• Sedgwick Ignores Medical Records and Denies Disability BenefitsSedgwick Ignores Medical Records and Denies Disability Benefits
  • Sedgwick Claims Management Services Disability Benefit ClaimsSedgwick Claims Management Services Disability Benefit Claims
  • Third Party Administrator Role in Disability Insurance ClaimsThird Party Administrator Role in Disability Insurance Claims


Does Sedgwick Approve Any Claims For Disability Benefits?

Sedgwick Claims Management Services (Sedgwick) is often a nightmare for disability insurance claimants to deal with.

On almost a daily basis we are contacted about an unreasonable Sedgwick disability denial. A simple review of the public comments posted on our website gives you a very quick understanding about the unreasonable manner in which Sedgwick can operate. You should also watch our Sedgwick videos and read some of the articles listed below to learn more about their conduct.

Our law firm has handled numerous Sedgwick disability Appeals and lawsuits throughout the USA. Contact us to discuss your options if your Sedgwick short term or long term disability claim has been denied. We never charge any fees or costs unless we recover disability benefits for you.

Is Sedgwick Claims Management A Disability Insurance Company?

Sedgwick is a third party administrator that manages short term and long term disability insurance claims on behalf of employers and insurance companies.

As a third party administrator Sedgwick may have the authority to approve or deny a disability insurance claim, but the money to actually fund the disability benefit is not paid by Sedgwick. For example, Sedgwick is the claims administrator for the AT&T disability plan, but the money to pay benefits, if approved by Sedgwick, comes from AT&T.

Sedgwick claims to have more than 6,400 employees in more than 150 offices throughout the US and Canada. Sedgwick prides themselves on providing cost effective claims management, which usually means they use special techniques to help employers or insurance companies reduce the amount of financial exposure due to paying disability benefits. Additional information about Sedgwick and their philosophy for handling disability insurance claims can be reviewed here.

From our law firm’s experience, Sedgwick appears to be overwhelmed with disability claims and they do not hire qualified people to administer claims. Sedgwick claims examiners function like robots and in most cases it seems as if they are programmed to deny disability benefits.

Sedgwick has all of the resources necessary to attempt to prove a claimant is not disabled. For example, Sedgwick purchased a company called Factual Photo. Factual Photo was purchased so that Sedgwick could have their own in-house resources in order to obtain video surveillance and photos of disability insurance claimants.

Share Your Thoughts With Us And Other Disability Claimants Nationwide

We encourage you to post your complaints, comments, or share your experience about dealing with Sedgwick.

It is our goal that your online posting will help educate other claimants across the country that must deal with Sedgwick.

We also recommend you to review our articles below summarising lawsuits and court decisions involving Sedgwick.

Please contact us privately if you would like assistance with your claim.

Read 21 Lawsuit Summaries

Leave a comment or ask us a question

There are 952 comments

  • Do you handle slip and fall claims caused by dog poop on the floor of Petsmart? I was there with my daughter who took her dog to the rear of the store to Banfield. They were previously asked to clean it up twice prior to mt slip so they had prior knowledge. I am looking to hire someone who knows how to deal with Sedgewick. By the way, the security tape somehow disappeared. My injuries are complete tear of right rotator cuff. Bicep hanging by a thread. Deltoid torn. Spained left knee. Left hip had to be popped back into the socket. This happened in Tucson AZ December 17, 2018. Coming up on statute so I need to file. If you don’t want to discuss, I would appreciate a referral. I am currently in Richmond VA so it can be filed federally. I have to let go of my current attorney as he has dropped the ball, although he is very nice. I need a bulldog attorney.

    BettySep 15, 2020  #952

  • Frank, formally, not that I am aware of. Most insurance companies and third party administrators will state in a denial letter that the time frame for filing an appeal will be extended. That being said, if you request additional time due to COVID impacting ability to get to your doctor then I expect Sedgwick will grant an extension.

    Stephen JessupSep 12, 2020  #951

  • Is tolling being given by Sedgwick in terms of filing an appeal as it is being given by the courts system because of COVID-19?

    Frank C.Sep 11, 2020  #950

  • My case has been pending since 2002. I have lupus and received a back comp amount but was supposed to get ‘lifetime’ for my lips. After CMS (91,000.00) or nearly enough; did their analysis, they realized they had been paying for my lupus all these years and cut off all lupus related bills. I can’t get a Sedgwick Doctor that will treat me and I have been without care since 9/19. I don’t have any money for a new lawyer. My existing lawyer says there is nothing he can do – that the laws changed and I am screwed. How can they renig on this? Can you help me?

    Lori M.Aug 31, 2020  #949

  • Susan, I am sorry to hear all that you have been through. It is terrible how you have been treated. We assist people with regards to their claims for disability insurance benefits. It sounds like Standard as denied your continued receipt of LTD benefits. If so, please contact us for a free consultation to see if we can assist you in getting your LTD claim reinstated.

    Alex PalamaraAug 21, 2020  #948

  • My name is Susan. I was an employee of Optum health division of United Healthgroup. I am going to make a clear statement first off about my career with Optum. I was struck by a semi, 2 failed neck surgeries intense pain and held a open fmla case for moderate to severe my entire career. Top performer in my 7th year they chose to attempt to assassinate. Healthcare appeal denied, broke urac accreditation multiple times. Bad atmosphere they committed perjury and fraud multiple times with agencies. Sedgwick followed their direction denying my case after 3 weeks. They lied to Bolivia, Sedgwick denied my case by using drs who were part of uhg panel. (Off limits, conflict) another dr lost his license in 3 of 7 states due to alcoholism and drug abuse.

