I wouldn't suggest signing anything without first talking to an attorney. It shouldn't cost you anything to get a consultation. Find someone who has a lot of experience representing injured workers in your area and talk to them about your settlement options. Initial settlement offers are almost always low. The insurance company wants to pay out as little as possible. An attorney will help ensure that you're fully compensated -- they understand how the system works and know how to negotiate with insurance companies. If you need a referral, feel free to contact me. I'm licensed in Illinois, but I know an experienced workers' compensation attorney near you who may be able to help. 1-800-807-9530.
Whether to sign a Compromise and Release (C&R) depends on a lot of factors. What was the level of permanent disability(PD)? What was the PD's dollar value? What does the doctor say about the need for future medical care. Do you have other insurance that would pay for that future medical care? What does your treating doctor have to say? Was the "comp insurance's doctor/QME" a doctor they chose or one you chose? Do you still have the right to seek a second opinion from a Panel QME? I can keep going but you get the idea.
Don't sign anything until you consult a workers' comp attorney. There are many good ones in the L.A. area. Find a good one here at www.avvo.com or at www.caaa.org. CAAA is the association for attorneys who represent injured workers here in California. Or call me for a referral.
A compromise & Release will close your right to future medical so you should have a workers' comp attorney review the QME report and weigh the pros and cons versus leaving your medical benefits open. Also your employer may require that you resign if you accept a C&R.