Walmart Associate Work Accident Injury in Texas
Walmart employees injured in Texas, while at work, should review the plan document for Walmart’s partial compensation for some such injuries. There are numerous provisions and definitions. It may help for a Walmart employee injured in Texas to retain a work accident attorney.
One of the provisions in Texas Walmart work injury plan documents allows the plan to require an injured Walmart worker to be subjected to a medical records review, or what Walmart refers to as an “independent” medical evaluation from a physician selected by a claims administrator for that purpose. The physician must be one approved by Walmart. The Walmart claims administrator weighs the findings of the approved physician, and an approved physician, if any, providing a second opinion, to make a benefit determination under the plan. Plan benefits provide for some compensation legally allowed as a result of a Texas work injury. However, it is our understanding that Walmart’s work injury plan does not provide compensation for some categories of damages available under the law, such as those for mental anguish, physical pain and suffering, physical impairment, and loss of earning capacity.
If you were injured as an associate while working for Walmart in Texas and disagree with a diagnosis or treatment recommended by an approved physician whose opinions is accepted by Walmart’s claim manager, you can request a second medical opinion. You have the right to a one-time examination by such opinion – at your own expense. The examination by that physician will be solely for the purpose of evaluating your condition after being injured at work and making a recommendation for your treatment. If the diagnosis of the physician providing a second opinion is contrary to Walmart’s approved physician, then Walmart’s claim administrator can designate a peer review physician to evaluate all the medical records and advise Walmart’s claim administrator. The claims administrator can then designate another Walmart-approved physician for further medical examination. Importantly, if you refuse to be examined, all benefits under Walmart’s plan can be suspended.
Any benefits you receive under Walmart’s Texas work injury plan expire on the earlier of 156 weeks after the date of injury, you reaching the maximum benefit limit, your termination of employment by Walmart for gross misconduct, the date that you do not receive treatment from a Walmart-approved physician for more than 60 calendar days (unless a claims administrator determines a good cause exists), the date you reach maximum rehabilitative capacity, or the date you failed to comply with requirements under the continuing benefits section of the plan document booklet provided to you by Walmart. You should contact a work injury attorney if you want to potentially obtain damages beyond the plan document.
Dean Malone
Dean Malone