A mandatory settlement conference is a workers’ compensation hearing that allows the injured worker and insurance company to discuss disputed issues and, if necessary, set the case for trial. The parties 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.
Ai injured worker or 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 the body are injured?
- whether the injured worker qualifies for temporary disability?
- if he or she 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. Requesting a Mandatory Settlement Conference
- 3. Related hearings
- 4. The result of Mandatory Settlement Conference
- 5. Filling out the pretrial conference statement
- Using 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 an injured worker or insurance company. It is held to resolve disputes between the parties 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 the parties to resolve the issues
- approve any agreement reached by the parties
- indicate that more information is needed before the case can be set for trial
To obtain to a hearing before a judge, the injured worker 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, an injured worker or insurance company can request a hearing.
An injured worker or insurance company can only obtain a Mandatory Settlement Conference hearing date by filing a Declaration of Readiness to Proceed (DOR).1
The Department of Workers’ Compensation provides instructions for filling out the Declaration of Readiness form.
In a DOR, the person filing the form chooses which hearing is applicable to his or her case:
- Mandatory Settlement Conference
- Status Conference
- Rating MSC
- Priority Conference
- Lien Conference
and lists all relevant issues:
- compensation rate – how much did the worker 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 the injured worker?
- permanent disability – what is the percentage?
- future medical treatment – is it necessary?
- aoe/coecoe – is there an injury?
- discovery – a dispute related to a deposition or records
- employment – was the injured worker an employee?
- whether light and modified duty is appropriate
If the issue is related to any medical reports, the report is identified.
The preparer of the DOR must list the efforts he or she made to resolve the issue before filing the DOR. The preparer must sign under penalty of perjury that every statement in the DOR is correct.2
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 address specific issues.
What is a Rating MSC?
A Rating MSC is the same as a regular MSC except that the medical reports evaluating the injured worker’s 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, the parties can reach 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 the injured worker was not an employee when the injury occurred, there is no workers’ compensation claim against the employer and no work injury.
- Alternatively, the worker 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, the injured worker’s case will be over. If the injured worker wins, the insurance company will have to provide workers’ compensation benefits.
However, benefits can only be requested if an attorney represents the injured worker.4
What is an Expedited Hearing?
An expedited hearing is a trial on a limited number of issues related to benefits for an injured worker. 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 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 for the injured worker, 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 the parties need the judge’s assistance on an issue.
It is an opportunity for the injured worker and 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 the injured worker. It is between the insurance company and medical providers and takes place after the injured worker’s case is over.
An injured worker may receive a Notice of a Lien Conference but does not need to attend this 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. A party 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 one side is 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, the injured worker and insurance company are required to fill out the
Pretrial Conference Statement.7 The statement is to clarify the issues in dispute and provide certainty to the party as to what is in dispute. This makes the trials more efficient.8
The Pre-Trial Conference Statement is a joint statement that sets the issues that will be decided at trial. It also states the issues the injured worker and the insurance company agree on, lists witnesses, and records documents and other materials that will be presented at trial.
On the Stipulations page of the Pre-trial Conference statement the parties will attempt to agree on:
- employment – was the injured worker employed by the alleged employer or was he or she an independent contractor?
- date of injury – do the parties agree on when the injury happened?
- insurance – was the employer insured?
- occupation – what is the employee’s job title?
- location of injury – what city did the injury occur in?
- whether there was actually a work injury
- earnings – what was the injured worker’s weekly wage?
- temporary disability and permanent disability rate
- temporary disability and permanent disability payments
- has medical treatment been provided
- any other areas of agreement
On the “Issues” page of the pretrial conference statement, the parties will give their position on issues in dispute, including:
- permanent and stationary dateapportionmentpermanent and stationary date
- parts of 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.
- the injured worker
- any witness to the injury
- investigator that may have recorded the injured worker’s activity level after the injury
- any person that claims he or she was supported by an injured worker in a death case
- any other person that has relevant information
- medical reports
- medical records
- employment records
All parties that fill out the joint pre-trial conference statement sign each page of the statement to note that he or she agrees with and understands everything in the statement.
Any information excluded from the Pretrial Conference Statement has a strong possibility of being excluded from the trial.9 The party that wants to show the evidence must 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.
The insurance company is much more knowledgeable than an injured worker regarding workers’ compensation laws. It will use that advantage to obtain a favorable settlement.
The insurance company would prefer the injured worker accept its analysis of the case as opposed to that of a judge.
If an injured worker is unsure about the settlement agreement offered by an insurance company, he or she can request a Mandatory Settlement Conference.
By filing for an MSC, an injured worker is protecting his or her rights and a fair result.
Call us for help…
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) LAW-FIRM. Our firm helps police officers, firefighters and other workers to get compensation for their job-related injuries.
- 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.