Texas Walmart Work Injury to Employee / Associat
The Texas Walmart work injury plan, for Walmart associates and perhaps employees and associates of related entities, provides certain benefits. However, just because it provides certain benefits does not mean an injured Walmart employee cannot retain an attorney and prosecute an arbitration proceeding. Arbitration is like litigation, except that it is a generally private process. A person arbitrating his or her work injury claim may be able to obtain damages which are not provided by a work injury plan, whether that is Walmart’s work injury plan or another company’s work injury plan. For example, most work injury plans do not provide compensation for pain and suffering, mental anguish, physical impairment, and or loss of earning capacity.
Walmart’s Texas work injury plan provides that a cost of the service or supply will be a covered charge only if you meet certain requirements. Treatment must be furnished by or under the direction of a medical provider that will Walmart approves, and you must generally obtain pre-authorization from the Walmart plan claims administrator. There is some compensation available for treatment provided as emergency care, if the claims administrator receives notification of such emergency care with no later of 24 hours after your receipt of such care or the claim administrator’s next business day, and moreover that, after you receive that emergency care, any subsequent treatments are provided by or at the direction of a Walmart-approved medical provider. Walmart reminds its employees and associates that any decision by such employees to seek treatment from an hospital or urgent care clinic does not necessarily involve emergency care.
Walmart provide a list of a number of covered charges, which are subject to limitations and restrictions otherwise set forth in Walmart’s Texas work injury plan. One category of covered medical is that for approved physician visits further, certain medical supplies are covered. Professional ground ambulance service, glasses or contact lenses, external hearing aids, and certain types of therapy, including physical therapy, speech therapy, and occupational therapy might be covered. There’s a long list of other potential covered items, including MRIs, CAT scans, radiology, surgery, home health care, skilled nursing care, mental health services, orthotics, and reasonable travel, meal and lodging expenses related to medical treatment that requires travel greater than 50 miles from your residence. However, do not assume that just because a charge is in the above-referenced list, or more specifically in the list in the actual plan document, that you will receive compensation. You should always communicate with Walmart’s plan administrator to determine whether you receive coverage.
Once again, as with other damages, just because Walmart or another employer does not provide compensation in its plan document does not mean that such compensation cannot be gained through a lawsuit or arbitration proceeding. The law provides that an injured employee, if he or she is employed by an employer that does not provide worker’s compensation coverage in Texas, can receive certain categories of damages if he or she can prove that the company is liable. If a Texas employer fails to provide worker’s compensation coverage, that employer waives certain defenses to any arbitration or lawsuit. You should contact a Texas work injury lawyer to determine your rights, and to find out whether arbitration or litigation would be appropriate for your claims.
Dean Malone
Dean Malone