A mandatory settlement conference (sometimes called an MSC hearing) is a workers’ compensation hearing that allows you (the injured worker) and the insurance company to
- discuss disputed issues and
- if necessary, set the case for trial.
You and the insurance company fill out a joint statement called a Pretrial Conference Statement that lists agreed and disputed facts. The judge uses the statement as a guide at trial.
You or the insurance company can request a Mandatory Settlement Conference by filing a Declaration of Readiness to Proceed (DOR). The DOR states the issues that could not be resolved informally and that require a judge to resolve.
At a mandatory settlement conference, the most common issues concern:
- if there is a work injury?
- which parts of your body are injured?
- whether you qualify for temporary disability?
- if you should receive permanent disability and what amount?
If the issues cannot be resolved, the case is set for a trial.
Mandatory settlement conferences are not the only type of hearing in California workers’ compensation.
Other hearings include:
- Rating MSC – hearing with a rating of the medical reporting
- Priority Conference – the issue of injury only
- Expedited Hearing – medical treatment or temporary disability disputes
- Status conference – any issue not ready for trial
- Lien Conference – medical billing disputes
Each of these hearings has a special purpose in the workers’ compensation system.
In this article, our California personal injury lawyers will explain:
- 1. What is a mandatory settlement conference?
- 2. How do I request a mandatory settlement conference?
- 3. What are the related hearings?
- 4. What is the result of the mandatory settlement conference?
- 5. What is the pretrial conference statement?
- 6. How do I use a mandatory settlement conference to obtain a fair result?
A mandatory settlement conference is one of several types of hearings that can be requested by you or the insurance company.
1. What is a mandatory settlement conference?
A mandatory settlement conference is one of several types of hearings that can be requested by you or an insurance company. It is held to resolve disputes between you and the insurance company or, if the dispute is not resolved, to set the case for trial.
The judge may:
- offer an informal opinion on the disputed issues
- work with you and the insurance company to resolve the issues
- approve any agreement reached by you and the insurance company
- indicate that more information is needed before the case can be set for trial
2. How do I request a mandatory settlement conference?
To obtain a hearing before a judge, you must first file a claim for workers’ compensation benefits. Once the claim has been filed, an Application for Adjudication of Claim must also be filed to obtain a case number.
The application provides the judicial authority to review the case.
With the case number, you or the insurance company can request a hearing.
You or the insurance company can only obtain a Mandatory Settlement Conference hearing date by filing a Declaration of Readiness to Proceed (DOR).1
2.1. How to file a declaration of readiness to proceed
The Department of Workers’ Compensation provides instructions for filling out the Declaration of Readiness form.
In a DOR, you choose which hearing is applicable to your case:
- Mandatory Settlement Conference
- Status Conference
- Rating MSC
- Priority Conference
- Lien Conference
and list all relevant issues:
- compensation rate – how much did you earn?
- rehabilitation/supplemental job displacement benefits – is there permanent work available?
- temporary disability – what are the dates and disability rate?
- self-procured medical treatment – is the insurance company responsible for medical treatment paid for by you?
- permanent disability – what is the percentage?
- future medical treatment – is it necessary?
- AOE / COE – is there an injury?
- discovery – a dispute related to a deposition or records
- employment – were you an employee?
- whether light and modified duty is appropriate
If the issue is related to any medical reports, the report is identified.
You must list the efforts you made to resolve the issue before filing the DOR. You must sign under penalty of perjury that every statement in the DOR is correct.2
3. What are the related hearings?
A Mandatory Settlement Conference is not the only hearing in the California workers’ compensation system. As indicated in the DOR, other types of hearings can be requested.
Each of these hearings addresses specific issues.
What is a rating MSC?
A Rating MSC is the same as a regular MSC except that the medical reports evaluating your condition will be rated by the Disability Evaluation Unit (DEU) prior to the hearing.3
The DEU is part of the Department of Workers’ Compensation and determines the permanent disability percentage ratings of medical reports. By having medical reporting rated before the Rating MSC, you and the insurance company can reach an agreement at the hearing on the value of the permanent disability.
It is, therefore, more likely the case can be resolved at the Rating MSC by way of Stipulation and Award or Compromise and Release.
What is a priority conference?
A Priority Conference is only set to determine whether there is a work injury. The determination can be made in two ways:
- If you were not an employee when the injury occurred, there is no workers’ compensation claim against the employer and no work injury.
- Alternatively, you may be an employee, but if there is no injury or the injury occurred outside of work, there is no claim.
If the insurance company wins on the above issues, your case will be over. If you win, the insurance company will have to provide workers’ compensation benefits.
However, benefits can only be requested if an attorney represents you.4
What is an expedited hearing?
An expedited hearing is a trial on a limited number of issues related to your benefits. The issues are:
- entitlement to medical treatment
- medical treatment in a medical provider network
- attendance at medical treatment appointment
- right to or amount of temporary disability
- which of the two employers will provide benefits
- any other issue that requires immediate action5
The expedited hearing is not set for a trial date. Any issues are tried by the judge at the time of the expedited hearing.
Because medical treatment and wage loss payments are urgent, the Workers’ Compensation Appeals Board hears the evidence and decides the issue as quickly as possible.
What is a status conference?
A Status Conference occurs when the case is not ready for trial, but you or the insurance company needs the judge’s assistance on an issue.
It is an opportunity for you and the insurance company to discuss an issue in person that may be causing a delay in benefits. As it is a hearing, a judge is available to assist in finding a solution.
