Stipulation With Request For Award (For Injury On Or After 1-1-2013) {DWC-CA 10214(a)}

DWC-CA form 10214 (a), STIPULATIONS WITH REQUEST FOR AWARD (For Injury On Or After 1-1-2013). This form is used in the state of California for workers' compensation cases. The stipulation outlines the terms of the settlement, including the amount of compensation to be paid and the nature and extent of the injuries sustained by the employee. The form is typically used for cases involving injuries that occurred on or after January 1, 2013, and is submitted to the Division of Workers' Compensation (DWC) for approval. Once the DWC approves the stipulation, it becomes an enforceable legal agreement between the parties. It is important to note that the DWC-CA form 10214(a) should only be completed with the assistance of an experienced workers' compensation attorney, as the terms of the stipulation can have a significant impact on the injured worker's future rights and benefits. (Rev 5/2020). www.FormsWorkflow.com