The U.S. Supreme Court refused to hear Debbie Shank's appeal, the St. Louis Post-Dispatch reports. A federal appeals court in St. Louis had found that Shank must repay everything Wal-Mart's insurance plan paid, even though the settlement with the insurer of the truck driver who hit her falls short of that amount.

Nathan Shank, 17, said his mother has already lost some amenities because of the legal case, including a private caregiver.

Shank, 52, now living in a nursing home, was a Wal-Mart employee at the time of the crash.

The settlement came to $417,477 after lawyer's fees and expenses, according to legal documents, while Wal-Mart has paid $469,216 for Shank's care.

Daphne Moore, a spokeswoman for the company, said Shank is in a "tragic situation."

"The reality is that the health plan is required to protect its assets so that it can pay future claims for other associates and their family members," Moore said.