Fraudulent claims are also a problem, as everyone in the workers' comp world acknowledges. Just as companies have a major incentive to deny claims, injured workers—who may be at home, in pain, collecting a paycheck, and nursing a grievance against their employer—can have a strong incentive to maximize symptoms or fake them outright. In one recent case, a Wal-Mart employee claimed to have hurt himself by falling into a grease pit. L&I ordered Wal-Mart to pay the claim, but Wal-Mart accused the man of inventing the accident and got the case dismissed.
Wal-Mart's efforts to resist questionable claims, however, may have been carried out with excessive zeal. Gary Moore of L&I charges that Wal-Mart has "unreasonably" forced its employees into legal proceedings to get what's owed them.
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Take the case of Cheryl Spruill. She was working as a stocker in the lawn and garden section of the Auburn store in spring of '98 when a heavy piece of gardening equipment that she and her manager were carrying fell on Spruill's chest. She was out of work for three months.
Wal-Mart accommodated her with a lighter-duty job in the beauty aids department, but, after a few weeks, Spruill chose to go to work as a waitress instead. While working at her new job, Spruill's pain got worse and she was eventually terminated because she could not perform the work, according to Spruill. At that point she applied for time-loss from Wal-Mart on the grounds that she was still suffering the effects of her initial injury.
Wal-Mart refused, arguing that Spruill's current symptoms were due to other causes, not the back strain she'd suffered in '98, and that she was capable of finding other work besides waitressing. Spruill's symptoms were highly variable and no clear physical cause or damage was ever identified.
L&I ruled in favor of Spruill. Then Wal-Mart appealed to the Board of Industrial Insurance Appeals, setting off months of costly litigation. The amount in dispute was only $1,598, but Wal-Mart hired an investigator to videotape Spruill and took extensive depositions. "They had to have paid their lawyer many times over what they would have had to pay [Spruill]," says paralegal Laurel Anderson of the Causey Law Firm in Seattle, which took Spruill's case. "No one litigates two months of time loss."
In January, the appeals board ruled in L&I's favor, and Wal-Mart paid up the $1,598. Spruill is now holding down an office job. Her attorneys plan to seek additional money for her, but only after the state takes over Wal-Mart's claims.
FOR THE MOMENT, the takeover is on hold. Earlier last month, Wal-Mart won a court-ordered stay, and Bill Wertz of Wal-Mart says his company is "now involved in negotiations with the state to see if we can work this out" before a trial. Wal-Mart will likely fight the case with full vigor.
In Washington, Wal-Mart paid about $1.5 million in workers' comp claims last year and has 300 claims presently open. But if L&I takes over, the agency says it will charge Wal-Mart about $1 million in premiums every quarter. Even more dismaying to Wal-Mart than the cost, perhaps, is the prospect of this quintessentially all-American company, whose very logo evokes the American flag, having a large part of its operation put under direct government control.
Other self-insured employers have been subject to complaints. But Dave Kaplan, acting executive director of the Washington Self-Insurers Association, says he suspects part of the problem for Wal-Mart is that it manages its workers' comp program out of Arkansas, rather than contracting with a local firm that is familiar with Washington laws. "It's unusual for a self-insured employer to be handling its claims a far distance away," he says.
Kaplan also wonders, "How much is a lack of knowledge and how much is corporate culture?" It's not hard to see how a discount store empire founded on supercheap prices and notoriously tough deal-making might apply those same hardball tactics to its own injured associates. The Wal-Mart way looks great for those of us buying cheap shampoo, but perhaps not so great for those who slip on it.
mfefer@seattleweekly.com