    15 months into this after denials the acct manager stated pay her immediately (due to privacy violations) at one point workers comp was filed I could not attend due to mothers cancer dx. Apparently workers comp sent info I never received stating I could have my hearing. The judge dismissed the case for me favored uhg. The company dropped down std and Ltd pd my claim under workers comp. Sedgwick and standard fully involved. They dropped down the case for workers comp and covered it back up with std and Ltd to tag me with mental health and refused to review my mountains of documents that proved my physical disability. The Standard at the 2 year mark extended by them by 2 days had my records. All physical. They never documented it on their log for 7 days. Ton more information.

    EBSA a joke! No investigation and they shut down an employment case still viable and refused to address disability. The entire system is corrupt and I am submitting my case to the federal court; fbi; inspector general of the United States. As a employee who was a top performer I am appalled that without blinking an eye uhg dictated to Sedgwick and the standard. Sedgwick takes their direction from your employer. This system needs to crumble and be rebuilt with people who have integrity. As employees you can typically buy up… if claims are filed they will be denied. Then everyone keeps their mouth shut. They cost me everything but my home. Legislation must change so games stop. If the take longer than x amount of days pro visionary funding must be paid. I believe it falls under false claim act and racketeering. What do you think? Please respond.

    Susan H.Aug 21, 2020  #947

  • Silvia, thank you for contacting Disability Insurance Attorneys Dell & Schaefer. Our firm works solely in the field of Disability Insurance and can’t help with your Workers Comp matter. I suggest speaking with a Workers Comp attorney.

    Gregory DellAug 20, 2020  #946

  • Gm, I am currently under Workers Comp temporary disability and I do have legal representation but my attorney seems to side with the Insurance (Sedgwick Claims Management Services, Inc), they have stopped my benefit before without any notice or reason only to later on use it to black mail me about my surgery approval. They basically told my attorney that they would authorize my surgery without a hustle if I gave up the 6 weeks they owed me and were ordered to pay, my attorney who had worked on the Insurance companies side for over 20 years before representing the people. He advised me that it was better to let go of the 6 weeks pay so they would authorize my surgery. Now my benefit check comes every other Tuesday and hasn’t come this week and I have a feeling that they stopped it again without any notice. I need help please, I am looking for another attorney because I feel the one I have sides with the Insurance Company.

    Silvia T.Aug 20, 2020  #945

  • Jaclyn, you can email me directly and I can let you know if I am able to help you or refer you to someone that can. Rachel@diattorney.com

    Rachel AltersAug 18, 2020  #944

  • I am dealing with Sedgwick for a disability claim through my employer and they are being absolutely horrible. I am thinking about legal action and would like to know what I need to do and what they need to do before I seek legal recompense. So far they have just been unavailable and won’t return my calls. This has resulted in a delay in my medical care. I am a veterinary surgeon and injured my hand. I am concerned their negligence and delay in care will result in function loss and negatively impact my earnings long term.

    Jaclyn B.Aug 18, 2020  #943

  • George, thank you so much for providing this insight. It is really appreciated to hear this perspective from a former employee. Given your experience I hope you are on to bigger and better things.

    Stephen JessupAug 10, 2020  #942

  • I’m a former Sedgwick CMS supervisor who worked for a year at the Orange, CA claim office. You are correct, Sedgwick adjusters for the most part are technically weak due to minimal amount of office time ongoing training and/or Sedgwick’s management focusing more attention in meeting the difficult to reach promises that the TPA routinely makes to their respective accounts. Prominent among these are expedited claim closures with all adjusting centered at ending benefits quickly and at the hinderance of the injured by returning to work sooner then medically feasible. The actual per claim adjusting time is reduced by 30% by inputting info to Sedgwick’s computer system directed at continually feeding the account/employer data surrounding outlined reserves and monetary savings. Office moral more often than not, is down leading to a claim adjuster revolving door and Sedgwick Holding hiring house-openings. That’s just a short sample of what I observed during my year of employment at this TPA.

    GeorgeAug 10, 2020  #941

  • I ate at chopt resturant in Atlanta, GA and found a piece of a tooth.. still makes me nauseous to think about it.. I reached out to chopt and was told there insurance company would reach out to me.. which is Sedgwick Management company after reading all of these awful comments I am unsure how to move foward.

    AnnabelleAug 6, 2020  #940

  • Stacie, we are sorry to hear of everything that you are going through. Please contact us for a free consultation. We would love to review the denial letter and your policy to see if we can assist you in proving to Sedgwick that your condition causing your claim is not pre-existing.

    Alex PalamaraAug 4, 2020  #939

  • I’ve never had a injury at work or done workman’s comp. I was fine day before injury now I am limited to standing over 45 minutes, arms numb, it’s been hard, doctor every week, could go three times, can’t afford it. Dollar tree goes through Sedgwick no money it’s been 5 months, I pay all my doctor bills, I’ve never talked to anyone. Sedgwick never returned my calls, no answer when I called. Now they say pre-existing. What can I do?

    Stacie C.Aug 4, 2020  #938

  • I have been having nothing but problems for the last two months. Now about my short term claim, I have given them every bit of info from the dr, they tell me the dr note is not a legal document and after visit summary’s are also no good info with Covid. This has been a night mare I have not been paid in two months now and they tell me by some guidelines they have it should only take 28 days to heal yet can not provide me these guidelines and I could find them online but would not tell me where. It’s been a total joke. I have had people hang up on the phone with me, they tell me all phone calls are recorded yet I can not have any of these phone calls from what reps have told me and I have even been told the txt messages I have received are wrong and don’t worries about it.

    Robert W.Aug 4, 2020  #937

  • I had an on the work job injury through Sedgwick and here I am 7 months later still trying to get help.

    Bryce B.Jul 28, 2020  #936

  • Jill: Sedgwick is a 3rd Party Administrator and manages claims for your employer’s self-funded short term salary continuation plan. You have a difficult and, unfortunately, not uncommon situation given the current pandemic. I suggest you contact our office and speak with one of the attorneys to discuss the specific questions you have and your options moving forward.

