Compromise And Release (Dependency Claim) {DWC-CA 10214(d)}

DWC-CA form 10214 (d), COMPROMISE AND RELEASE (Dependency claim). This form is used in the state of California in the workers' compensation system. In workers' compensation cases, a dependency claim is a claim made by a dependent of a deceased worker for benefits such as death benefits and burial expenses. A compromise and release is an agreement between the parties to settle the claim for a lump sum payment rather than ongoing benefits. The DWC-CA form 10214 (d) is used when the parties have agreed to settle the dependency claim through a compromise and release. It is signed by both the dependent and the employer or their insurance company, and once approved by a workers' compensation judge, it becomes a final and binding agreement. It is important to note that the decision to settle a dependency claim through a compromise and release should be made carefully, as it may affect the dependent's right to future benefits. It is recommended that the dependent seek legal advice before signing a compromise and release agreement. (REV. 11/2008). www.FormsWorkflow.com