You agreed to settle your California workers’ compensation case. So why have you not received the settlement documents or your check?
Many injured workers assume the case is basically over once they accept an offer. It is not. Even after both sides agree on an amount, several things still have to happen:
- The settlement documents must be prepared.
- The injured worker and all necessary parties must sign.
- The settlement must be filed with the Workers’ Compensation Appeals Board.
- A workers’ compensation judge must review and approve it.
- The insurance company must issue payment.
Any one of these steps can create a delay.
The uncomfortable truth is that some delays have nothing to do with a judge. The defense attorney simply has not prepared the documents, circulated them for signature, or filed the completed agreement.
At Lee Injury Attorneys, we do not consider a case finished when the insurance company accepts our demand. We do not consider it finished when our client signs. We continue pushing until the settlement is fully executed, filed, approved, and paid.
A recent en banc decision from the California Workers’ Compensation Appeals Board, Calvin Gaines, et al. v. ABM Aviation, Inc., explains what judges can and cannot require when reviewing a settlement. The decision arose from the Van Nuys Workers’ Compensation Appeals Board, but it is binding on workers’ compensation judges and Appeals Board panels throughout California.
What Did the WCAB Hold in Gaines?
The WCAB issued its unanimous en banc decision on June 24, 2026. The lead case number is ADJ20216367.
The Board announced two formal holdings:
- A California workers’ compensation settlement is enforceable only after approval by the Workers’ Compensation Appeals Board. The judge must decide whether the agreement is valid and adequate to protect the injured worker and the public interest.
- If a settlement is inconsistent, does not comply with the Labor Code, or appears inadequate, the judge may issue an Order Suspending Action. If the parties still do not provide enough information, the judge may hold a hearing and create an evidentiary record concerning the adequacy of the settlement.
The Board also explained that substantial medical evidence is not required to support every settlement. A judge cannot use an Order Suspending Action to compel a medical evaluation, force a dismissal with prejudice, or reduce an attorney fee without proper notice, due process, and an adequate record.
Accepting a Settlement Starts the Final Process
Most California workers’ compensation cases resolve through either a Compromise and Release or a Stipulated Award.
A Compromise and Release usually provides a lump-sum payment and closes the injured worker’s right to future medical treatment. A Stipulated Award generally pays permanent disability over time while leaving future medical care open.
Before accepting either option, injured workers should understand the difference between a Compromise and Release and a Stipulated Award.
Once the parties agree on an amount, someone still has to prepare the settlement documents.
Defense counsel often drafts the Compromise and Release because the insurance company has information concerning prior payments, credits, liens, medical expenses, and the exact terms it wants included in the agreement.
That does not mean the documents will arrive promptly.
We regularly see accepted settlements sit for days or weeks because the defense attorney has not prepared the paperwork, obtained final authority from the adjuster, or followed up on a missing signature.
We do not simply put the file aside and wait.
We call and email defense counsel, follow up with the adjuster when appropriate, demand the documents, review them when they arrive, and send them to our client for signature as quickly as possible.
Once the settlement is fully signed by everyone whose signature is required, we are also willing to electronically file it and submit it to the judge for approval ourselves rather than waiting indefinitely for defense counsel to complete a step the defense side ordinarily handles.
That is one way our background representing insurance companies helps our clients today. We approach the final settlement process with the same urgency and organization expected on the defense side. We identify what has to happen next, determine who is responsible, and keep pressure on that person until the case moves.
Where Workers’ Comp Settlement Delays Usually Happen
To understand a delay, you first need to know exactly where the settlement is in the process.
The defense has not prepared the documents
The parties agreed on the amount, but the Compromise and Release has not been drafted.
This is one of the most frustrating delays because the injured worker has already accepted the deal and reasonably believes payment is coming soon.
We push defense counsel to prepare the documents as soon as the agreement is confirmed. Once the paperwork arrives, we review it to make sure it accurately reflects the deal before our client signs.
The documents are not fully signed
The injured worker may have signed, but the defense attorney, employer, claims administrator, insurance carrier, or another necessary party may still need to sign.
A settlement cannot be submitted as a fully executed agreement until the required signatures are obtained. We follow up on missing signatures instead of allowing the documents to sit in someone’s inbox.
The signed settlement has not been filed
A completed settlement does not help the injured worker if it remains on a lawyer’s desk.
Once the agreement is fully executed and the supporting documents are ready, it should be filed with the Workers’ Compensation Appeals Board for approval. When the defense side does not move promptly, we are prepared to file the completed settlement ourselves.
