California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 4.5 - Division of Workers' Compensation › Subchapter 1.6 - Permanent Disability Rating Determination › Section 10165.5 - Notice of Options Following Disability Rating (DEU Form 110)

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
STATE OF CALIFORNIA
Department of Industrial Relations
Division of Workers' Compensation
DISABILITY EVALUATION UNIT
NOTICE OF OPTIONS FOLLOWING DISABILITY
					 RATING
This is a disability rating determination (Rating) prepared
					 by the State of California Disability Evaluation Unit within the Division of
					 Workers' Compensation. It describes your percentage of disability. This
					 percentage is based on your limitations as reported by the doctor, your
					 potential loss of future earning capacity, your age, and the type of work you
					 were doing at the time of your injury. If the rating indicates that you have
					 some permanent disability, you should automatically begin to receive permanent
					 disability payments. Payments are made in installments, every two weeks, for
					 the number of weeks shown on the rating, less any permanent disability payments
					 made to you prior to the rating.
If the rating is not disputed by you or your employer, you
					 do not have to take any action to receive your benefits. We do want you to know
					 that you may have two options you may want to consider. They are:
1) STIPULATED FINDINGS AND AWARD;
2) COMPROMISE AND RELEASE;
1)
STIPULATED FINDINGS AND AWARD
If you and the employer, carrier or agent accept the
					 rating, written agreements may be submitted to the Workers' Compensation
					 Appeals Board (WCAB) requesting that an Award be made without the need for a
					 hearing. We recommend this option when the rating is not disputed, and you have
					 a need for future medical care. A Workers' Compensation Judge will review the
					 stipulations and issue an award.
ADVANTAGES
* A stipulated award is a quick, easy way to settle your
					 case while protecting your rights;
* There is no need to take time off work to go to a
					 hearing;
* The Division of Workers' Compensation will review the
					 settlement to protect your rights at no cost to you, there is no need to hire a
					 lawyer;
* If your condition worsens, you can apply for additional
					 payments anytime within five years from the date of your injury;
* If you need additional medical care or you are to receive
					 a life pension (rating of 70% or more), your rights to future benefits can be
					 fully protected and a judge can enforce the award if there later becomes a
					 problem.
* You may request a lump sum payment of all or part of your
					 permanent disability if you can show a financial need or hardship. However, a
					 Workers' Compensation Judge must first be convinced that it would be in your
					 best interest.
DISADVANTAGES
* You normally will not receive a lump sum payment, but
					 will receive your benefits in payments every two weeks.
2)
COMPROMISE AND RELEASE
A Compromise and Release Agreement is a settlement which
					 usually permanently closes all aspects of a workers' compensation claim except
					 for vocational rehabilitation benefits, including any provision for future
					 medical care.
The Compromise and Release is paid in one lump sum to you.
					 It must be reviewed and approved by a Workers' Compensation
					 Judge.ADVANTAGES
* You may receive more money than you would receive under a
					 Stipulated Findings and Award because you are giving up your future rights in
					 exchange for money.
* If the employer, or insurance company disputes the
					 rating, a Compromise and Release will assure you receive an agreed amount of
					 money now rather than risk getting nothing or a lesser amount later.
* You will receive your benefits in one lump sum.
DISADVANTAGES
* A Compromise and Release usually permanently releases the
					 employer from all future responsibilities. After your case has been resolved by
					 a Compromise and Release Agreement, you cannot ask for more medical treatment
					 at your employer's expense, nor can you claim additional benefits if your
					 disability or condition becomes worse. Also, if you later die as result of the
					 injury, your dependents would not be entitled to death benefits.
* Once a Workers' Compensation Judge has approved your
					 Compromise and Release, the settlement is final and it cannot be set aside
					 except in very rare circumstances.
If you would like more information, you can receive
					 recorded information free of charge, by calling 1-800-736-7401 or you may
					 contact your local Information and Assistance officer (listed in the state
					 government section of your telephone book under Department of Industrial
					 Relations, Division of Workers' Compensation). You may also consult an attorney
					 of your choice.
SPECIAL NOTICE TO UNREPRESENTED INJURED
					 WORKERS
If you disagree with the rating because you believe that
					 the rating was improperly calculated or that the doctor failed to address any
					 or all issues or failed to properly rate your impairment, you may request
					 administrative review of the rating within 30 days of receipt of the rating,
					 from the Administrative Director of the Division of Workers' Compensation. In
					 some cases, you may be entitled to an additional medical evaluation or a
					 different medical specialist. Your request should include a copy of the rating
					 and a copy of the report from the doctor. A copy of the request must be sent to
					 your claims adjustor.
If you have questions about whether to request
					 administrative review of your rating or whether another medical evaluation is
					 appropriate, you should contact the local Information and Assistance Officer
					 listed in the state government section of your telephone book under Department
					 of Industrial Relations, Division of Workers' Compensation. They can tell you
					 how to file the request if you decide to do so.
1. New
					 section filed 4-25-91; operative 4-25-91 (Register 91, No. 26). New section is
					 exempt from review by OAL pursuant to Government Code section
					 11351.
2.
					 Amendment of section filed 1-28-94; operative 1-28-94. Submitted to OAL for
					 printing only pursuant to Government Code section
					 11351
					 (Register 94, No. 4).
3. Amendment of section and NOTE filed
					 12-31-2004 as an emergency; operative 1-1-2005 (Register 2004, No. 53). A
					 Certificate of Compliance must be transmitted to OAL by 5-2-2005 or emergency
					 language will be repealed by operation of law on the following
					 day.
4. Certificate of Compliance as to 12-31-2004 order, including
					 further amendment of section and NOTE, transmitted to OAL 4-29-2005 and filed
					 6-10-2005 (Register 2005, No. 23).
Note: Authority cited: Sections
						133 and
						5307.3, Labor
						Code. Reference: Sections
						124,
						4061,
						4062,
						4062.01,
						4062.1,
						4062.2,
						4062.5,
						4064,
						4067,
						4660,
						4662,
						4663 and
						4664, Labor
						Code.