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Old 03-25-2008, 06:01 PM   #1
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WalMart Vs Brain Damaged Woman

A company with a heart

JACKSON, Missouri (CNN) -- Debbie Shank breaks down in tears every time she's told that her 18-year-old son, Jeremy, was killed in Iraq.

Even though the 52-year-old mother of three attended her son's funeral -- she continues to ask how he's doing. When her family reminds her that he's dead -- she weeps as if hearing the news for the first time.

Shank suffered severe brain damage after a traffic accident nearly eight years ago that robbed her of much of her short-term memory and left her in a wheelchair and living in a nursing home.

It was the beginning of a series of battles -- both personal and legal -- that loomed for Shank and her family. One of their biggest was with Wal-Mart's health plan.

Eight years ago, Shank was stocking shelves for the retail giant and signed up for Wal-Mart's health and benefits plan.

Two years after the accident, Shank and her husband, Jim, were awarded about $1 million in a lawsuit against the trucking company involved in the crash. After legal fees were paid, $417,000 was placed in a trust to pay for Debbie Shank's long-term care.

Wal-Mart had paid out about $470,000 for Shank's medical expenses, but in 2005, Wal-Mart's health plan sued the Shanks for the same amount.

The Shanks didn't notice in the fine print of Wal-Mart's health plan policy that the company has the right to recoup medical expenses if an employee collects damages in a lawsuit.

The family's attorney, Maurice Graham, said he informed Wal-Mart about the settlement and believed the Shanks would be allowed to keep the money.

"We assumed after three years, they [Wal-Mart] had made a decision to let Debbie Shank use this money for what it was intended to," Graham said.

The Shanks lost their suit to Wal-Mart. Last summer, the couple appealed the ruling -- but also lost it. One week later, their son was killed in Iraq.

"They are quite within their rights. But I just wonder if they need it that bad," Jim Shank said.

In 2007, the retail giant reported net sales in the third quarter of $90 billion.

Legal or not, CNN asked Wal-Mart why the company pursued the money.

Wal-Mart spokesman John Simley, who called Debbie Shank's case "unbelievably sad," replied in a statement: "Wal-Mart's plan is bound by very specific rules. ... We wish it could be more flexible in Mrs. Shank's case since her circumstances are clearly extraordinary, but this is done out of fairness to all associates who contribute to, and benefit from, the plan."

Jim Shank said he believes Wal-Mart should make an exception.

"My idea of a win-win is -- you keep the paperwork that says you won and let us keep the money so I can take care of my wife," he said.

The family's situation is so dire that last year Jim Shank divorced Debbie, so she could receive more money from Medicaid.

Jim Shank, 54, is recovering from prostate cancer, works two jobs and struggles to pay the bills. He's afraid he won't be able to send their youngest son to college and pay for his and Debbie's care.

"Who needs the money more? A disabled lady in a wheelchair with no future, whatsoever, or does Wal-Mart need $90 billion, plus $200,000?" he asked.

The family's attorney agrees.

"The recovery that Debbie Shank made was recovery for future lost earnings, for her pain and suffering," Graham said.

"She'll never be able to work again. Never have a relationship with her husband or children again. The damage she recovered was for much more than just medical expenses."

Graham said he believes Wal-Mart should be entitled to only about $100,000. Right now, about $277,000 remains in the trust -- far short of the $470,000 Wal-Mart wants back.

Refusing to give up the fight, the Shanks appealed to the U.S. Supreme Court. But just last week, the high court said it would not hear the case.

Graham said the Shanks have exhausted all their resources and there's nothing more they can do but go on with their lives.

Jim Shank said he's disappointed with the Supreme Court's decision not to hear the case -- not for the sake of his family -- but for those who might face similar circumstances.

For now, he said the family will figure out a way to get by and "do the best we can for Debbie."

"Luckily, she's oblivious to everything," he said. "We don't tell her
what's going on because it will just upset her."
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Old 03-25-2008, 06:04 PM   #2
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Inevitable result of free market fanaticism.
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Old 03-25-2008, 06:07 PM   #3
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Note to self (again) : Do not work for Walmart.
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Old 03-25-2008, 06:13 PM   #4
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I wonder how unusual that policy (right to recoup medical expenses if an employee collects damages in a lawsuit) really is though.
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Old 03-25-2008, 06:19 PM   #5
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Regardless of policy, at some time there has to be some humanity and decency and individual treatment of human beings. They brag about how they hire handicapped people, and they treat one in such a way. Complete hypocrisy.
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Old 03-25-2008, 06:20 PM   #6
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Most health insurance policies state that the insurer has a right to recover costs if the subscriber receives a settlement. It's not just Walmart.

It sounds cold and callous but most settlements resulting from an injury claim include a portion for previous and future medical bills. If those bill were already paid by your health insurance provider, they are going to want reimbursement.
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Old 03-25-2008, 06:23 PM   #7
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Another prime example of the greed of corporate America. Destroy this nonsense before it's too late for all of us!!!
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Old 03-25-2008, 06:36 PM   #8
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I imagine most people in the US with health insurance through their workplaces have a similar clause in their policies.