The judge is reviewing the settlement
Once filed, the agreement may remain pending while the judge reviews the documents and supporting evidence.
Some settlements are approved within days. Others take several weeks depending on the district office, the judge’s workload, and whether the submission is complete.
Judicial approval is only the final part of the larger claim. Our guide to how long a California workers’ compensation case takes to settle explains the earlier stages involving medical treatment, QME evaluations, permanent disability, and settlement negotiations.
The judge issued an Order Suspending Action
An Order Suspending Action, commonly called an OSA, means the judge reviewed the agreement but wants more information before deciding whether to approve it.
It is not necessarily a rejection of the settlement.
The settlement was approved but has not been paid
Once the judge issues an Order Approving Compromise and Release, the remaining issue is payment.
At that point, the attorney should confirm when the approval order was served, when the insurance company received it, whether the checks were issued, and where they were mailed.
Signing the Settlement Does Not Make It Enforceable
Under Labor Code section 5001, a California workers’ compensation settlement is not enforceable until it is approved by the Workers’ Compensation Appeals Board.
The judge is not merely confirming that everyone signed the last page. The judge must decide whether the agreement is valid and whether it adequately protects the injured worker and the public interest.
This review matters because a Compromise and Release may permanently resolve claims involving:
- Permanent disability
- Temporary disability
- Future medical treatment
- Penalties and interest
- Multiple injury dates
- Additional body parts
- Employment Development Department benefits
- Medical liens and other liens
- Credits claimed by the insurance company
- The supplemental job displacement voucher
The judge therefore needs enough information to understand the claim, the defenses, the benefits already paid, and why the settlement amount is reasonable.
Judicial review provides an important safeguard, but injured workers should still recognize the warning signs that an insurance company may be lowballing a workers’ compensation settlement before signing away future medical care and other valuable rights.
What Is an Order Suspending Action?
A judge may issue an Order Suspending Action when the agreement is incomplete, inconsistent, or does not provide enough information to determine whether the settlement is adequate.
Common reasons include:
- Missing medical reports
- A body part or injury date that was not properly listed
- Inconsistent settlement language
- Unexplained benefit credits
- Unresolved liens
- Missing information about EDD benefits
- An insufficient explanation of the settlement amount
- Questions about the requested attorney fee
Many suspension orders can be resolved by filing a missing report, correcting the paperwork, or providing the judge with a clearer explanation.
An injured worker should ask their attorney for a copy of the OSA and a straightforward explanation of what the judge requested. The file should not simply sit after the order is received. The attorney needs to respond, provide the missing information, and keep working toward approval.
What Happened in Gaines?
The Gaines decision involved 24 individual cases assigned to the same workers’ compensation judge at the Van Nuys district office.
Many involved denied claims that the parties wanted to settle before completing a QME evaluation or other discovery. The judge issued similar Orders Suspending Action requesting medical records and other information. In several cases, the orders also suggested that injured workers obtain medical evaluations or dismiss their claims with prejudice.
The WCAB concluded that this approach exceeded the proper use of an Order Suspending Action.
The Board rescinded the suspension orders, disqualified the judge from further proceedings in the cases, and returned the matters to the presiding judge for reassignment.
Do You Need a QME Before Settling a Denied Claim?
Not in every case.
This is one of the most important parts of the Gaines decision.
The WCAB explained that substantial medical evidence is not required to support every settlement. Settlements exist in part so the parties can avoid the delay, expense, and uncertainty of proving every disputed issue through medical evaluations and trial.
The judge still needs sufficient information in the formal record to determine whether the settlement is adequate. But that information does not always have to include a final QME report.
The parties may be able to explain:
- Why the insurance company denied the claim
- What evidence supports the injured worker
- What defenses would be raised at trial
- What treatment the worker received
- What benefits were already paid
- Why both sides want to avoid further litigation
- How the settlement amount was calculated
If relevant medical reports already exist, they should be filed. The parties cannot withhold relevant records or incorrectly represent that no medical evidence exists.
But an injured worker is not automatically required to complete a QME process simply because the parties decided to compromise a disputed claim.
Can a Judge Order a Medical Evaluation Through an OSA?
The WCAB held that a judge cannot order an injured worker to attend a medical evaluation merely by putting that requirement into an Order Suspending Action.
If the judge believes an evaluation is necessary, the parties must receive notice and an opportunity to be heard. The judge may need to conduct a hearing and create a proper evidentiary record supporting the order.