    Jay SymondsJul 24, 2020  #935

  • I have been out of work due to severe depression and anxiety. I’ve been with my employer for 19 years so I’m not a short term employee looking to stay home and get paid. I’m also a HR manager. Sedgwick is our short term disability payer and LOA approver. I started suffering from depression and anxiety at the end of May. After calling off for a week and realizing I wasn’t getting better, I called around my area looking for a psychiatrist to talk to and submitted an FMLA request with Sedgwick. Due to COVID, all doctors in my area were booked until the middle of July. I found that doctor on demand had an earlier appointment on June 22nd. I set up the appointment and was given medication and set up follow up appointment. I also contacted Sedgwick for an extension on my due date for hcp paperwork and they gave me until June 28th.

    What I found out was that Dr on Demand does not fill out hcp paperwork so I saw my primary physician. She put me out until the end of July. She filled out the hcp paperwork and I submitted the dr notes from the psychologist from Dr on Demand. Sedgwick is denying the paperwork because I didn’t see someone right away and that depression/anxiety is “subjective” and they need more info. The dr notes talk of my issues but thats not enough. They sent more hcp paperwork to my primary doctor to fill out. I have explained time and time again why I didn’t see someone right away. They also want a follow up appointment but apparently my primary doctor isn’t good enough. The psychiatrist on Dr on Demand is no longer taking appointments so I can’t see her again. My primary doctor has increased my medication (tripled the dose) and scheduled a follow up with me in September.

    Right now I’m on an unexcused absence so I’m about to lose my job of 19 years AND I’m not getting paid. This is not helping my depression and anxiety to say the least. I’m panicked at this point and getting no where. People are right… Sedgwick is programmed to deny everything to save money.

    Jill D.Jul 24, 2020  #934

  • Rodney, I am sorry to hear of your issues with Sedgwick and your claim for benefits. Please contact us at your convenience for a free consultation to see if we can assist you in getting your claim approved.

    Alex PalamaraJul 21, 2020  #933

  • Been on an LOA since July 2 2020 for mandated quarantine. Am not going to get covid pay thru Sedgwick because I learned July 21st that Sedgwick put in my LOA the wrong way and all they can say is sorry. In the meantime I have no money coming in and me and the wife are caring for a grandchild at the moment. Don’t know who else to contact.

    Rodney I.Jul 21, 2020  #932

  • I had been denied for most of my leave except for small amount of time when I had 2 back surgeries. 1 failed. Sedgewick kept pushing me to get back to work when I could barely walk and I was going thru disability process. I won fully favorable on my disability where Sedgewick denied all of it. I can’t believe how they treat people.

    Melissa J.Jul 17, 2020  #931

  • James: This seems very unusual. Sedgwick is a third party administrator and likely has an administrative services agreement with your mother’s employer. Her employer should have the information necessary to contact Sedgwick.

    Jay SymondsJul 15, 2020  #930

  • My mother has a claim through them since 8/2019. Haven’t be able to reach them since January. Emails fail to go through and numbers are disconnected. What should be the next step?

    James A.Jul 15, 2020  #929

  • I have been offered a settlement from Sedgewick for disabilitiy involving 513 knee, 420 back, 530 foot, 510 legs, 842 psych in the amount of 167,000 but have to pay back 20k for permanent disability already paid to me. Is this a fair settlement? I was hurt 5 years ago on the job and am still on permanent disability.

    Mike M.Jul 15, 2020  #928

  • I have been dealing with them for months and it seems they are very slow about handling claims and getting updated information to me in a timely manner. I have also had problems with them giving my doctor’s office the run arounds when it comes to getting information by withholding my signed release form. I am out due to complications that are still ongoing from what is thought to have been COVID even though my test was negative, I have lung damage and other health issues from it now. I am really tired of dealing with them, but since Walmart uses them I feel stuck with their unprofessional uncaring behavior. Wouldn’t be dealing with this if my employer had offered protection from this virus sooner than they did, since they didn’t want to offended members if we was to wear a mask.

    KeithJul 15, 2020  #927

  • Anthony, you will need to file an administrative appeal of the denial if you have not already. As Sedgwick is a third party administrator for your employer (meaning they are not the insurance company) the actual payment of benefits would come from your employer. If you have not contacted your HR to voice your concerns/or ask for potential assistance, it is recommended.

    Stephen JessupJul 8, 2020  #926

  • During the covid lockdown I was and am currently dealing with severe anxiety, my doctor put me on meds and approved up to 3 months STD with review for longer. My doctor called Sedgwick multiple times and let them know I called them 3 times and they denied me for “Not enough information” while having anxiety issues. It’s very hard to keep calling these guys and getting treated badly.

    Anthony B.Jul 8, 2020  #925

  • Connie, you should contact an employment lawyer who specializes in this area of law.

    Rachel AltersJul 4, 2020  #924

  • During the few shifts I worked at Kohls I was suppose to be greeter and help run Cash Register. Buggies weren’t getting wiped down and count of people in building was not being kept.

    Connie W.Jul 4, 2020  #923

  • I’ve worked at Kohl’s for over 10 years. Developed RA, Lupus, and mixed connective tissue disease in 2013. Was furloughed from Kohls and was afraid when asked to come back to work, that I would lose my job and health insurance. Returned to work for a few shifts. Had RA and Lupus flare. Finally got into see Dr. My Dr. Wrote a 2 page letter stating why I should not be working in retail with my medical condition. Kohls will not let me go back on unemployment and I have filed for short term disability with Sedgwick. Haven’t heard from them. I am down to nearly zero money in bank and I don’t know how to proceed or what to do. My manager at Kohls suggested I step down?

    Connie W.Jul 4, 2020  #922

  • Michael, please email me at Rachel@diattorney.com and I will set up a time for us to talk.

