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In workers’ compensation there are generally two ways your claim can settle informally:
Stipulations with Request for Award; or
Compromise and Release.
STIPULATIONS WITH REQUEST FOR AWARD:
A Stipulation with Request for Award consists of you and the adjuster handling your claim agreeing on the amount of permanent disability benefits you will receive. This amount is based on the medical opinions of your primary treating physician, a panel qualified medical evaluator or an agreed medical evaluator.
This will be an agreement to any temporary disability benefits and will address future medical care. Future medical care is based on the medical reports, but generally will include language that there is need for future treatment. The insurance company will be responsible for paying for ongoing medical care, subject to utilization review and Independent Medical Review.
COMPROMISE AND RELEASE:
A Compromise and Release is a lump sum payment that you and the adjuster handling your claim agree on. The lump sum payment takes into consideration the permanent disability benefits and future medical treatment. The future medical treatment is described within the medical reports used to settle your claim, with the lump sum being an estimate. If your claim settles this way, the workers’ compensation carrier will no longer pay medical treatment.
Should there be no settlement agreement, it will be decided by a judge at the Workers’ Compensation Appeals Board. There are a few other ways to resolve a workers’ compensation claim, but those are relatively rare and only used in unique circumstances.
If you have any questions about your workers’ compensation injury or want to talk to an attorney in Fresno, please call 559-408-7436 or fill out the form to the right.