The same due process concern applies to suggesting that an injured worker dismiss a claim with prejudice.
A dismissal with prejudice can permanently prevent the worker from pursuing the claim again. It should not be used as an ultimatum against someone who wants to settle rather than continue through additional discovery.
Who Is Settlement Review Designed to Protect?
The purpose of settlement review is to protect the injured worker and the public interest.
It is not the judge’s role to renegotiate the agreement for the insurance company or protect the carrier from paying more than the judge believes the case is worth.
Insurance companies are represented by adjusters, claims professionals, and defense attorneys. They are responsible for evaluating their own litigation risk.
The WCAB explained that if the record suggests the insurance company might be overvaluing a claim, that generally supports a conclusion that the settlement is adequate for the injured worker. It is not a reason to reject the agreement.
Gaines Did Not Create Automatic Settlement Approval
The decision does not mean every settlement must be approved.
A judge may still request additional information when the agreement appears inconsistent, violates the Labor Code, or may be inadequate. If the written information is insufficient, the judge may hold a hearing and create a formal evidentiary record.
The judge may request:
- Relevant medical records
- Denial letters
- Benefit payment histories
- Witness statements
- Deposition testimony
- Information about related civil claims
- An explanation of settlement value
- Documentation supporting the attorney fee
If the settlement itself is adequate but the requested attorney fee remains disputed, the judge may approve the settlement and order the disputed fee held in trust until the fee issue is decided at a hearing. That prevents a separate attorney-fee question from unnecessarily delaying the injured worker’s settlement.
The central rule after Gaines is straightforward: the judge must have enough reliable information to decide whether the settlement is adequate, but the parties are also entitled to proper notice and due process.
When Does the Insurance Company Have to Pay?
The payment period begins after the settlement is approved, not when the injured worker signs it.
The standard California Compromise and Release form states that Labor Code section 5800 interest is included if the settlement amounts are paid within 30 days after the date of approval. If payment is made later, additional interest may be owed. An unreasonable delay may also raise separate penalty issues.
If your settlement was approved more than 30 days ago and you have not received payment, ask your attorney:
- When was the approval order served?
- When did the insurance company receive it?
- Have the settlement checks been issued?
- Where were the checks mailed?
- Is the insurance company claiming that something else is required?
Do not count the 30 days from the date you signed the agreement. The date of judicial approval is what matters.
We Do Not Stop Working When the Settlement Is Signed
The final stage of a workers’ compensation case is where unnecessary delays frequently happen.
Nothing frustrates us more than getting a settlement signed by our client the same day, or within 24 hours, and then waiting weeks for a simple defense signature.
The injured worker’s case may already have lasted for months or years. The worker may have been unable to work, fallen behind on bills, and suffered serious financial hardship. Once everyone has agreed to settle, there should be urgency. The documents should be signed, filed, approved, and paid.
The defense attorney may be slow to prepare the paperwork. A signature may be missing. The fully signed agreement may remain unfiled. The judge may request additional documents. The insurance company may delay issuing payment.
Every one of those stages requires follow-up.
At Lee Injury Attorneys, we do not put the file away when our client agrees to settle. We push defense counsel to prepare the documents, review them promptly, get our client’s signature as quickly as possible, chase missing signatures, file the completed agreement, respond to an Order Suspending Action, monitor approval, and confirm payment.
We are also willing to take a fully signed settlement to the WCAB ourselves and seek approval rather than allowing it to sit unnecessarily. Sometimes defense counsel prefers to handle the appearance themselves. That is part of the system we deal with. But our client should not have to wait several more weeks simply because nobody on the other side feels any urgency.
David Lee and Michael Lee are California Certified Workers’ Compensation Law Specialists who previously represented employers and insurance companies. We understand how the defense side manages settlements, where the process often slows down, and what needs to happen to get a completed agreement in front of a judge.
We represent injured workers throughout Los Angeles County, including Lancaster, Palmdale, Quartz Hill, and surrounding Antelope Valley communities. We also serve the San Fernando Valley, Orange County, Ventura County, Riverside County, San Bernardino County, Lancaster, Palmdale and injured workers throughout Southern California.
If the defense attorney has not sent your settlement documents, your signed agreement has not been approved, or your payment is late, call or text Lee Injury Attorneys for a free consultation.
We do not treat a settlement as finished when it is signed. We treat it as finished when it is approved and paid.
This article provides general information about California workers’ compensation law and is not legal advice for any particular case.
