Stipulation And Award And Or Order (Lodi)

STIPULATION and AWARD And/or ORDER. This form is an official decision issued by the California Workers’ Compensation Appeals Board (WCAB) when both parties—typically the injured worker (applicant) and the employer or insurer (defendant)—reach an agreement to resolve part or all of a workers’ compensation claim. By signing this form, the parties waive the requirements of Labor Code §5313, allowing the judge to issue an order or award based on the stipulation without further written findings. The form identifies the applicant, attorneys for both parties, and interpreters (if applicable), and provides space for the Workers’ Compensation Judge to approve the stipulation and enter it as an official award or order. In some cases, it may also be entered as a Final Findings and Award/Order following an expedited hearing. The version provided is signed by Judge Maribeth Arendt, a WCJ of the California DWC. www.FormsWorkflow.com