    Rachel AltersJun 23, 2020  #921

  • 30 year career pilot.. Head on car accident at work.. TOTAL DENIAL OF ALL CLAIMS.. over 3 years, non benefits whatsoever.. I NEED HELP

    MichaelJun 23, 2020  #920

  • I am a 15000 hour, former corporate pilot. On May 27, 2017 I was in a head on car accident in Oregon while at work. My employer filed a Workmen’s Comp claim for me almost immediately. I have a stack of 073 docs stating my obvious injuries from doctors. The most medically regulated industry in the world, and all their rules and regulations, are ignored by my “adjuster”. I was told that “given the current state of the economy, we don’t see any reason why you can’t return to work”.

    A severe post concussion TBI, a badly damaged C3/4, and a torn meniscus in my right knee, and I have been denied EVERY SINGLE BENEFIT for over 3 years now. I have received NO EFFECTIVE TREATMENT WHATSOEVER. They have literally ended my career, and made sure that I would never fly again, by not treating ANY of my 3 injuries. After approving minimal senseless treatments, they cancel approvals midstream, effectively putting me in debt on top of all of this. I’m on my second lawyer. NOTHING

    MikeJun 10, 2020  #919

  • Charles, I am sorry to hear that Sedgwick has initially denied your claim. Please contact us so that we can review the denial letter. We always offer a free consultation.

    Alex PalamaraMay 24, 2020  #918

  • I have worked for GE for 31 years. I have gone through numerous lumbar surgeries within the last 2 years. I was approved for SSDI the first time around. I am 90% VA disabled for other conditions. I exhausted my 6 months of STD benefits and I am on long term now. Sedgwick administrates the decision for early disability pension for GE. I have been denied the first time and am working on my appeal now. This is about Sedgwick approving me being permanently disabled. Do you have any suggestions? Thanks.

    Charles R.May 24, 2020  #917

  • Narendra, if the denial is related to a disability insurance policy then please feel free to contact our office to discuss how we may be able to assist you.

    Stephen JessupMay 7, 2020  #916

  • I want to file a case against Sedgwick in denying my claim.

    Narendra K.May 7, 2020  #915

  • Christina, please call us for a free consultation. We will gladly speak with you to figure out if there is any way we can assist you. However, please keep in mind that Sedgwick is typically a 3rd party administrator so any buyout would not likely be with them.

    Alex PalamaraApr 27, 2020  #914

  • Can you help with medical buyouts? That is all I have left. The company is Sedgwick and I would like to be rid of them.

    Christina R.Apr 27, 2020  #913

  • Imran: It should not take Sedgwick this long to make a decision on your STD claim. If your claim is governed by ERISA, a decision should have been made within, at most, 105 days or approximately mid-February 2020. I suggest you contact our office and speak with one of the attorneys to discuss your situation and answer any specific questions you may have regarding your claim.

    Jay SymondsApr 3, 2020  #912

  • I work for At&t, my short term disability claim still just hanging since October 29, 2019. I keep sending all my medical reports, MRI, X-rays report whatever I have and still they are asking updated medical information. Now At&t stop my medical insurance, more than a month not paid anything from October 29, 2019. I am going thru the worst time of my life, no money and medical insurance because of Sedgwick.

    Imran K.Apr 3, 2020  #911

  • I applied to for intermittent FMLA on 3/5/2020. I was told that more information was needed and I was given another set of paperwork for my doctor to fill out and returned by 3/30/2020. I returned the paperwork on 3/21/2020 and I have heard nothing. I have doctors treatments and appointments with specialist coming up and the time has not been approved. I requested a call back a few days ago and I am still waiting. This company is terrible and the worst experience ever especially for someone who is sickly.

    Ieasha O.Mar 31, 2020  #910

  • Yes I’ve been off work since 1/30/2020, they paid me for the same illness but now I got approved for pay all February and when March came first they said they didn’t receive medical firm from my doctor. Had my doctor send in paper again denied my payment for 2/29/2020 till 3/13/2020 but approve payment from 3/14/2020 till 4/6/2020, same illness same doctor. Now behind on my bills for the month of May.

    Eddie J.Mar 26, 2020  #909

  • Bryan, the AT&T disability plan is very restrictive as to what it will and will not cover. That being said, based on the misinformation you received regarding which benefit to apply for I believe you need to speak with an employment attorney to see what your options are.

    Stephen JessupMar 26, 2020  #908

  • Recently denied long-term disability by At&t/Sedgwick because I was not informed that any disability related to military connected. After 20-years of employment as a facility tech, I received my 100% VA disability. I was informed via CWA union steward that I had an option to chose PMR (permanent-medical restriction) or long-term disability. The claims administer for Sedgwick ask me to chose given the fact that I was never informed by either Sedgwick claims administrator nor CWA that my only option was PMR since military service disability are ineligible for long-term. After 20 years of labor, and a year long of qualified STD (short-term disability) I’m left only with a very small pension.

    Bryan S.Mar 26, 2020  #907

  • Karen: These are unprecedented times and it is unclear how California State Disability would handle a claim involving an increased risk of illness. You may be better served working with your employer to see if there are appropriate accommodations that can be made to decrease any added risk you may have in the workplace.

    Jay SymondsMar 20, 2020  #906

  • How do I apply for State Disability, as I am 66 years old? My immune system is compromised with this coronavirus now going around. So I’m at high risk. I have worked for Wal-Mart for 29 years, and I am HIV positive. I do however take medications to help with my Viral load and CD4 count… Right now I am undetectable as my numbers on my CD4 are over 988. When numbers reach below 200; is when my physicians say a person can have Aids. I would like to know, currently I am drawing SSI, due to my husband passing away in 2010. I’m drawing Survivor benefits.

