A Stipulations with Request for Award is a California workers’ compensation settlement in which you and the insurance carrier agree on the key facts of your claim — the permanent disability rating, the weekly payment, the body parts covered, and the date of injury — and ask a Workers’ Compensation Appeals Board judge to turn that agreement into a binding award. The defining feature of this settlement is that it keeps your claim open for future medical treatment related to the injury, instead of closing everything out with a one-time lump sum.
How It Differs From a Compromise and Release
California workers’ compensation offers two main settlement paths. A Compromise and Release (filed on form 10214(c)) trades a single lump-sum payment for closing the entire case, including future medical care. A Stipulations with Request for Award (form 10214(a)) does the opposite: you receive permanent disability payments over time at the agreed rate, and the insurer stays responsible for medical treatment reasonably needed to cure or relieve the effects of the injury.1California Legislative Information. California Labor Code 4600
That open medical window is the single biggest reason workers choose stipulations over a lump sum. If your shoulder flares up five or ten years later and still relates to the original injury, the insurer still owes the treatment. A separate form, 10214-b, exists for death benefit cases.2Division of Workers’ Compensation. DWC Forms
What the Agreement Locks In
The anchor of the settlement is the permanent disability rating, a percentage between 0% and 100%. That number drives the weekly payment amount, the total number of weeks you’ll be paid, and the scope of covered medical care. The stipulations also fix:
- The date of injury, or the period of exposure for a cumulative trauma claim.
- The specific body parts affected.
- Which body parts or conditions remain open for future medical treatment.
- Your average weekly wage at the time of injury, which sets the dollar value of each weekly payment.
Be thorough about the future-medical list. If your medical report mentions the low back and radiating leg symptoms, both should appear. Listing conditions explicitly prevents the insurer from later denying care by arguing it fell outside the agreement.
How the Weekly Payment and Total Are Calculated
Under Labor Code 4658, California uses a tiered, cumulative schedule to convert a disability rating into weeks of payment. For injuries on or after January 1, 2013, the brackets are:3California Legislative Information. California Labor Code 4658
- 0.25%–9.75%: 3 weeks per 1% of disability
- 10%–14.75%: 4 weeks per 1%
- 15%–24.75%: 5 weeks per 1%
- 25%–29.75%: 6 weeks per 1%
- 30%–49.75%: 7 weeks per 1%
- 50%–69.75%: 8 weeks per 1%
- 70%–99.75%: 16 weeks per 1%
Because the brackets stack, higher ratings earn disproportionately more weeks. A 25% rating isn’t 25 × 6; the first 9.75% is counted at 3 weeks each, the next 5% at 4 weeks each, and so on up the ladder.
The weekly payment itself is two-thirds of your average weekly earnings at the time of injury, bounded by statutory minimums and maximums. For injuries occurring on or after January 1, 2026, the permanent disability rate floors at $160 per week and caps at $290 per week.4Division of Workers’ Compensation. DWC Workers’ Compensation Benefits Verifying your pre-injury wages carefully matters, because an error ripples through every payment for the life of the award.
What You Need Before You File
A stipulated award cannot move forward without a final medical report from a Qualified Medical Evaluator (QME) or an Agreed Medical Evaluator (AME). That report feeds into California’s Permanent Disability Rating Schedule, which the Disability Evaluation Unit uses to produce an official rating.5Department of Industrial Relations. Schedule for Rating Permanent Disabilities If you disagree with the evaluator’s findings, you have 20 days to object if you’re represented and 30 days if you’re not. Miss that window and the rating sticks.
Beyond the medical report, pull together:
- Your ADJ case number from the WCAB’s Electronic Adjudication Management System.6California Department of Industrial Relations. DWC EAMS and Legacy Case Number Lookup
- The insurance carrier’s claim number, legal name, and service address.
- The official disability rating from the Disability Evaluation Unit.
- Pay stubs, tax records, or employer wage statements covering the time of injury.
Every entry on the settlement form has to match the medical evidence already in the file. A disability percentage on the form that contradicts the medical report will get the submission rejected or returned for correction.
The Form and the Judge’s Review
The settlement is filed on DWC-CA form 10214(a), available from the Department of Industrial Relations.7Division of Workers’ Compensation. DWC-CA Form 10214(a) – Stipulations with Request for Award You fill in the disability percentage, the weekly rate, the total weeks of payments, the body parts included, and the terms for future medical care. All parties sign and date: you (the applicant), the carrier’s representative (the defendant), and any attorneys. Unsigned or undated forms get sent back.
