Claim disposition agreements and disputed claim settlements
In 1990, SB 1197 permitted the use of claim disposition agreements. CDAs are agreements between insurers and workers in which workers release their rights to claim benefits other than medical services. In 1995, SB 369 prohibited the release of preferred worker benefits. CDAs significantly reduce subsequent litigation because workers relinquish rights for most workers’ compensation benefits.
Insurers and workers can also come to disputed claim settlements. DCSs are agreements in which the worker receives compensation for all or part of a claim in which there is a dispute over the compensability of the claim. The DCS may cover the entire claim, so the entire claim will be denied. In other cases, the DCS covers the compensability of certain conditions or the DCS covers the dispute about whether the injury remains the major contributing cause for the need for treatment. In these cases, the claim is partially accepted, and the DCS covers the specific conditions.
Both CDAs and DCSs are approved at WCB. Insurers and claimants often negotiate DCSs and CDAs at the same time. Over the past decade, about half of the DCSs have been accompanied by a CDA issued at approximately the same time.