    Is SSI and SSDI the same thing, and I really do not wish to jeopardize my health and take further risks more than I have to. I currently work as a cashier. My adult children are very concerned about me coming so close in contact with the public, and it is very hard as a cashier to keep a distance of 6ft between myself and my customers. I guess what I’m asking is, would I qualify to receive State Disability to stay at home and be compensated and paid for my time missed from work? My Store Manager is an awesome person and I give her my utmost respect. She is great at what she does.

    Karen L.Mar 20, 2020  #905

  • I was involved in a accident caused by a semi truck driver delivering goods for company well known pizza chain in the US it is clear that the driver was at fault. Fortunately my insurance carrier USAA covered 70% of my loss wage while I was off for 4 mos. Now my insurance. Has had no response nor have I. Sedgwick will not return any calls to me. They were sent a demand letter from my carrier USAA and no response either way. I would like to know does anyone know if Sedgwick has a certain number for a certain department that I will have better luck with speaking to someone besides a voicemail saying that they are on another line and leave a message because I’m starting to believe that kasandra warner at Sedgwick is just ignoring me and my insurance carrier.

    Please if anyone has any info I would appreciate it.

    JimMar 9, 2020  #904

  • Brian: I suggest you contact a Worker’s Compensation attorney to discuss your situation and options.

    Jay SymondsMar 7, 2020  #903

  • I was injured on the job 2/3/20 injuring my knee, filled out appropriate paperwork filed it with Sedgwick, went to company doctor, put in a brace and on crutches, sent by Sedgwick to do MRI and got report back that went to company doctor and I have several tears in my meniscus and need to have surgery, referral was sent back to Sedgwick, they called me and told me that orthopedic surgery appointment would be set up in 3 to 4 days they also set me up for physical therapy that I can not do due to the restrictions I am on by doctor and they do not know why I’m am there before I have surgery. I have returned to company doctor on more than one occasion and they now have me on pain medication trying to wait on Sedgwick to get orthopedic doctor scheduled, I call 3-4 times a day to reach out to my case worker to let them know what is going on and why the orthopedic has not been scheduled after two and half weeks later, all communication has stopped on there end and they will not return my phone calls and messages left on my Sedgwick.com. 3 to 4 times a day asking them to please return my calls so that I may let them know the status of what us going on with me and that I have fallen three times waiting for them to get ortho lined up and am I a great deal of pain. I show up for work every day and am on light duty but I need this fixed so I can get back to work doing the job they pay me to do at Lowe’s.

    Please if you have any info on what I should and should not be doing please advise. Thank you for your attention to this matter!

    Brian G.Mar 7, 2020  #902

  • Harry, I am sorry to hear of your denial and the fight Sedgwick has given you in approving your claim. We would like to review the denial letter to assess if we can assist you with the next steps of your claim. Please contact us at your convenience so that we can offer you a free consultation.

    Alex PalamaraMar 6, 2020  #901

  • I am a 62 year old pharmacist who works for Walgreens. I am currently dealing with Sedwick. I have had 2 spinal surgeries (l5-s1) laminectomy/discectomy, spinal stenosis and several knee surgeries (anterior cruciate ligament) meniscal tear, etc. Due to clinical findings of: a. hypertension, b. pre-diabetes, c. high cholesterol/triglycerides, d. psychiatrist’s diagnosis of: anxiety and depression e. patient’s decreasing ability to manage pain. f. physical and stressful work environment. My primary care doctor has sent correspondence to Sedwick stating that he recommends I do not return to work. My claim has been denied and it has been sent to a department where they are asking me if I would like to have them hold my job for 1 year.

    Harry G.Mar 6, 2020  #900

  • I can’t view your review our short articles summarizing lawsuits and court decisions involving Sedgwick.

    Can you please send me a link?

    AnthonyMar 4, 2020  #899

  • I’m having issues with FMLA time. NUMEROUS reps & lead specialists REPEATEDLY told me my hours that I would be getting back for this month. Based upon what I was told, I used my hours as needed. I was then DENIED the time because it was unavailable. When I reached out, I was told that I was given incorrect information and they reps, once the calls would be pulled, would be coached. That doesn’t help the fact that I used time that was Unavailable. Why would I use time that’s not fair for me to use? Because not only did your representatives tell me that I have this time available, but their website consistently reflects incorrect time as well which I have screenshots to prove. It’s a damn shame when a representative tells you “this is the time I’m seeing available and that’s what it shows on the website, I would take a screenshot…”. This is not the first time this is happened to me with Sedgwick, and I’m not the first person to have this happen. I know at least two other people who have had the same issue of being told they had time available when they actually did not due to the incorrect information being listed on Sedgwick‘s website as well as incorrect information being given out by their representatives.

    And forget trying to work with their supervisors, they are completely nasty and don’t listen to what you have to say. I don’t understand how a company like this is still in business and how fortune 500 companies have them as a claim reporting company with as many issues that go on with these people. Also, I had a short term disability claim and I was never told that my FMLA claim and disability claim would pull from the same time bank. If it had been told to me, Which they claim they mailed a letter out to me that I never received, I would’ve spaced out my surgeries because I had to have two so I wouldn’t use up my entire FMLA bank. This company is horrible to deal with and this most recent incident was the straw that broke the camels back.

    ChristinaFeb 27, 2020  #898

  • Dena, I am sorry to hear of the troubles you are having. Unfortunately, it is not uncommon. Please feel free to contact us so that we can learn more about your claim and be of assistance to you.

    Alex PalamaraFeb 25, 2020  #897

  • 65 days, only 2 responses from Sedgwick. What’s their problem?

    DenaFeb 25, 2020  #896

  • Unfortunately if they paid you all of the past due benefits, then you do not have any other recourse.

