This blogger greets you again, but with the
topic on the most common way to settle your workers’ compensation injury, the “Stipulation
with Request for Award”. But what is a “Stipulation with Request for Award” and
how does it work?
A “Stipulation with Request for Award” generally
gives you a lifetime medical award (yes, until you die, even if you switch
employers, retire, get fired or move out of state). However, medical care is generally
limited to treatment in the insurance company’s medical provider network (MPN)
subject to denials of care. Your monetary award will be limited to the value of
your percentage of permanent disability (PD) which originates from the impairment
assigned from the QME or AME which can be further reduced based on
apportionment (how much of your disability is from work or is pre-existing or is
from non-industrial factors).
A “Stipulation with Request for Award”
generally pays you the value of your percentage of permanent disability in
payments of $290.00 per week (for maximum wage earners) until the sum is paid in
full. Note, the payments may have started on the “permanent and stationary”
date if you were not working at the time of being found “permanent and
stationary” by a doctor. If you were working, you would not have received
payments beginning on the permanent and stationary date, thus, retro pay may be
paid to make you current and to catch up on payments that would have been paid
(but were not because you were working). However, there are exceptions to this
general rule on when PD payments start.
Accrued benefits owed to you are generally paid
to your attorney first (if you are represented). Sometimes the accrued PD is
not enough to pay the attorney fee and in that case the insurance company will
borrow money off the back end of your payments to pay your attorney. Borrowing
money off the back end of your payments generally involves a 3% interest rate
which is much cheaper than interest rates today. Payments to you should
continue until the remainder is paid. Then, no further PD money is owed to you.
However, there are exceptions to this general rule and in some cases,
additional PD payments can occur.
Why is permanent disability paid in payments?
Well, permanent disability is first translated into a number of weeks of
payments under Labor Codes §§ 4453 and 4658. Then, the amount paid per week
is determined on your average weekly wage multiplied by two-thirds with a
minimum permanent disability payment per week of $160.00 and a maximum
permanent disability payment per week of $290.00. Put another way, a 12%
permanent disability rating that is worth 38.25 weeks of payments, is worth
$6,120.00 to a minimum wage earner and $11,092.5 to a maximum wage earner.
Through this example, you can see that the same injury to a minimum wage earner
is worth less compared to a maximum wage earner. This concept applies to wage
loss supplemental pay as well, which we call temporary disability and
highlights how the workers’ compensation system regarding indemnity
discriminates based on earnings.
In a “Stipulation with Request for Award,” you
can reopen your claim within 5-years of your original date of injury if your
injury worsens, thereby seeking an increase in the percentage of permanent
disability. Also, within 5-years of your original date of injury, you can seek
compensation for a compensable consequence (a consequential injury that would
have never occurred but for the original injury). Within 5-years from your
original date of injury, you can also use unspent temporary disability pay if a
work comp doctor pulls you off work or gives you work restrictions your
employer cannot accommodate (but that is rare if a doctor has already deemed
you to be “Permanent and Stationary”).
In conclusion, I hope this information helps
you better understand how the most common settlement type (the “Stipulation
with Request for Award”) works. However, please beware, much more can be
settled, waived, dismissed or released in a “Stipulation with Request for
Award” so you must read and fully understand everything that is agreed upon.
That is why having a skilled, trained and knowledgeable attorney is important.
Having a good attorney can help you secure a good QME or AME to start with and
can help you secure proper compensation and medical care.
Mastagni Holstedt attorneys have built a track
record of success at trial and on appeal in state and federal courts across
California. Founded on attorney-client privilege, we have been assisting police
officers, firefighters and other safety workers for decades in matters ranging
from internal discipline and criminal defense to wage and hour, disability and
workers’ compensation claims. If agreed upon, our office can file your claim
for you, direct you to treatment, give you the best advice and see you through
your injury until the end. This blog is for educational purposes only. This is
not legal advice. There is no substitute for competent legal advice tailored to
your specific circumstance.
By Jonathan Drake Char, Esq.
