A Findings and Award is a judge’s determination based on the evidence that the injured worker is entitled to workers’ compensation benefits. There has to be a trial for there to be a Findings and Award.
A worker’s case can end in other ways.
- A Findings and Order is a judge’s decision that no benefits are due.
- A Stipulation with Request for Award is an agreement between the injured worker and insurance company as to the benefits that will be provided. It results in a Stipulated Award.
- A Compromise and Release is an agreement between the injured worker and insurance company to end the case for a lump sum payment.
A Findings and Award begins with a Mandatory Settlement Conference and then a trial. After the trial, the judge will issue the decision within 30 days.
A Findings and Award must be supported by “substantial evidence,” meaning the evidence must be reasonable and credible.
A Findings and Award can include a ruling as to:
- whether there a work injury and to what parts of body
- medical treatment
- temporary disability benefits
- permanent disability benefits
The injured worker is awarded interest from the date of the award.
Once a decision is made, the same issue cannot be tried again.
A Findings and Award can be appealed with a Petition for Reconsideration.
In this article, our California personal injury attorneys will explain:
- 1. What is a Findings and Award?
- 2. What is the process to get a findings and award
- 3. What is the standard for a findings and award?
- 4. What does an Award include?
- 5. Can the same issues in a Findings and Award be tried again?
- 6. Appeal of a California Findings and Award
- 7. Most cases will not end with a Findings and Award
After a trial in a California workers’ compensation case, a judge will issue a decision. If the injured worker is awarded benefits, the decision is called a Findings and Award.
A Findings and Award is based on the evidence presented at trial.
Every injured worker has the opportunity to have a trial and obtain a Findings and Award if he or she disputes the benefits provided.
Example: Debbie believes she is entitled to more temporary disability than the insurance company paid. There is a trial on this issue.
The judge issues a decision titled a Findings and Award that gives Debbie temporary disability for the period she believes she could not work due to her injury.
A Findings and Order is a decision by a judge based on evidence that does not award benefits to the injured worker.
Usually, a Findings and Order means the insurance company has proven the injured worker is not entitled to benefits.
Example: The insurance company denies George’s workers’ compensation case. It argues that George is an independent contractor rather than an employee and therefore is not entitled to workers’ compensation benefits. There is a trial on this issue.
The judge issues a decision titled a Findings and Order. The judge finds George is in fact an independent contractor, so he is not awarded any benefits.
A California Stipulation with Request for Award is a written agreement between the injured worker and the insurance company as to what benefits are due.
The agreement is approved by a judge. The approval is called a Stipulated Award. The insurance company then pays the benefits stated in the Award.
Example: Sam and the insurance company agree that he has 12% permanent disability for his ankle injury. They write up an agreement called a Stipulation with Request for Award that states this.
The judge reviews the agreement and approves a Stipulated Award for 12% permanent disability.
A Compromise and Release is an agreement between the injured worker and insurance company to end an injured worker’s case.
A judge does not make a finding in a Compromise and Release. A judge only determines if the agreement seems fair.1
Example: Anne and the insurance company reach an agreement to resolve her entire case, including any future medical care, for $20,000. There is no specific value for temporary disability, permanent disability, or the future medical care.
The judge decides the agreement is fair and it can be settled.
The agreement to estimate the cost of the case and settle everything is called a Compromise and Release.
Getting to a Findings and Award requires following specific procedures after filing a claim for workers’ compensation benefits in California.
The process for a Findings and Award begins with requesting a Mandatory Settlement Conference with a Declaration of Readiness to Proceed.
A Declaration of Readiness is filed when there is a dispute between the insurance company and the injured worker.
At the Mandatory Settlement Conference, the injured worker and insurance company fill out a Pre-Trial Conference Statement, listing the issues that are in dispute.
The case is then set for trial.
Example: Ted believes the insurance company should pay for his shoulder injury. The insurance company says the shoulder injury did not occur at work.
Ted files a Declaration of Readiness to Proceed, requesting a Mandatory Settlement Conference on the issue of whether his shoulder injury is work-related.