    Gregory DellFeb 12, 2020  #895

  • I am a 20 year employee of AT&T who also happens to be an alcoholic arguably because of it. I was in a downward spiral due to my addiction and sought treatment as allowed for and encouraged by AT&T through the company’s short-term disability plan administered by Sedgwick. What transpired next was beyond my belief, which apparently is “business as usual” reading your website and browsing the internet. My application for disability benefits went as typical with Sedgwick being summarily denied from day one through the appeals process. A high level summary of my particular experience follows:

    In June of 2018, I checked myself into a hospital emergency room for an uncontrollable drinking problem I was having and seeking help for. I was subsequently admitted to a detox center for seven days followed up with a substance abuse rehabilitation program for another 60-90 days. From the beginning I provided Sedgwick with everything they asked for in good faith to the best of my ability. I only attended approximately 30 days in rehab, as I was forced to return back to work early due to the unexpected financial situation I found myself in after being summarily denied disability benefits by Sedgwick. Shortly after returning to work, early than recommended by my treating physicians, I developed a rupture in my large intestine (along with sepsis) which required emergency colostomy surgery. Six months later I underwent another surgery, to reverse the colostomy, all of which could have been avoided had Sedgwick acted in good faith with my disability claim to begin with.

    While I finally received my disability benefits through the appeals process six months later, is there any additional legal recourse for damages I may or may not have against AT&T and Sedgwick? I am afraid the answer is most likely not under ERISA from what research I have done on-line.

    AnonymousFeb 12, 2020  #894

  • Natalie, I am sorry to hear all that you have been through and for Sedgwick to be treating you like this. Please contact us so that we can discuss your claim. We will desire to review the correspondence that Sedgwick has sent you.

    Alex PalamaraFeb 5, 2020  #893

  • Following the sudden death of my husband, my short term disability was approved by Sedgwick. Fast forward 3 months and I’m back at work. I receive a letter saying that my STD is now denied and they want their money back in 30 days. How can they change their minds like this. This is adding salt to the wounds and is stressing me out!

    NatalieFeb 5, 2020  #892

  • Raymond, long-term disability is voluntarily elected and paid for by the employee in many cases. If you chose not to elect it or enroll in it during the annual enrollment period you may not have long-term disability coverage. You should contact your human resources advisor and ask them about the long-term disability plan and if you were enrolled.

    Cesar GavidiaJan 22, 2020  #891

  • Hi. I’ve worked for Wal-Mart since 2016, I was diagnosed with a 100% blockage in my right leg, after weeks of test I finally got the surgery and yes Sedgwick approved my loa and std. Since then I got a major debt in my right leg from groin to ankle, I was put on blood thinners which caused me to bleed then I had a heart attack a few weeks ago. They took me off the blood thinners for now, but during all of this my 12 weeks are up my short term disability is done, and Wal-Mart and Sedgwick say I don’t have long term. I’ve fielded for unemployment benefits, I have no income and I’m not out of the woods on my health.

    Raymond C.Jan 22, 2020  #890

  • Robert, we hear you with your thoughts on Sedgwick. They can certainly make these claims difficult. Unfortunately, a lawsuit might not be able to be filed until all the administrative remedies are exhausted. So one might be tasked with dealing with Sedgwick until all the appeals have been filed and denied. Please do not hesitate to reach out to us for a free consultation to discuss your claim.

    Alex PalamaraJan 1, 2020  #889

  • After reading so many comments here, I am wondering why anyone continues to attempt to deal with Sedgwick? Sedgwick should be considered irrelevant to resolving a problem. The claimant should bypass Sedgwick and directly sue the company at fault. It is far better to take one’s chances in front of a fair minded and unbiased judge or even an unbiased arbitrator that is appointed and paid for by the court instead of dealing with such a biased company whose sole purpose is to represent their clients and do anything to save them money – claimants be damned! The court system is the only way in which an honest claimant can seek protection from Sedgwick practices. Companies who claim to be ‘reputable’ and value their public opinions should also be exposed for using Sedgwick.

    Robert J.Jan 1, 2020  #888

  • Kevin, it appears Sedgwick is arguing a lack of “objective medical evidence” to support restrictions and limitations and in doing so acknowledge the Vitamin D deficiency but argue there is no basis to for restrictions and limitations on account of same. This may be your final appeal with Sedgwick so it is important to make sure all potential information to support your claim is submitted. Please contact our office to discuss your claim in greater detail and to determine what assistance we may be able to provide.

    Stephen JessupDec 23, 2019  #887

  • On August 2018. I had become sick, with symptoms of fatigue, muscle pain, dizziness, and a doible ear infection. I started seeing my doctor, and was given several doses of an antibiotic, over a couple of months, going back after a few weeks and then taking another one. By October, 2018, I was feeling so bad with the dizziness, that I was getting nauseous. I started calling off at work, or showing up for work and leaving after about an hour or so. I was now losing weight, going from a health 213, down to 179 by mid December, and then another 29 pounds by March of 3019. I couldn’t stand up or walk, as went on FMLA on October 26th, 2018.

    I had seen my doctor about 12 times from August thru December, had a CT scan on my head, had an MRI, saw an ENT, had a biopsy, and was finally diagnosed with a vitamin D deficiency. I went back to work on mid December, 2018, after being out for 9 weeks. After sedgewick declined my first claim, stating I only had an ear infection, my doctor wrote a letter outlining all my symptoms, and they didn’t bother auth the note, they only look at test results. After my second appeal, they finally acknowledged that I have a vitamin D deficiency. Then they declined the claim once again. I’m now on my final, final appael, and the still don’t recognize the symptoms as being debilitating. My job requires that I drive power equipment, and be able to lift 50 lbs. By the way, my doctor has written 5 letters to them, each one starting I was under his care, and I was to be excused from work for the 9 weeks.

    Thanks, Kevin M.

