Roughly 7,000 workers have filed a class action lawsuit in federal court against Wal-Mart, alleging that the organization and its partners acted in bad faith and did not provide adequate health care to Colorado workers injured on the job. The suit also names Wal-Mart’s claims adjusters, Claims Management, Inc. (CMI), their insurers, American Home Assurance Co. (AHA), and its treating physicians, Concentra Health Services, as additional defendants.
The named plaintiffs in the case, Josephine Gianzero and Jennifer Jensen, filed suit in 2009 after being injured on the job. Both employees were working at Colorado Springs area stores. Gianzero was injured after falling, and Jensen was hurt when she was hit by a wooden pallet. Both employees went to doctors employed by Concentra for treatment of their injuries.
Employees in the class allege that Concentra entered into contracts and conspired with Wal-Mart, CMI and AHA to limit available treatments. Concentra created “flowsheets” which proscribed treatments that its doctors must follow when examining injured Wal-Mart workers. It is also alleged that when Concentra doctors asked CMI for permission to send the plaintiffs to specialists, CMI would consistently deny the requests as not being medically necessary.
Under Colorado workers’ compensation rules, employers or insurance companies are not allowed to dictate the type of treatment an injured worker will receive. Treatment must be provided if it is reasonably necessary. There are harsh penalties in place for willful and knowing violations of the Colorado Workers’ Compensation Act. Employers may face high fines, and insurance companies could face license revocation.
While the state has not given any indication of possible penalties it may impose, the class has asked for compensation because of these alleged violations. The workers are requesting damages, stating that Wal-Mart acted in bad faith when processing these claims. Additionally, they are asking the court for an injunction to prevent Wal-Mart from engaging in tactics that restrict the amount of care that those injured on the job receive.
Wal-Mart has denied the allegations. In its response, Wal-Mart indicated that it changed workers’ compensation policies in 2008 and this matter should no longer be an issue. They filed a motion to dismiss the case which was denied, and the matter is currently going through the litigation process.