Workers Comp Help
Back Injury While Working For Sam's Club
In 1996 I was injured on the job at a Sam's Club. A member of the management team was present when I was injured. It is definitely a policy of Sam's to "discourage" the filing of any worker's compensation claim. You are held up to ridicule and the possible termination of your job.
Wal-Mart uses many different discouragements. An acquaintance of mine filed for carpal tunnel syndrome. As soon as she filed the claim, she was ordered to undergo a drug test because of the "accident" and Wal-Mart's policy to drug test anyone involved in an accident. The results went to Bentonville. She was notified by phone that she had failed the test, denied a copy of the test and they refused her request for a retest. Then her job was terminated immediately.
Another acquaintance was promised a different position if she would let the club handle her injury outside of the state workers compensation domain and never mention or list her limitations again. She currently remains in their employment but endures constant harassment. She will not testify because she is too close to retirement.
Wal-Mart is basically self insured in the workers compensation area except in a few states. When you file a claim, you are referred to CMI, Inc. In actuality, it is a division of Wal-Mart who's employees are paid by Wal-Mart. Which is okay in self-insured companies. In the case of states where a company must carry outside insurance, the insurance company must handle the claims. In Wal-Mart's case, the insurance company hires CMI, Inc. as a third party administrator to handle the claims. What it boils down to is that Wal-Mart has complete and total control of all claims.
In my particular case, the claim was closed by the company without the doctor releasing me or treating me. Sam's manager said I was okay and that the case was closed. Not only do they tell you what doctor you will see, what quality of treatment as well as what and how much treatment you will receive. The doctors they chose do not manage their own case, Wal-Mart does.
During the two years provided for adjustment of the claim, Wal-Mart allowed charges associated with that injury to go through the group health coverage (again self-insured). They also changed the diagnosis to reflect a different cause for the charges to leave no paper trail as to a request for treatment during that same two year period. When I inquired about the original claim, they denied that a claim existed. Yet three years later in 1996, when I injured my back with the team leader present they claimed that it was an extension of the original claim and that the time period for filing an adjustment had expired.
I contacted A.I.G., the insurance carrier of record and they had absolutely no knowledge of my first or second injury. CMI retains any and all "alleged" paperwork within their own little kingdom. The paperwork did not turn up for the 1993 injury until 1997 when I bypassed CMI in an effort to obtain my legal rights
When I attempted to get medical treatment for herniated disks in my back, I was denied coverage through workers compensation and through group health. It took 1 1/2 years to find a surgeon who would operate to alleviate the excruciating pain without a guarantee of payment. The treatment of the injury is to date not completed. I am over $25,000.00 in debt and still unable to return to work and have now been terminated from my job. Needless to say they have not paid a penny in temporary total disability nor made any offer of compensation.
I have interviewed approximately 25 attorneys attempting to get legal representation during the appeals process. Wal-Mart is so bold and brazen as to brag about the inability of potential lawsuit victims to obtain legal representation due to their tactics and resources. A 1996 Arkansas business journal printed an article with those particular remarks.
During the appeals process, I have been denied vacation pay that I had accumulated, denied prescription medication because my insurance wasn't paid thirty days in advance. I am followed if I shop in the store. After the first hearing that was continued, I entered the store to be followed by 5 members of management during my shopping trip. Derogatory remarks were made if I picked up anything. The employees were called into a store meeting while I was there. This treatment continues to this day.
My medical claims have been labeled as denied pending investigation for fraud. Wal-Mart has now hired an attorney out of state who is requesting independent medical exams out of state. They did schedule one in-state but have not paid any expenses which were due in advance and it is now 6 months past that exam.
Last year while I was still employed, I was sent to the hospital on an emergency basis for chest pain. When I was admitted, the hospital called Blue Cross/Blue Shield pre-certification and was given that. When the information crossed Wal-Mart's computers, my insurance was retroactively cancelled, the claim denied and my job terminated. The insurance was cancelled for late payments. Since that time and after much pressure on my part, I have received a refund of over $400 for overpayment of insurance.
When I appealed the decision, I was told that they were not going to do anything and that I would have to file suit. In the meantime, the hospital is suing me for the $3000+ in bills. The termination was on the grounds that I had not returned to work in a year's time. I appealed on the grounds that I the workers compensation claim was in the appeals process and that no medical treatment had been allowed I was again told that there was nothing they could do. The date of my termination was "mis-entered" in order to forestall the payment of my profit sharing by a full three months. When I received the distribution, approximately $4000 had been retained because I had not completed my seven year vestment requirement before I was injured.
The story goes on and on. The last time I saw the back surgeon who so very graciously and kindly did surgery to alleviate my immediate excruciating and debilitating pain (and has not received a penny to date) my abdominal cavity was filled with blood which was being allowed to dissipate without additional surgery. An MRI indicated that there was also an additional small herniation. My physical therapy was interrupted because the bill was so high and there was no way for me to make payment while appealing Wal-Mart's decisions. I do not feel that treatment has been completed and that deterioration of my spine continues at an accelerated rate due to the lack of medical supervision.
The Hartford has now decided to discontinue the long-term disability that I pay for because they feel I can work at some sort of job in spite of the fact that no doctor has released me yet. When I called their home office about the stoppage of those payments I was informed that Wal-Mart "pretty-well controls who gets disability".
Wal-Mart's attorneys received another continuance until June 2001 before we are rescheduled for another workers compensation hearing. The prospects of retaining a quality attorney for the allowed fees are extremely dark. My cause seems pretty hopeless but I will not quit now. I will attempt to represent myself when the time does come.
One other time, I went on the internet to obtain some information about CMI and Wal-Mart contacted my then attorney about that move. I am not sure what to say about possible repercussion from anything I do but at this point it really doesn't matter. The only thing I can say for sure is that my theme song is that old Tennessee Ernie Ford song, I Owe My Soul To the Company Store.