    Kevin M.Dec 23, 2019  #886

  • I have been fighting Sedgwick now for almost a year but cannot find an attorney willing to work with me all due to the fact I am back to work now. I had three separate doctors telling me to stay out of work until medically cleared by a neurologist. Ok it started with surgery on Feb 6 and then a fall two weeks later where I hit my head. I was having intermittent vertigo which I wrongly attributed to the shoulder surgery. I was unable to return to work as the computer screen would trigger the episodes. I tried when I couldn’t I reopened the short term disability due to the fact they refused to make it a new case since it was within 30 days for surgery case.

    I could not drive, I could not walk across the room without assistance. I experienced over 100 episodes of severe dizziness a day there was no way I could be at work but apparently cause I dont work with heights Sedgwick says I could be at work. They have created so much damage to my family financially it will take years to recover. I need help they have ruin my work reputation and at this point its about them doing the right thing.

    Debra W.Dec 9, 2019  #885

  • Tara: Is this a claim under the Family Medical Leave Act (FMLA), if so I suggest you contact an employment lawyer to discuss your issues. If this is a disability claim, although it doesn’t appear to be, I suggest you contact our office and speak with one of the attorneys to address the specific questions you have regarding your situation.

    Jay SymondsDec 6, 2019  #884

  • This is my second time (two different issues) with Sedgwick. The most recent one was enough to make me want to be proactive about their crookedness. My daughter became ill on Oct 1, 2019 causing me to miss work. When I noticed that we were in for the long haul (Oct 8, 2019), I called to open an initial claim. I was told by the rep that an emergency room diagnosis isn’t valid unless she was hospitalized or for obvious reasons like broken bones. Apparently, syncope with fainting spells up to 15 minutes (which caused two concussions in a week time frame) isn’t valid. When I finally got all the specialists to agree that she had syncope, it was Nov 5. I opened my claim that day, paperwork back to them within 2 days. I was denied 5 days in October, while taking her to specialists, her physician, and such. I am at risk of loosing my job because these people do not do theirs. Now, they told me I am not allowed to apply again for this issue or appeal it. I have all of our correspondences. And my rep will not return emails in a timely manner. I have asked to speak to her supervisor and was never contacted. I called, got her voicemail and then it hung up before I could record it, 6 times.

    Even my company I work for are appalled because I never kept them out of the loop, even giving them the dates (and I know my HR person forwarded them to her as well) so they can pull the calls. Now they are asking me for times because they don’t want to do their job and look for the calls. I told her she has the dates and she can pull the calls, I shouldn’t have to go through my bill and pull times. I am in fear of loosing my job and I am almost positive I have been having anxiety issues and depression because of this woman. I see my doctor about it on Dec 12 because I am having a hard time dealing as this point, with a company who changed what they say every other correspondence on top of dealing with a sick kid, 4 other kids, finances, and work. This is the worst company ever. I even submitted over 1,000 pages of doctor appointments via fax, including dr reports. My upper management said they would even submit letters because it is not right what is happening (after the labor board said to) and they still will not let me re apply or appeal.

    Tara H.Dec 6, 2019  #883

  • Get an attorney immediately! Sedgwick is horrible. I have been dealing with them without an attorney for almost five years because of a crushed foot. I have an attorney now. Also if the injury is bad enough time for SS disability right away. I was dumb and waited 3 1/2 years and now I am waiting for an appeal decision. It took 18 months to get a hearing. Sedgwick worships the almighty dollar and does not care one bit about people. They will try to screw you over in any way they can. They don’t care if you become opioid addicts (I refuse them) so that you can return to work. They don’t care if you are in pain. My latest Controversion says that I am stable enough to return to my job at greeter. Well I am not and have never been a greeter and that position does not even exist in the company I work for. They do not care. GET AN ATTORNEY right away. Do not Sedgwick or any other company being paid by your employer to do what’s best for you. Learn from my stupidity. Hire an attorney and save yourself a lot of grief.

    Mary Lou W.Nov 24, 2019  #882

  • Tonya, if you have received a denial letter from Sedgwick you will need to file an appeal. If you have not, they likely have additional time in which to make a decision on your claim give your date of disability. I suggest you contact our office and speak with one of the attorneys to address the specific questions you have regarding your situation.

    Jay SymondsNov 16, 2019  #881

  • I work for Walmart and the fight with Sedgwick is crazy. I been out since 10/29/2019 and they tell me my doctors didn’t give a good enough reason ls for me to be out even though I had a adrenal crisis at work and ended up in the hospital. My doctor put me out of work for the month as of now because I can’t lift heavy stuff. I’m a service manager in auto and it’s not an easy job to not be able to bend move have pain shooting threw my back to chest and not be able to get up and even be able to move do to my body is in an adrenal crisis but Sedgwick says that’s not a good enough reason to approve my short term disability and they never reply back to calls. Just keep says it’s under review and they are not very respectful to anyone who calls them and they really don’t care if people loose everything they have.

    TonyaNov 16, 2019  #880

  • Steven, Sedgwick can be very difficult to deal with. I am sorry they are denying this final two weeks of your short term claim. Please contact us for a free consultation. We can discuss your rights and the steps available. We can also discuss your LTD claim.

    Alex PalamaraNov 9, 2019  #879

  • I have been out on leave for some time now. I have two more weeks to go before Long Term Disability “I’m fighting for that as well”. I have Mollaret’s Recurrent Meningitis with severe migraines. I even have the Neurologist MD doctor write a letter stating I am unable to work because of the severe migraines and the narcotics I’m taking, I’m even taking monthly injections. Sedgwick is denying the last two weeks of my claim stating that my condition is episodic intermittent illness when the letter he sent them states that it’s a constant ongoing condition.

    Steven S.Nov 9, 2019  #878

  • Taylor, you can contact our office and ask to speak to a lawyer. However we do not normally handle Sedgwick claims outside the state of Florida.

