted
- If my claim was denied
- How I return to work
- How my case is resolved
Your case is resolved when there is an agreement between you and the claims administrator or a judge issues an order about your workers' compensation payments and future medical care that will be provided to you. In order to protect your rights, whether or not you are represented by an attorney, settlements must be reviewed by a workers’ compensation administrative law judge, to determine whether they are adequate.
What types of settlements are there?
There are two different ways to settle your case:
- Stipulations with Request for Award (stips)
- Payments - You and the claims administrator agree on the amount of temporary or permanent disability payments you will receive. This is usually paid in weekly payments
- Medical care - The claims administrator usually agrees to pay for medical care if needed.
- Compromise and Release (C&R)
- One payment - The claims administrator agrees on an amount to resolve your claim. This is usually paid in a lump sum
- Medical care - If the lump sum includes the estimated cost of future medical care, the claims administrator will no longer pay your doctor. This becomes your responsibility.
What if my case doesn't settle?
If you and the claims administrator are unable to agree on a settlement, your dispute will need to be decided by a workers’ compensation judge.
Want to learn more? Find it in the guidebook
Did you know?
- You can contact the Information and Assistance Unit if you have questions or call the DWC Information Services Center at 1-800-736-7401 to speak to a live representative.
- You are not required to accept the claims administrator’s offers. You can negotiate a settlement. If you can’t reach an agreement with the claims administrator, you can present your case to a workers’ compensation judge. The judge will decide what benefits you will receive. This decision is called a Findings and Award. It will be sent to you in writing.
- You can consult an attorney. Lawyers who represent injured workers in their workers’ compensation cases are called applicants’ attorneys. Your attorney can’t directly charge you for his or her services. Your attorney’s fee will be paid out of a portion of your workers’ compensation benefits. You can get names of applicants’ attorneys from the State Bar of California, a local bar association, or the California Applicants’ Attorneys Association.
Questions workers have: