1 Answer

Yes

Q: How is my claim finally resolved?A: After the amount of PD in a claim is determined, there is usually a settlement or award for benefits. This award must be approved by a workers' compensation judge. If you have an attorney, your attorney should help you obtain this award. If you don’t have an attorney, the claims administrator will help you obtain the award. You can also get help from the I&A officer at the local Workers’ Compensation Appeals Board office. If your doctor said further medical treatment for your injury or illness might be necessary, the award may provide future medical care.There are two types of settlements. A settlement is mutually agreed on by you and the claims administrator.

You can resolve your whole claim through one lump sum settlement called a compromise and release (C&R). A C&R may be best when you want to control your own medical care and/or you want a lump sum payment for your permanent disability. A C&R usually means that after you get the lump sum payment approved by the workers’ compensation judge, the claims administrator will not be liable for any further payments or medical care. A C&R must be mutually agreed upon by you and the claims administrator.

You can also agree to a settlement called a stipulation with request for award (stip). A stip usually includes a sum of money and future medical treatment. Payments take place over time. A judge will review the agreement.

If you cannot agree to a settlement with the claims administrator, you can go before a workers compensation judge, who will decide your permanent disability award. A judge’s finding is called a findings and award (F&A). The F&A generally consists of an amount of money and a provision for the claims administrator to pay for approved future medical treatment.

If you need more information, first contact the claims administrator handling your claim. If you need one of the Information & Assistance (I&A) guides or other help, call an I&A office or attend a workshop for injured workers. The Fresno I&A office is located at 2550 Mariposa Street, Room 2035, Fresno, CA 93721-2280 and can be reached by phone at (559) 445-5355. You can also get information on local workshops and download the guides from the Web at www.dir.ca.gov/dwc/.