The Morris Law Firm Blog

March 8, 2012

WALMART GOES NON-SUBSCRIBER IN TEXAS

Filed under: Personal Injury, Workers' Compensation — Tags: , , , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 7:14 pm

There is an old saying “Don’t piss on me and tell me it’s raining.”  This was my first thought when I read Walmart’s explanation of why they are becoming a non-subscriber in the State of Texas.  They claim “we want to be certain Walmart Associates have access to quality physicians and receive prompt, fair, and excellent care.”  (Page 5 of Texas Injury Care Plan).  Walmart does this by limiting in almost every aspect the ability their Associates handle they work injury claims.

Under their new plan, Walmart has changed the benefits to their Associates when injured in the Course and Scope of their employment.  There are many differences from the Texas Workers’ Compensation system.  Injured Associates should familiarize themselves with the requirements of the Texas Injury Plan.

Indemnity Benefits

The Plan limits salary replacement benefits to 120 weeks.  While, the Texas Workers’ Compensation system allows for up to 104 weeks of Temporary Income Benefits, three weeks of benefits for each point of impairment rating and supplemental income benefits for workers who receive over a 15% impairment rating, resulting in benefits for up to 401 weeks.  So, Walmart’s new plan provides less than 1/3 of potential weeks of indemnity benefits.

Medical Treatment

Walmart will also cap medical treatment at 120 weeks.  Under the Texas Workers’ Compensation system, workers’ have lifetime medical treatment to treat the effects of the compensable injury. Under the Plan, if an Associate disagrees with the Walmart doctor, the injured Associate may have a onetime evaluation with another doctor (paid for by the Associate), Walmart will review this record when they make treatment decisions.

Conclusion

Walmart has created a completely different system with very few of the benefits going to their injured Associates.  However, by going non-subscriber, Walmart has lost their statutory protection from being sued for claims of negligence. So, if an Associate is injured as the result of an act of Negligence, they potentially have a claim for damages against Walmart.

The Morris Law Firm (214)3571782 email info@themorrisfirm.net

March 2, 2012

RECORDED STATEMENTS IN TEXAS WORKERS COMPENSATION CLAIMS

Filed under: Workers' Compensation — Tags: , , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 9:46 pm

A colleague of mine recently asked if injured workers in Texas Workers Compensation claims are required to provide a recorded statement to the insurance company.  This is an interesting question.

When they get a notice of a claim, many insurance companies perform what they call a three prong investigation.  The investigator contacts and gets a statement from the injured worker, the medical provider and the employer.  In most cases they take a recorded statement from the injured worker.  If the injured worker is not available it may be weeks after the accident.

Although we generally allow recorded statements of our clients, it is not mandatory that you do so.  The recorded statement is to help the investigator gather facts to make a determination of your claim.  Your statement could affect the compensability of your claim, the accepted conditions or if you have disability.  If they have told you that your claim is already being denied, all you are doing is providing them an opportunity to collect evidence against you.

If you allow the investigator to take a recorded statement there are a few keys that you should follow:

a)      Make sure you are alert and clear headed at the time of the statement (shortly after accidents, many are affected by medications);

b)      Give a clear statement as to how you were injured and ALL the body parts

c)      Anything you don’t know or remember, answer that you don’t know or remember;

d)     Ask them to explain any question you don’t understand;

e)      Answer all questions truthfully, especially in regards to your history of injuries and treatment; and

f)       Stay polite, you do not help your cause by arguing with the investigator.

Always remember that a Texas Workers’ Compensation claim is a legal matter.  Anything information you provide can be used by the insurance company.  When making a legal determination, always have advice from a competent professional.

The Morris Law Firm, (214)357-1782 info@themorrisfirm.net

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