Chapter 4.5. Division of Workers' Compensation
Subchapter 1.8.5. Electronic Adjudication Management System Rules
Article 1. Definitions and General Provisions

§ 10205.2. Compromise and Release Forms and Stipulations with Request for Award Forms.

The following optical character recognition forms shall be used to settle case by either a compromise and release or stipulation with request for award.

(a) DWC-CA form 10214(a) (Stipulations with request for award) revision dated 11/2008 is incorporated by reference;

(b) DWC-CA form 10214(b) (Stipulations with request for award, death case) dated 11/2008 is incorporated by reference;

(c) DWC-CA form 10214(c) (Compromise and release) revision dated 11/2008 is incorporated by reference;

(d) DWC-CA form 10214(d) (Compromise and release, dependency claim) revision dated 11/2008 is incorporated by reference;

(e) DWC-CA form 10214(e) (Compromise and release, third party settlement) revision dated 11/2008 is incorporated by reference.

Note: Authority cited: Sections 111, 133, 138.2(b) and 5307.3, Labor Code; and Stats. 2011, c. 559, §17 (A.B. 1426). Reference: Sections 5002, 5003, 5004 and 5005, Labor Code.

HISTORY

1. Renumbering of former section 10214 to new section 10205.2, including amendment of Note, filed 12-10-2012 as a change without regulatory effect pursuant to section 100, title 1, California Code of Regulations by the Division of Workers' Compensation and as a file and print by the Workers' Compensation Appeals Board pursuant to Government Code section 11351 (Register 2012, No. 50).