Workers’ compensation cases can be tough, but when the injured employee is going up against one of the corporate giants, such as Wal-Mart, things can get that much tougher. What does an injured Wal-Mart employee need to know before filing a workers’ compensation claim against his or her employer?
We have asked attorney, Alaina Sullivan, and here is what she had to say:
Filing a Workers’ Compensation Claim Generally
After the Wal-Mart employee has been injured, the first step is to get immediate medical care for the injury. It depends on the state where the injury occurred in most cases, but emergency treatment is allowed, and many times the employee can also choose the provider for initial treatment.
The employee also needs to inform the employer of the illness or injury as soon as possible, which normally means within 30 days of the incident. The employer should have forms for the employee to complete, and once these forms are completed and returned to the employer, the company will send them to the insurance company.
Depending on the state, the injured employee must also file a separate claim with the state’s workers’ compensation agency.
The insurance company then conducts an investigation before making an official decision. If the claim is approved, the injured employee begins receiving benefits immediately. If it is denied, the employee then has a right to appeal the denial.
This process can be quite lengthy and it is always recommended that a workers’ compensation attorney be consulted before proceeding.
Handling Claims with Wal-Mart
In the past, Wal-Mart has been known to deny workers’ compensation benefits. In the 2010 case of Wal-Mart Stores Inc. v. Donald Greg Wells, the Kentucky Court of appeals denied the corporation’s attempt to argue that a worker’s civil award from two third parties associated with the incident barred the employee from receiving workers’ compensation benefits from Wal-Mart.
Similarly, in the 2012 case of Gianzero et al v. Wal-Mart Stores, Inc., a U.S. District Court pressed hard on the store who was being accused of not making it possible for medical providers to make independent assessments on what the best care would be for injured Wal-Mart workers.
The problem is Wal-Mart disputes claims much like an insurance company. They have the financial resources and manpower to do so. This power can often intimidate workers from pursuing a claim past the initial denial.
Wal-Mart created a subsidiary called Claims Management, Inc., which acts as the company’s third-party insurance adjuster. This subsidiary handles all claims against the company, including those made by injured Wal-Mart workers, requesting workers’ compensation benefits.
They have their own department that handles the legal claims, as well, including any appeals of denials for workers’ compensation.
Consult a Workers’ Compensation Attorney
It is always recommended that a workers’ compensation attorney be contacted after the initial denial is received from any company. However, it is recommended even more so when that company is a larger and well-financed company like Wal-Mart.
They will have their own attorneys handle the matter should the claim be appealed to the administrative law level and higher if he goes to the circuit court system. They are counting on the fact that an individual employee has no knowledge of the legal system, let alone workers’ compensation law.
In addition, these hearings require a general knowledge of rules of evidence when presenting the case before the administrative law judge. A workers’ compensation attorney will be able to help present the case properly.
Just because the employee is going up against a large corporation does not mean he or she cannot be successful. If the facts are there, the case can be made for the claim to be approved.
However, getting those facts before the judge can be tough, including getting medical records proving that the injury occurred and that it is preventing the employee from performing his or her job duties.
Medical experts may also need to be deposed if the injury is particularly tough to prove and if the company is disputing that the injury is from the job and not something independent of the employee’s work duties.
Contact an Attorney Today
If you are in the process of pursuing workers’ compensation and are a Wal-Mart employee, a workers’ compensation attorney can help review your case and discuss your options.
An attorney can listen to the facts of the case and can best advise you on how to proceed. Contact an attorney experienced in workers’ compensation law to schedule a consultation today.
*The content of this article serves only to provide information and should not be construed as legal advice. If you file a claim against Walmart, or any other company, you may not be entitled to any compensation.