California
Workers Comp
EAMS Forms
Last updated: 5/30/2015
Stipulation With Request For Award (Death Cases) {DWC-CA 10214(b)}
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Description
DWC-CA form 10214 (b), STIPULATIONS WITH REQUEST FOR AWARD (Death Case), A California Stipulation with Request for Award is a written agreement between the injured worker and the insurance company as to what benefits are due. The agreement is approved by a judge. The approval is called a Stipulated Award. The insurance company then pays the benefits stated in the Award. (REV. 11/2008). www.FormsWorkflow.com
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