Only those of us without any health insurance at all are safe!
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Old 03-25-2008, 06:40 PM   #9
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Quote:
Originally posted by indra
I imagine most people in the US with health insurance through their workplaces have a similar clause in their policies.

Only those of us without any health insurance at all are safe!

You are correct. It works the same way with medical payments through workers compensation or an auto accident. Health insurance is for profit and they want to keep those profits.
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Old 03-25-2008, 06:49 PM   #10
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The attorney missed the lien? Does this extend to all group health insurance or employer funded health insurance plans like Walmart's?

However, Walmart has always gotten bad press on its health care plan. Another PR disaster for the company--which it will survive.
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Old 03-25-2008, 07:11 PM   #11
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Quote:
Originally posted by Bono's American Wife



You are correct. It works the same way with medical payments through workers compensation or an auto accident. Health insurance is for profit and they want to keep those profits.
So, in other words, the attorney didn't get enough out of the trucking company to provide for her future care, or, the judge didn't award enough.

Either way, very, very sad for the woman and her family.
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Old 03-25-2008, 07:19 PM   #12
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$417,000 won't go very far at all if you're talking skilled nursing facility care for someone who's likely to live another 30 years. But I assume the conceit behind the lien is effectively that whatever the settlement amount was, it's enough.
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Old 03-25-2008, 08:06 PM   #13
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The good news is the lawyer got 600k of the 1M settlement. Too bad she didn't have to pay taxes on the 400k. Then she'd have about 200k, and at least walmart's insurance company would have paid out.
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Old 03-25-2008, 08:40 PM   #14
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This isn't unusual. It's called subrogation, I believe. My company's health plan does it, too.

I would imagine Walmart's health plan is an ERISA plan, in which case it's "governed" by the DoL, and that means you have to stick to the rules stated in your health plan. I believe there are some instances where exceptions can be made, but I don't know how much wiggle room there is, even in sad stories like this.

That's the way it is with my company, at least. This may be an oversimplification of how it works, but it's my understanding that if we made exceptions in our health plan and were caught doing so, the whole plan (and therefore everyone covered under it) could be put at risk.
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Old 03-27-2008, 01:21 PM   #15
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Wal-Mart also takes out life insurance on their employees so Wal-Mart can collect money when the employee dies. Creepy!
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Old 03-29-2008, 10:38 AM   #16
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Quote:
Originally posted by corianderstem
I would imagine Walmart's health plan is an ERISA plan, in which case it's "governed" by the DoL, and that means you have to stick to the rules stated in your health plan. I believe there are some instances where exceptions can be made, but I don't know how much wiggle room there is, even in sad stories like this.
They were just talking about this on MSNBC, and whoever they were talking to stated that subrogation isn't something a company will always do - so I guess Walmart does have a choice whether or not to go after the money.

On the one hand, it makes logical sense to try and get their money back. On the other hand, jeez Walmart - have a heart. I know all companies are concerned about the rising costs of health care and will take money back where they can, but come on.
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Old 03-30-2008, 08:14 PM   #17
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Quote:
Originally posted by corianderstem

have a heart.
Left to the drug companies and major corporates to do this is futile.
Can either of the candidates really have or will have the heart?

That remains to be seen..
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Old 04-01-2008, 02:28 PM   #18
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Originally posted by MrsSpringsteen
Wal-Mart spokesman John Simley, who called Debbie Shank's case "unbelievably sad," replied in a statement: "Wal-Mart's plan is bound by very specific rules. ... We wish it could be more flexible in Mrs. Shank's case since her circumstances are clearly extraordinary, but this is done out of fairness to all associates who contribute to, and benefit from, the plan."
I do guess this does haev to do a lot with setting a certain precedent

not that this makes it easier to swallow
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Old 04-02-2008, 07:16 AM   #19
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Nothing like some bad PR to "help us step back"

CNN) -- A former Wal-Mart employee who suffered severe brain damage in a traffic accident won't have to pay back the company for the cost of her medical care, Wal-Mart told the family Tuesday.

"Occasionally, others help us step back and look at a situation in a different way. This is one of those times," Wal-Mart Executive Vice President Pat Curran said in a letter. "We have all been moved by Ms. Shank's extraordinary situation."

On Tuesday, Wal-Mart said in a letter to Jim Shank that it is modifying its health care plan to allow "more discretion" in individual cases.

"We wanted you to know that Wal-Mart will not seek any reimbursement for the money already spent on Ms. Shank's care, and we will work with you to ensure the remaining amounts in the trust can be used for her ongoing care," Curran said.

"We are sorry for any additional stress this uncertainty has placed on you and your family."

Wal-Mart's reversal came as shock to Shank.

"I thought it was an April Fool's joke," he told CNN.

"I (would) just like to let them know that they did the right thing. I just wish it hadn't taken so long," Shank said. "But I thank them and I hope they come through with all that they said they're going to do.
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Old 04-02-2008, 07:25 AM   #20
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One of the rare occasions where the media can influence a companies cost-benefit for the better.
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