Category: WM WC Claim 2025

A BIG RELIEF

On By mikeykjrIn WM WC Claim 2025, Worker's compensationLeave a comment

As expected, lawyers I inquired with contacted me. I contacted one who ended up referring me to another. Gave all information regarding claim and we are moving forward.

I know it’s not permanent. Just signed docs so they can review all paperwork involved. Still..at least I have someone willing to look into the case.

Won’t mention who, nor will I mention further information about my w/c case here. I might give general feelings of what is going on but not specifics. Honestly, I think I have done enough without consulting one, so I don’t want to muddle what they do in case the other side finds this site.

But knowing that someone is at least looking at my case is a HUGE relief.

I honestly think I may be able to get a full nights rest now knowing I MIGHT have someone in my corner to help me through this crap.

It’s Going to Get Ugly Around Here

On By mikeykjrIn WM WC Claim 2025, Worker's compensationLeave a comment

It is known navigating through the worker’s compensation process is a nightmare. I’ve been on a leave of absence (LOA) for over a month and not getting any compensation, yet. Unfortunately, it’s time to take matters to another level as I am getting no where with anyone.

I was warned and know, through experiences of others, this whole process can be be a challenge. Some cases are resolved almost immediately because the “evidence” and supporting documentation are apparent. Others, like mine, take time to resolve, because details are vague the supporting documentation may not support the evidence.

As I have documented here, I have three four entities working on my case. First, my employer is Walmart. Second, the Worker’s Compensation board has assigned a case number and is “monitoring activities”. Third is a third party insurance company working with Walmart. Lastly, there is Walmart Corporate Claims Services in which I have a worker’s compensation worker assigned to me. Lastly, there is another company Sedgwick, who also handles FMLA where an employee reports absences or Leave of Absences.

Over the last couple of weeks, I get one notice after another from Walmart Claims services either “Refusal” or “Objection” to such claims. In the case of Sedgwick, I get a refusal to approve my LOA because of lack of medical documentation. I have enough stress in my life being out of work for almost a month or more now with a tentative return to work on September 5, 2025. Even my request for worker’s compensation for lost wages over this times has been denied, “Your workers compensation was accepted for an acute knee injury only. It appears that your current issues are due to the lower back, and seem to be of a degenerative nature. In regards to the workers compensation claim, there will be no compensation for lost time.” Unfortunately, I have to take this to another level – an inquiry with a lawyer.

My medical appointments are so spread out over time, I’m just sitting and waiting. I have another appointment August 26, to start physical therapy. I don’t see my worker’s compensation provider through my medical provider until September 5, for a re-evaluation. Meanwhile, I’m living on wages saved which is dwindling down to almost nothing but the end of the month.

Last week, I put in requests through various worker’s compensation lawyers for a consultation. No one yet has gotten back to me. Again, I know they have to sift through various requests themselves, review the initial request, then get back to me. Again, this all takes time. I can only hope one comes through to inquire further about my case.

Lastly, the only income I have is my 401K. One loan was taken out last month. I just requested a second general purpose loan today to cover my rent and utility expenses for next month. I attempted a full withdraw but that was denied. I know the consequences of such requests but it’s the only source of any income I have right now.

I can only hope things start to come together shortly rather than later. While I have no control over the processes involved, I do what I can when I can. Mentally, I’m depleted. Physically, I have been hurting a lot lately but continue to attempt walks and do exercises as needed. Spiritually, I ask assistance on a daily basis to get me through the day.

That is all for now.
MK

Shot by an Arrow – Not Giving Up

On By mikeykjrIn WM WC Claim 2025Leave a comment

I was in a good mood this morning. Felt good for my re-eval with the w/c doctor. Support from people here brought me out of a bought of depression. I was feeling it was going to be a good day I can deal with no matter what happened.

Met with the w/c doctor. Obviously no changes in condition since I wasn’t able to get physical therapy yet. I just received the “approval” Thursday of last week. But I haven’t had a call from SOS (the provider) this week. The conditions where there same – fine walking for about two minutes, then sudden pain up the right leg and then constant pain and muscle tightening up my leg thereafter until I got home to put my leg up. Explained to the w/c doctor it use to take me 10-20 min to get to a local store, now takes me 30-45 minutes due to several stops on the way due to pain. My fear of walking without support because I have already fell on someone’s lawn (thankfully) who assisted me to get up. I always have my phone to call 911 but my point is try to avoid it. Again, conditions were not improved since our last visit.

During her typical physical exam she did things with the leg, then the knee. When she did things with the right hip my whole world changed. It appeared there was the source of pain. However, she was not going to rule out some sort of back injury as noted on my original claim. I showed her some paperwork of a denial of a procedure while we discussed other things. She has no clue what they want or need to reverse their decision so that will have to come at a later time.

Meanwhile, I left the visit with the following outcome. Out of work for another full month. Continue to f/u with P/T and following any recommendations. She was going to follow up with procedure that was denied, following up with fellow providers as to the how to handle the claim. No changes in meds.

During my ride home my landlord’s partner/wife. She explained her displeasure of driving me two times a week to Syracuse for P/T. We discussed seeking another provider closer. When I got home, I called someone right around the corner who said they do accept W/C and scheduled my first P/T visit at the end of August.

Afterward, I followed up the the corporate w/c contact. I had send them an email last week which I received no reply. I sent another regarding compensation for lost wages and this is what I received: “In regards to the workers compensation claim, there will be no compensation for lost time.” Great, so this has now gone sideways.

Well…this is my plan of action:

  1. I will NOT under ANY circumstances give up!
  2. I will continue to do what the doctor recommends which is sent to the W/C Board now that a case is assigned and wait for any decision on the case. The employer may continue to deny the claims but until I receive actual documentation of such I am going forward anyway.
  3. Look and speak to a W/C attorney who may be able to help me navigate the consistent B/S I have to deal with my employer during this process.
  4. In the meantime, file another claim with Sedgwick, as if the above doesn’t apply, to cover my butt for the absences for the next month.
  5. Follow up with Sedgwick on previous claims, as they continue to be in pending status for further information which is already attached to the cases. (Another f*king headache).
  6. Made an appointment with a local P/T that works with w/c with appt on 8/26 in the afternoon.
  7. Sent a request to withdraw the balance of my 401K for medical hardship reasons. It’s the ONLY income I have left and I need to pay my bills!
  8. Lastly, look for work from home employers (either p/t or f/t). This may take a while because there is some shady stuff out there to navigate.

With that said, the saga will continue another day which I’ll keep those interested updated as well documented here for my own records.