Walmart Work Injury Compensation Plan in Texas
The Texas Walmart work injury plan, for the benefit of Walmart employees and associates, contains a list of non-covered injury circumstances. If you have been injured while working for Walmart, or an associated company in Texas, you will want to review this list. The list includes things such as an injury occurring while in a state of intoxication; an injury occurring under circumstances where your employment did not place you at a greater risk of injury than you would’ve been exposed as a general member of the public; an injury caused by your willful intention or attempt to injure yourself; horseplay; fighting; and or you being untruthful or demonstrating bad faith in connection with administration of the plan. The list contains other examples, and you should review these, if necessary, with any work accident attorney that you retain.
Walmart’s Texas work benefits injury plan contains a section on requesting benefits. In addition to providing proper notice of your work accident, you or your representative must complete an incident report form, a medical authorization within 24 hours after you report the injury. You must submit these forms to your supervisor or any other person that the claims administrator specifies. You also are required to provide written or oral recorded statements, and provide proof and demonstration as the claims administrator requires. Walmart indicates that it will not pay benefits under the plan if notice of your injury and required information is not provided.
Regardless of whether you comply with the plan or not, Texas law allows injured workers who work for employers who do not have workers compensation coverage to file suit or, any alternative, if an agreement requires it. Arbitration under a work injury plan like that of Walmart is similar to a lawsuit. The difference is that an arbitrator is typically an ex-judge, in any court trial, “occurs as a court hearing” in a conference room at the end of the case. Regardless, most cases settle and do not require a trial or arbitration hearing. Our Texas work accident law firm has handled cases through trial and final arbitration hearing and, our lawyers are very familiar with procedures required to litigate or arbitrate work injury claims.
Walmart’s plan document for employment accidents of associates in Texas also contains a medical benefits section subject to medical management and other provisions of the plan, the plan will pay for supplies and medical services which are approved by the claims administrator with no co-pays or deductibles. However, as we have previously written, Walmart can require an employee to obtain treatment from Walmart-approved physicians. An employee must see those physicians to qualify for plan benefits regardless, even if an employee does not obtain plan benefits, he or she may have claims under Texas law for the Walmart work injury.
The Walmart injury plan document also contains a section regarding first in continuing treatment. The first covered charge for an injured employee must be received from an approved medical provider and incurred within 14 calendar days after you report your accident or injury, unless the claims’ administrator determines that good cause exists. For example, while this is not in the plan document, if you are so severely injured that you are in a coma and or could not appropriately communicate, such could constitute “good cause.” You should report all injuries quickly, and comply with the plan document.
Dean Malone
Dean Malone