Injured Wal-Mart worker must get scripts from employerPosted On: Jul. 1, 2019 2:26 PM CST
Wal-Mart has the right to insist that an injured worker have her prescriptions filled at one of its stores, a divided Supreme Court of Louisiana ruled Wednesday, stating that the woman had not been experiencing delays in treatment.
Elizabeth Soileau injured her right arm and hand in the course and scope of her employment with Wal-Mart Stores Inc. and subsequently received medical treatment, including prescriptions, some of which she filled at a Wal-Mart pharmacy, according to documents in Elizabeth Soileau v. Wal-Mart Stores Inc., filed in New Orleans.
In 2016, Ms. Soileau obtained a judgment against Wal-Mart ordering that she was entitled to receive certain prescriptions, as prescribed by her physician, and then began filling her prescriptions at a local pharmacy.
Wal-Mart in 2017 notified Ms. Soileau in writing that she could only use "a Wal-Mart or Sam's Club Pharmacy" for her future prescriptions needs. Wal-Mart further advised Ms. Soileau it would not issue reimbursement for medications dispensed to Wal-Mart workers' compensation patients from any pharmacy other than a Wal-Mart or Sam's Club Pharmacy, according to documents.
Later that year, Ms. Soileau filed a motion alleging "Wal-Mart is refusing to approve or authorize medications anywhere other than Wal-Mart" and she "should not be forced to obtain medications from her employer directly and cannot go without her medication,” according to documents.
Ms. Soileau testified at a hearing before the Office of Workers' Compensation that Wal-Mart's pharmacy denied two of her workers' compensation prescriptions, but admitted she had no written documentation of the denial, documents state.
A workers compensation judge denied Ms. Soileau's motion, finding that “Wal-Mart had the right to choose the pharmacy at its retail stores to fill Ms. Soileau's prescriptions.” However, the workers compensation judge explained that in the event Ms. Soileau experienced any delays or deficiencies in the filling of her prescriptions, she has a remedy under Louisiana law, documents state.
Ms. Soileau appealed. A divided panel of the court of appeal reversed, finding “that a conflict of interest would be created if Wal-Mart were permitted to designate its own pharmacy as the only pharmacy Ms. Soileau could use for her workers’ compensation prescriptions.” Two judges dissented, one of whom found the matter was “premature,” as there was claim that Wal-Mart had not filled her prescriptions, according to documents.
Similarly, the state’s highest court was divided on the issue, with the majority finding the issue “premature” as Ms. Soileau failed to make adequate allegations that she was being underserved, which are essential under state law, according to the ruling that vacated the ruling of the appeals court and reverted back to that of the workers compensation judge.
“The arguments presented by Ms. Soileau demonstrate convincingly that no real and actual dispute has been presented in this matter,” the court wrote. “Rather, her arguments focus on abstract harm she might suffer in the future if Wal-Mart is permitted to restrict her to its own pharmacy. The injury resulting from this purported conflict of interest is not based on any actual facts or occurrences; rather, she asks the court to assume that she will suffer harm if certain hypothetical facts occur. We decline to render an advisory opinion based on facts which may or may not occur at some unspecified time in the future.”
Two judges dissented, one writing “I agree with the appellate court that a conflict of interest arises when an injured employee's employer appoints itself as a health care provider for the injured employee, without the agreement of the employee.”
Officials with Wal-Mart and attorneys involved could not immediately be reached for comment.