Third Party Compromise And Release {DWC-CA 10214(e)}

DWC-CA form 10214 (e), THIRD PARTY COMPROMISE AND RELEASE. Upon approval of this Compromise Agreement by the Workers' Compensation Appeals Board and payment in accordance with the provisions hereof, said employee releases and forever discharges said employer and insurance carrier from all claims and cause of action, whether now known or ascertained, or which may hereafter arise or develop as a result of said injury, including any and all liability of said employer and said insurance carrier and each of them to the dependents, heirs, executors, representatives, administrators or assigns of said employee. It is agreed by all parties hereto that the filing of this document is the filing of an application on behalf of employee and that the workers' compensation administrative law judge may in his or her discretion set the matter for hearing as a regular application, reserving to the parties the right to put in issue any of the facts admitted herein, and that if hearing is held with this document used as an application the defendants shall have available to them all defenses that were available as of date of filing of this document, and that the workers' compensation administrative law judge may thereafter either approve said Compromise Agreement and Release or disapprove the same and issue Findings and Award after hearing has been held and the matter regularly submitted for decision. (REV. 11/2008). www.FormsWorkflow.com