At the hearing, Ted and the insurance company fill out the Pre-trial Conference Statement, listing the issue as to whether there is a work injury to Ted’s shoulder. The case is set for trial.
At the trial, any witnesses that have something to say on the disputed issues will testify. The judge will take in any documents that either side wants to present as evidence.
Example: Julie has a trial in her workers’ compensation case. She testifies about her injury and submits medical reports discussing her injury and permanent disability.
The insurance company submits different medical reports.
The case is then submitted for a decision.
The judge will send the parties a
- written summary of evidence,
- the decision, and
- the basis for the decision.2
A California workers’ compensation judge must make a decision on all major issues addressed at trial.3 He or she must issue a decision within 30 days of the case being submitted.4
Example: Derek had a trial in his workers’ compensation case 24 days ago. The issue was the amount of permanent disability Derek should get.
A week ago, he received a Summary of Evidence that gave a brief overview of his testimony and the documents that were submitted to the judge by both parties.
Today he received the decision titled a Findings and Award that provided Derek with 14% permanent disability for his work injury.
A California Findings and Award must be supported by substantial evidence. It is evidence that is reasonable, credible, and of solid value. It is evidence that a reasonable person might accept. 5
A preponderance of evidence means more likely than not, or a greater than 50% chance that the evidence supports one side. 6
An injured worker must prove by a preponderance of the evidence that:
- he or she sustained an industrial injury
- the injury was related to employment with the employer
- the injury resulted in disability7
Example: Kareem testifies at his workers’ compensation trial that he injured his back at work lifting a box. He also discusses his pain level and how he has difficulty working.
There is a medical report from Kareem’s doctor stating his disability level.
The judge reviews Kareem’s testimony and the medical report and finds them to be substantial evidence, and it is more likely than not that Kareem has a back injury and permanent disability caused by work.
The Award can include any of the major workers’ compensation benefits:
- injury and parts of body
- medical care
- temporary disability
- permanent disability
An insurance company must pay interest on an Award.8
Example: Wendy receives a Findings and Award in her case. She is awarded:
- temporary disability from March 3, 2017 to March 3, 2018, at a rate of $765 a week
- permanent disability of 13% for her back and 7% for her shoulder
- future medical care for her back and right shoulder
Once an issue has been tried and there is a Findings and Award, it cannot be tried again.9 This is called Res Judicata.
This applies to a civil court or a workers’ compensation court.
Example: Tessa’s workers’ compensation case ends with a Findings and Order that she is not entitled to any benefits for her psychiatric injury claim from stress at work.
Tessa wants to file a civil claim against her employer. But some of her claims cannot go forward in civil court because they have already been decided by the workers’ compensation court.
Either the insurance company or injured worker can appeal any finding that they disagree with.10
Example: Jen has a trial in her workers’ compensation case on the issues of temporary disability and permanent disability.
Jen is awarded permanent disability of 23% but no temporary disability.
Jen believes she should have been awarded temporary disability as well, and shecan appeal the decision on the temporary disability issue.
The insurance company believes the 23% permanent disability is too much and can appeal that issue.
It is rare that a case in California workers’ compensation ends in a trial and a Findings and Award or Findings and Order by a judge.
Most cases will end with an agreed settlement that is either a Stipulated Award or a Compromise and Release.
Call us for help…
For help with filing a workers compensation claim in California, completing workers comp forms or appealing a denial of benefits, contact us. Our firm helps police officers, firefighters and other workers to get compensation for their job-related injuries in California.
- California-Western States Life Ins. Co. v. Industrial Acci. Com. (1963). 59 Cal. 2d 257.
- Cal. Lab. Code § 5313.
- Pierson v. Industrial Acci. Com. (1950) 98 Cal. App. 2d 598.
- Cal. Lab. Code § 5313.
- Braewood Convalescent Hospital v. Workers’ Comp. Appeals Bd. (1983) 34 Cal. 3d 159, 164.
- Cal. Lab. Code § 3202.5.
- Cal. Lab. Code § 3600.
- Cal. Lab. Code § 5800.
- Scott v. Industrial Acci. Com. (1956) 46 Cal. 2d 76.
- Cal. Lab. Code § 5900(a).