• Sedgwick Ignores Medical Records and Denies Disability BenefitsSedgwick Ignores Medical Records and Denies Disability Benefits

AT&T Employee Dealing With Sedgwick Has Horrible Disability Benefit Claim Experience

Our client, an AT&T employee for more than 40 years became disabled and unable to do her job due to cervical myeolapathy neck pain, chronic headaches and a torn rotator cuff in her shoulder. Her claim for short term disability benefits under the AT&T disability benefits plan has been nothing but a “headache”. AT&T hires Sedgwick Claims Management to handle the administration of all disability benefit claims.

Unfortunately for AT&T employees, Sedgwick can be very difficult to deal with and appears to be trained to deny more claims then they approve. Sedgwick handles claims for multiple companies throughout the county and their background is in handling worker compensation claims.

From our experience the Sedgwick employees treat every disability claim as if it is a worker compensation claim, which is not good for disability claimants. It also appears that the claim reps that are assigned to manage a disability claim and make claim decisions are not qualified to do so. For example, on numerous occasions, multiple Sedgwick claim reps have admitted that they don’t understand or have any knowledge regarding a claimant’s medical condition.

Our client’s claim was initially denied despite overwhelming medical support. Her claim was immediately approved by Social Security Disability. Sedgwick sent our client for a Compulsory Medical Exam with their hired doctor. The Sedgwick hired doctor determined that our client could not perform any occupation and Sedgwick continued to deny the claim. Our law firm submitted an Appeal January 25, 2012 and on February 22, 2012 Sedgwick reversed their claim denial. One would think that Sedgwick would leave our client alone at this point and continue to pay benefits, but on March 7, 2012 Sedgwick once again attempted to deny benefits despite a letter they sent stating that benefits were approved through March 17, 2012. Our law firm contacted Sedgwick and after several letters and phone calls, they advised that they made a mistake and benefits should be paid through March 17, 2012.

In the mean time, Sedgwick requested no additional information in their February 22, 2012 letter, yet during the week March 20, 2012 called our office and claimed that our client needed to submit additional medical information our they would have to send her for another compulsory medical examination and they are stopping payments AGAIN! We submitted updated medical information and a statement from our client’s orthopedic surgeon certifying her disability.

Without any basis whatsoever, Sedgwick calls our office and states that our client does not have support for disability and she needs to be examined again. Keep in mind that our client is only eligible for another 4 months of STD benefits with Sedgwick. The following is a response letter we sent to Sedgwick as we refuse to allow them to push our client around.

What more could you possibly expect from Ms. XXXX? You have had your own doctor physically examine her and she has been seen by five of her own treating physicians. She has also been approved for SSDI benefits. In the month of March 2012 she has been seen by a Physiatrist, Orthopedic Spinal Surgeon and her Physical Therapist. She continues to take narcotics in order to manage her pain. On March 27, 2012, her Orthopedic Surgeon documented that her condition is progressive and that she has significant restrictions and limitations that prevent her from working. Ms. XXXX has spinal myeolapathy which is a permanent condition affecting her spinal cord. She is unfortunately not going to get better and she cannot return to work.

Please provide an explanation in writing as to why the medical support provided to AT&T is insufficient evidence of Ms. XXXXs’ disabling condition. In accordance with ERISA regulations please specifically state what additional information Ms. XXXX must provide in order to support her claim for disability. Please identify the names and qualifications of any individuals at Sedgwick that have determined that Ms. XXXX is not disabled. Please address any requests in writing to the undersigned and do not call us requesting any information as we don’t trust Sedgwick. We will respond accordingly. If AT&T / Sedgwick are denying benefits, please provide a formal denial letter so that Ms. XXXX can comply with the appeal guidelines. We are demanding that payments are sent immediately. If you are seeking any additional information please send your request in writing.

On a daily basis we receive phone calls from disability claimant’s nationwide that have been denied either short term or long term disability benefits. We have identified a pattern of unreasonable disability claim denials by Sedgwick. We will continue to prosecute claims against Sedgwick and we welcome the opportunity to provide a free consultation regarding any long-term disability insurance claim.

Disability Attorneys Dell & Schaefer handle long term disability claims throughout the country and represent hundreds of claimants against every major long-term disability insurance company in multiple states.

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FAQ

Do you help Sedgwick claimants nationwide?

We represent Sedgwick clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Sedgwick disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Sedgwick. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Sedgwick.

How do you help Sedgwick claimants?

Our lawyers help individuals that have either purchased a Sedgwick long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Sedgwick:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Reviews   *****

Michael C.

I am extremely happy that I decided to sign on with Dell & Schaefer. Mr. Symonds is the most honest attorney that I have ever dealt with. He explained the appeal process to me exactly as it turned out. He also knew exactly when to send in the appeal for Short Term Disability so that the Long Term Disability was approved within days of the STD approval. I feel very confident that he will have my back for the years to come. He and his assistant Sonia are always polite and quick to get back to me whenever I have questions.

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