If it turns out there is a triable issue, the case can be set for a Mandatory Settlement Conference.
What is a lien conference?
A Lien Conference involves payment for medical treatment. This does not involve you. It is between the insurance company and medical providers and takes place after your case is over.
You may receive a Notice of a Lien Conference but do not need to attend this conference.
4. What is the result of the mandatory settlement conference?
If the issues are not resolved at the MSC, the case is normally set for trial, but it can be:
- set for another Mandatory Settlement Conference
- set for a Status Conference
Continuing a case to another conference is not generally favored by judges. You must show “good cause” as to why the hearing should be continued.6 Good cause means there must be a valid reason to justify a continuance.
What is considered good cause is at the discretion of the judge, but cannot simply be that you are unprepared.
Alternatively, if the case is not ready to go to trial, the case can be taken off the court’s calendar.
If the case is set for trial, you and the insurance company are required to fill out the Pretrial Conference Statement.7 The statement is to clarify the issues in dispute and provide certainty as to what is in dispute. This makes the trials more efficient.8
5. What is the pretrial conference statement?
The Pre-Trial Conference Statement is a joint statement that sets the issues that will be decided at trial. It also states the issues you and the insurance company agree on, lists witnesses, and records documents and other materials that will be presented at trial.
5.1. Issues of Agreement
On the Stipulations page of the Pre-trial Conference statement, you and the insurance company will attempt to agree on:
- employment – were you employed by the alleged employer or were you an independent contractor?
- date of injury – do you and the insurance company agree on when the injury happened?
- insurance – was your employer insured?
- occupation – what is your job title?
- location of injury – what city did your injury occur in?
- whether there was actually a work injury
- earnings – what was your weekly wage?
- temporary disability and permanent disability rate
- temporary disability and permanent disability payments
- has medical treatment been provided
- any other areas of agreement
5.2. Disputed Issues
On the “Issues” page of the pretrial conference statement, you and the insurance company will give your positions on issues in dispute, including:
- permanent and stationary date
- parts of your body injured
- any other issues
In death cases, there are additional issues such as whether the cause of death is related to employment and who the dependents are.
5.3. Witnesses
Witness include:
- you
- coworkers
- supervisors
- any witness to your injury
- the investigator that may have recorded your activity level after the injury
- any person that claims they were supported by the injured worker in a death case
- any other person that has relevant information
5.4. Exhibits
Exhibits include:
- medical reports
- medical records
- employment records
You must sign each page of the statement to note that you agree with and understand everything in the statement.
Any information excluded from the Pretrial Conference Statement has a strong possibility of being excluded from the trial.9 You have to have a good reason why it could not have been obtained earlier so that it can be listed as an exhibit in the trial.10
Example: John fills out the Pretrial Conference Statement with the insurance company’s attorney at the Mandatory Settlement Conference. At the trial, John realizes he forgot to list a witness he wants to have testify about how his injury happened, and he wants to include a medical report from his private doctor that discussed his injury.
Because John did not initially list these items, they may be excluded from the trial, and it can hurt John’s case.
Example: At the trial, the insurance company shows up with surveillance video of Amy playing tennis. The video was taken after the Mandatory Settlement Conference. The insurance company wants to show the video in court to prove that Amy is not as seriously injured as she claims.
Amy objects because the video was not listed on the Pretrial Conference Statement. The video is excluded because the insurance company cannot show why it could not have obtained the video earlier.
Any issues the parties agree on at the MSC, called a stipulation, are binding at the trial. An incorrect stipulation cannot be taken back without good cause.11
Example: At the MSC in Jill’s case, the insurance company stipulated that Jill earned $900 a week. At the trial, the insurance company wanted to change this amount to $800. But the insurance company had already agreed to this by stipulation and could not alter it later.
6. How do I use a mandatory settlement conference to obtain a fair result?
The insurance company is much more knowledgeable than you regarding workers’ compensation laws. It will use that advantage to obtain a favorable settlement.
The insurance company would prefer you to accept its analysis of the case as opposed to that of a judge.
If you are unsure about the settlement agreement offered by an insurance company, you can request a Mandatory Settlement Conference.
By filing for an MSC, you are protecting your rights to a fair result.
Contact us for additional help…
Contact us for help with your workers’ compensation case.
For help with filing claims, preparing for depositions in workers comp cases, or completing workers comp forms, contact us. Our firm helps police officers, firefighters and other workers to get compensation for their job-related injuries.
For help with filing claims, preparing for depositions in workers comp cases, or completing workers comp forms, contact us at (855) 809-0900. Our firm helps police officers, firefighters and other workers to get compensation for their job-related injuries.
Legal References:
- Cal. Code Regs., tit. 8, § 10414, subd. (a).
- Cal. Code Regs., tit. 8, § 10414, subd. (d).
- Cal. Code Regs., tit. 8, § 10250.1.
- Cal. Lab. Code § 5502(c).
- Cal. Lab. Code § 5502(b).
- Cal Lab. Code § 5502.5.
- Cal. Lab. Code § 5502(d)(3).
- County of Sacramento v. WCAB (2000) 65 Cal. Comp. Cases 1, 5.
- Cal. Lab. Code § 5502(d)(3).
- Savemart Stores v. WCAB (2006) 71 Cal. Comp. Cases 1727.
- County of Sacramento v. WCAB (2000) 65 Cal. Comp. Cases 1.