Walmart Texas Associate and Employee Work Injury and Accident Plan Benefits
The Walmart Inc. Texas Injury Care Benefit Plan provides a number of benefits to injured Walmart associates and workers. While the benefits may change over time, it is our Texas law firm’s understanding as of the date of this post, that the maximum amount for all benefits combined payable for an injury is $500,000 per employee, and up to $1 million per occurrence. There are some wage replacement benefits available, as well as a death benefit.
Even though the wage replacement benefits are available, the plan apparently does not pay for loss of earning capacity. Loss of earning capacity damages are available pursuant to Texas law if a person is injured while at work. Proving up such damages can take testimony from a vocational rehabilitation expert and/or economist. This testimony occurs with regard to any Walmart work injury claim in an arbitration proceeding. Arbitration is necessary because Walmart’s Injury Benefit Plan does not allow an employee to file a lawsuit for any claims arising from a work injury. A Texas work injury attorney will understand how to file such an arbitration case.
The Walmart Texas Associate Injury Benefit Plan provides information about reporting your Walmart work injury. It says that you should report your injury immediately, to your supervisor then on duty, and/or within three calendar days following the date of the occurrence. The plan indicates that you should not wait, as your injury may get worse over time.
It also indicates that you should complete an incident report within 24 hours after you report the injury. The incident report will provide details of the incident that resulted in your injury.
It is our experience from working with clients on employment injury claims in Texas, that the incident report can be a very important document in an arbitration or lawsuit regarding the injury. Many times, supervisors of our clients will indicate that our clients did nothing wrong and which led to the injury. We have found that some companies will later try to allege that it was our client’s fault that he or she was injured. Thus, you should complete any incident report truthfully and accurately, and dispute any assertions made by coworkers and/or a supervisor which are inaccurate. If you try to do that later, it will look as if you are not being truthful.
The Walmart Associate Injury Plan also indicates that you should use a Walmart-approved medical provider for treatment. It reads that, in order to receive injury benefits, the healthcare providers must have been approved by the plan’s claim administrator. It also indicates that you must receive your first medical treatment from an approved medical provider within 14 days after the injury is reported.
We have found in working Texas non-subscriber work injury claims that many healthcare providers that are approved by various companies have little incentive to truthfully report the full extent of a person’s injury. We find that, far too often, these “approved” healthcare providers are incentivized, through receiving plenty of work from a given employer, to indicate that an employee can simply return to work with minor medical treatment. This is therefore very important that you be truthful with all healthcare providers regarding your injuries. Also, if you believe that you’re not being treated fairly by any company’s approved healthcare provider, and you have health insurance available, you might consider using your health insurance to see a different provider regarding your work injury.
The Walmart Employee Injury Plan also provides that you must follow all approved physician’s instructions and keep all scheduled appointments. You must also keep Walmart informed about your return-to-work status, including any changes in your work restrictions.
We have found in handling cases related to employee injuries in Texas that some adjusters for some companies will terminate benefits if our client fails to strictly comply with the requirement to follow physician’s instructions and keep all scheduled appointments. It is therefore very important that you notify healthcare providers if you have a conflict regarding an appointment. It is also important that you keep notes regarding any missed appointments and/or changed appointments. This could be important later if you choose to hire a work injury attorney and arbitrate or litigate any claims regarding your injuries.
Companies like Walmart have plans as we have described in this blog post to save money. They have chosen not to obtain workers’ compensation coverage. As a result, under Texas law, they have waived some defenses to work injury claims. If you need assistance with a work injury claim, you should contact a good work injury attorney in Texas.
Dean Malone
Dean Malone