Walmart, like most employers in Pennsylvania, must have Workers’ Comp coverage in case its workers sustain an injury in the course of their jobs. This means that you should be able to file a claim with their Workers’ Comp if you were hurt at work. However, claims are not always so easy.
To start your claim, you give notice of your injury to Walmart, which handles claims through a third-party administrator (TPA) instead of using an insurance company. They will likely deny your claim, at which point you can file a Claim Petition through the Workers’ Comp Office of Adjudication (WCOA) to have your case heard by a Workers’ Comp Judge (WCJ). Work with a lawyer; you never have to do this on your own.
Call Cardamone Law today for help from our Certified Pennsylvania Workers’ Compensation Lawyers. Dial (267) 651-7945.
How Do You File a Workers’ Comp Claim with Walmart?
Typically, when you get injured at work, you give your employer notice of the injury, and they file a claim with their Workers’ Comp insurance carrier. Walmart is such a big company that it insures itself instead of using an outside insurance company, handling claims through a third-party administrator.
Essentially, this TPA accepts, investigates, and rejects or pays claims using Walmart’s funds. That means they are quite likely to deny your initial claim, and you will have to file in another way to get your benefits granted.
Filing a Claim Petition
To get your claim before a WCJ, you take the following steps:
Seek Medical Care
Before doing anything else, get medical care for your injuries. This will create medical records detailing when and how the accident happened and what injuries you suffered.
You also want to get care quickly to avoid making things worse or missing out on a chance to heal.
Give Your Employer Notice
You still have to go through the initial steps of notifying Walmart and its third-party administrator of your injury so they can investigate and deny the claim first.
Notice must be given within 120 days – though 21 days is expected – or else your claim can never proceed to a Claim Petition.
File a Claim Petition
Your Claim Petition is a document explaining your injuries, their cause, and the effects (lost wages, amputations, etc.). This must be filled out properly, and you should always work with a Workers’ Comp Attorney to file the Petition.
Claim Petitions must be filed within 3 years of the initial injury.
Medical Exams
From there, you will undergo exams the employer requires, such as an independent medical exam (IME) to confirm your condition. This exam is far from independent, as your employer chooses the doctor and wants information it can use to deny your claim.
We may also need to get you checked out by doctors that we can choose to counter their doctor’s reports and show your injury is serious and work-related.
Ongoing Care
You need to continue getting care and getting better. During the first 90 days of care, you may need to use doctors your employer chooses, depending on whether covered specialists are on the list and other factors.
Other Evidence Collection
We may also take depositions and collect other evidence to build your case. We then submit this to the court and take the case to a hearing.
Workers’ Comp Hearings
The case is ultimately decided after a hearing, during which the WCJ accepts evidence and testimony, asks questions, and learns the facts of the case. The WCJ then decides your claim; no jury is involved.
Payment or Settlement
If the WCJ rules in your favor, they can order Walmart to pay your benefits on an ongoing basis. However, you can potentially settle your claim and have the benefits paid in a lump sum or through a structured settlement instead.
FAQs for Filing a Workers’ Comp Claim Against Walmart
Does Walmart Have Workers’ Compensation Insurance?
Most employers are not big enough and rich enough to pay Workers’ Comp benefits out of pocket, so they work with insurance carriers to handle payment for them. Walmart is big enough, so instead of using insurance, they pay claims themselves.
However, this means there’s no insurance company to handle the claims, and they use a third-party administrator to handle the claims for them.
Are Benefits Different for Walmart Workers?
The fact that Walmart uses a TPA instead of Workers’ Comp insurance doesn’t change what is covered. Workers’ Comp should still pay benefits for
- All medical care costs
- Around 2/3 of your lost wages or 2/3 of the difference in pre- and post- injury wages if you still work to some extent (all subject to caps and floors)
- Additional benefits for permanent lost function, amputation, facial scarring, lost hearing, or lost vision.
What Evidence Do I Need for My Work Comp Claim Against Walmart?
To win a Workers’ Comp claim, you need to show that the injury was work-related; to get wage-loss benefits, you have to show the injury disabled you for at least 7 days. This means providing evidence: medical records, doctors’ reports, testimony, etc. Our Philadelphia Workers’ Comp lawyers can help you find and collect all of this.
When Should I File a Work Comp Claim?
Workers’ Comp claims can be made any time you suffered a work-related injury and needed medical treatment. If you missed at least 7 days of work, you can also get wage-loss benefits.
You must notify Walmart of your injury within 21 days (but you technically have up to 120 days). Claim Petitions need to be filed after a denial, within 3 years of the injury date.
Does Walmart’s Workers’ Comp Cover Truckers and Delivery Drivers?
Walmart’s operations include more than just warehouse and store workers, with delivery drivers and truckers often being staff members, too. If you are a direct Walmart employee, you should be covered; if you work as a “gig worker” or independent contractor, you might not be covered.
Check with a lawyer about the specific facts of your case and your work to determine your eligibility; do not trust that Walmart’s opinion on the matter is correct.
Call Our Workers’ Comp Lawyers in Pennsylvania Today
If you were hurt working for Walmart in Pennsylvania, call our Allentown, PA Workers’ Comp lawyers at Cardamone Law today at (267) 651-7945.