Attorneys typically file electronically through the JET Filing system; unrepresented workers can mail the paperwork to the appropriate WCAB district office.8Division of Workers’ Compensation. DWC EAMS JET File
A Workers’ Compensation Administrative Law Judge then reviews the stipulations. Labor Code 5702 allows parties to stipulate to the facts in writing, and the WCAB can issue findings and an award based on those stipulations or set the matter for a hearing if more information is needed.9California Legislative Information. California Labor Code 5702 This isn’t a rubber stamp. If the rating looks inconsistent with the medical evidence or the terms appear to shortchange the worker, the judge can reject the stipulations or require additional testimony.10Department of Industrial Relations. California Code of Regulations Title 8 10835 – Effect of Stipulations
Once the judge signs the Award, the agreement has the force of a court order. Under Labor Code 4650, the first permanent disability payment is due within 14 days after the last temporary disability payment, and the insurer must keep paying until the full amount owed has been paid.11California Legislative Information. California Labor Code 4650
If the Insurer Pays Late
An insurer that unreasonably delays or refuses payment, before or after the award, faces a penalty of up to 25% of the delayed amount or $10,000, whichever is less. If the insurer catches its own mistake and self-imposes a 10% penalty within 90 days, it can avoid the larger one. Claims for these penalties must be brought within two years of when the payment was due.12California Legislative Information. California Labor Code 5814
One trap worth knowing: when the WCAB approves a stipulated award, any accrued penalty claims that existed beforehand are presumed resolved unless the parties specifically exclude them. If the insurer owes you penalties for past delays, carve that issue out of the stipulations before you sign.
Changing the Award After It’s Signed
California gives you two separate paths to challenge or modify a stipulated award, depending on timing.
Petition for Reconsideration
Any party affected by a WCAB decision can petition the full appeals board to reconsider it. The window is tight: generally 20 days from service of the decision, extended to 25 days if service was by mail, under Labor Code sections 5900 through 5903.13California Legislative Information. California Labor Code 5900 The board can also grant reconsideration on its own motion within 60 days. Miss the deadline and the award is final.
Petition to Reopen
If your condition later worsens or improves, the WCAB retains continuing jurisdiction and can rescind, alter, or amend the award for good cause, including a recurrence, increase, or decrease of disability.14California Legislative Information. California Labor Code 5803 But no award can be changed after five years from the date of injury, and any counterpetition from the other side must be filed within 30 days of the original petition.15California Legislative Information. California Labor Code 5804
That five-year limit applies to the disability portion of the award. Future medical care has no expiration date. A shoulder covered under a stipulated award today can still be treated at the insurer’s expense decades later if the treatment is reasonably needed for the effects of the injury.
Attorney Fees
California doesn’t set a fixed percentage cap on workers’ compensation attorney fees. The WCAB must approve any fee as reasonable, weighing the complexity of the case, the time invested, and the result.16California Legislative Information. California Labor Code 4906 In practice, approved fees in permanent disability settlements commonly land around 12% to 15% of the award. The fee comes out of your benefits, not on top of them, so your net is lower than the stated award. Your attorney has to disclose the customary fee range before you hire them.
Taxes and the Social Security Offset
Benefits received under a stipulated award aren’t taxable. Federal law excludes amounts received under workers’ compensation acts from gross income,17Office of the Law Revision Counsel. 26 USC 104 – Compensation for Injuries or Sickness and California follows the same exclusion.
Social Security Disability Insurance is where it gets complicated. If you receive both SSDI and workers’ compensation, federal law caps the combined total at 80% of your average current earnings before the injury. When the two together exceed that ceiling, the Social Security Administration reduces your SSDI (not your workers’ compensation) to bring the total back under 80%.18Office of the Law Revision Counsel. 42 USC 424a – Reduction of Disability Benefits Report any workers’ compensation payments to the SSA promptly. Unreported payments can trigger overpayment notices and clawbacks later.
Medicare Set-Aside Considerations
Because a stipulated award keeps the insurer on the hook for injury-related treatment, Medicare’s interests are generally already protected. Medicare Set-Aside Arrangements show up far more often in Compromise and Release settlements, where the case closes entirely.
CMS review thresholds still apply across all workers’ compensation settlements, though. CMS will review a proposed set-aside when the claimant is already a Medicare beneficiary and the settlement exceeds $25,000, or when the claimant reasonably expects to enroll in Medicare within 30 months and the settlement exceeds $250,000.19Centers for Medicare & Medicaid Services. Workers’ Compensation Medicare Set Aside Arrangements No law requires submitting a proposal, but doing so when the thresholds apply creates a safe harbor against later disputes with Medicare over who should have paid. If you’re on Medicare or expect to be soon, raise this with your attorney before you sign.