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Reset Form STATE OF CALIFORNIA DIVISION OF WORKERS' COMPENSATION WORKERS' COMPENSATION APPEALS BOARD THIRD PARTY COMPROMISE AND RELEASE Case Number 1 Case Number 4 Case Number 2 Case Number 5 Case

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What is compromise and release third?

Compromise and release third refers to a legal document that is used to settle a workers' compensation claim. It is typically the third settlement agreement between the injured worker and the workers' compensation insurance carrier.

Who is required to file compromise and release third?

The injured worker and the workers' compensation insurance carrier are required to file the compromise and release third.

How to fill out compromise and release third?

To fill out the compromise and release third, both the injured worker and the workers' compensation insurance carrier must provide their respective information, including details about the claim, settlement amount, and any agreed-upon terms.

What is the purpose of compromise and release third?

The purpose of the compromise and release third is to provide a final settlement for the workers' compensation claim, resolving any remaining disputes between the injured worker and the insurance carrier.

What information must be reported on compromise and release third?

The compromise and release third must include information such as the injured worker's personal details, claim information, settlement amount, any agreed-upon terms or conditions, and the signatures of both parties.

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