Award (Lodi)

AWARD. This form issued by the State of California, Division of Workers’ Compensation, Workers’ Compensation Appeals Board records the final administrative ruling in a workers’ compensation case. Signed by a Workers’ Compensation Administrative Law Judge (WCALJ), in this case Judge Maribeth Arendt, it documents the official decision in favor of the applicant (injured worker) against the defendant (employer or insurer). The order may include multiple components: (A) temporary disability indemnity, (B) additional temporary disability, (C) permanent disability indemnity (minus any approved attorney’s fees), (D) liens against compensation, (E) authorization for further medical treatment, (F) reimbursement for medical-legal expenses, and (G) approval of stipulations. The form may also note that the matter is taken off calendar, or that jurisdiction over liens is reserved for later determination. The bottom section provides for service certification in accordance with California Code of Regulations §§10628–10629. www.FormsWorkflow.com