Walmart Associate Work Accident Claim in Texas
Walmart employees and associates in Texas, if injured in a workplace accident, may be able to receive certain benefits under Walmart Inc.’s Texas Injury Care Benefit Plan. That plan also provides an arbitration agreement, which requires arbitration of any claims related to a work injury if an injured Walmart associate chooses not to merely accept benefits under the plan. In other words, the arbitration agreement keeps a Texas Walmart employee from filing a lawsuit to recover compensation for a workplace injury.
Walmart’s plan contains a section regarding the content and manner of an adverse benefit determination. If Walmart’s work injury plan claim administrator determines that benefits are not available, there are certain requirements as to how the employee will be notified and what is to occur. The notification to the employee must be written in a manner which is calculated to be understood by the employee, and it has to include reasons for the adverse benefit determination, references to the specific plan provision, a description of additional materials or information necessary for the injured employee to perfect his or her claim, as well as other things.
Walmart’s Texas work injury plan for employees and associates also contains a section regarding additional requirements for medical benefit claims. If an adverse benefit determination is in response to a claim for medical benefits, the notice to the injured Walmart employee has to include additional information. If the adverse benefit determination is in response to a claim for any wage replacement benefits pursuant to the Walmart work injury plan, that notice also has to contain additional information.
A Walmart associate in Texas who is injured, and who suffers an initial adverse benefit determination under Walmart’s work injury plan, can appeal that determination to an appeals committee within 180 days following his or her receipt from the Walmart claims administrator of the adverse benefit determination. There are a number of things that you must do if you’re a Texas Walmart injured employee, related to filing such an appeal. You should reference the plan document if you choose to do so.
All the description in this post about Walmart’s work injury plan is aside from an injured Walmart worker’s ability to file an arbitration proceeding in Texas and to potentially obtain damages resulting from the work injury. Those damages can include things which are potentially not included as benefits in the plan document, such as pain and suffering, mental anguish, physical impairment, and loss of earning capacity. A Texas workplace accident attorney who is accustomed to arbitrating cases should be able to competently arbitrate any claim related to a Walmart work injury. Our law firm has been successful in lawsuits and arbitration against various Texas employers and obtaining compensation for our clients as a result of work injuries.
Dean Malone
Dean Malone