    Rachel AltersOct 31, 2019  #877

  • I have been out on leave from comcast since 08/22/2019. I have panic disorder, anxiety disorder and Ptsd. Sedgwick has received all information supporting these diagnosis. Today I was told because of my appearance I did not fit the candidate of a person who suffers. What exactly does a person with these disorders look like? Sedgwick has lost documentation over 40 times causing delay after delay after delay to my benefits. The recording stated my disability claim was approved and than speaking to a rep they denied it. This company makes a joke of the mental health community and they have no regard to the pain and suffering that clients receive. I am looking for representation.

    Taylor B.Oct 31, 2019  #876

  • Gregory, I am sorry to hear all that Sedgwick has put you through. Unfortunately, we have heard similar stories in the past. Please contact us for a free consultation. We will gladly speak with you and review the denial letters you have received concerning your claim.

    Alex PalamaraOct 23, 2019  #875

  • My torment with sedgewick and the cwa local in greenville sc is a long story. I will try to make it short. Well I to deal with these sorry individuals on 2 different claims 4 years apart and the union is as sorry as sedgewick. The first time after colon resection surgery they paid me for a little then stopped, went back to work early and tore my incestions, was out again with no pay and no benefits but got a lady in augusta georgia that got half of my pay for me.

    Then sept 16, 2016 fell off ladder broke my neck and messed up my back 12 disc in all. Att sent me home 5 months later after giving me accomidations and it was a struggle, then they found out I was taking pain meds and sent me home. I got paid benefits 2 months and they stopped paying me. I called them and had to resend all my records again, oh yeah they changed my case worker 4 or 5 times and their excuse for not paying was that they didn’t receive my records (what a bunch of bs) so anyway had records sent and called them back couple days later. Was told records unacceptable, I therefore asked why and was told needed the ones for the last 30 days which hadn’t seen a doctor because I was diagnosed type 2 diabetes and my neck surgeon wanted them under control before doing neck fusion surgery. Then I called union and was told they get back to, called a dozen times before the 180 day appeal process was up which I knew nothing about.

    I called the union numerous times and finally got a 3 way call with vice president and president and was told my 180 days was up and that they wasn’t chasing that rabbit for me. So that my rim job from these sorry sobs. I was told I could sue the union for non representation and I hope to sue sedgewick and maybe att. If I don’t get any money these folks need to be held accountable. Oh they went back and did a 3 year audit on my vacation and said I owed them over 300 hours back pay which they deducted from my check before they sent me home. Come to find out my old boss had coded my sick leave as vacation for the colon resection surgery 3 years prior. But I got it down to 97 hours and couldn’t prove those hours. If Mr Dell wants to call me please do. I still haven’t had my neck surgery or back surgery and I’m ready for some releif.

    Gregory G.Oct 22, 2019  #874

  • Lynette, you should contact a workers compensation attorney who could assist you.

    Rachel AltersOct 12, 2019  #873

  • I fell on ice at while working for FedEx Express and Sedgwick will Not pay for the medication that I need to get function without muscle spasms.

    LynetteOct 11, 2019  #872

  • Regan, at this point hopefully they have enough to approve the claim and pay you the back benefits owed. Unfortunately, there is not much that can be done to expedite their decision making process. If you get another denial I suggest you contact our office and speak with one of the attorneys to address the specific questions you have regarding your situation.

    Jay SymondsOct 9, 2019  #871

  • Like many others, my employer uses Sedgwick to handle claims for any leave of absence. My job proviodes 16 weeks paid maternity leave after you give birth. Unfortunately due to high blood pressure and some severe anxiety with my pregnancy andb my doctor recommended I take off a few weeks before my due date to rest and prepare of the birth of my first child. My last day of work was 8/6 and I gave birth on 9/4. I filed a STD claim for the days between 8/6-9/4 and then opened my claim for my maternity leave. A week after bringing my baby home I am thinking everything is great and I will get paid soon..I contact Sedgwick only to find out BOTH of my claims have been denied. The stated they did not receive documentation from my doctor, and I do not qualify for paid maternity leave until my STD claim is approved. I quickly made an appointment with my doctor and we filled out the paperwork and faxed it back. I did get confirmation they received it.

    I was supposed to get an answer in 72 hours and today (10/8) I am notified that the medical documents need further review and it will be 5 more business days. I am a single mother and I have been out of work for two months with no pay and one month at home with a newborn with no pay. I am terrified after reading so many other complaints from other victims that I will be denied for whatever reason and I will have to continue this battle. I have bills stacking up with no income and a baby feed. Please I need help. I am on the verge of losing my home and I have no way to pay for daycare so I can go back to work.

    Regan D.Oct 9, 2019  #870

  • Sedgwick does a phenomenal job.

    It’s very simple. Short-Term Disability is an employee benefit, not a legal right. Medical documentation is required to substantiate a company paying you to not work.

    You’d be surprised how difficult it can be for people to provide even the most basic information about their medical care. Efforts are made daily to obtain information needed to support a claim decision.

    When over 300 of the Fortune 500 use Sedgwick for their claims management, you have to ask yourself who knows what they’re doing? The majority of America’s large employers or some law firm?

    The Sedgwick GuyOct 4, 2019  #869

  • Has there ever been a class action law suit brought against Sedgwick for their actions toward injured workers? There are so many stories about Sedgwick’s negligence but if they are never held accountable they will continue doing their bad behavior.

    JennskiiOct 3, 2019  #868

  • Rose, I am sorry to hear of your loss and of the additional stress Sedgwick has caused you. The fact that they based a denial on your claim being subjective is somewhat comical as most mental health claims are subjective in the sense that there is no blood test to prove depression. However, your claim has factual evidence in the form of your noted loss of father. Either way, regarding your disability claim, an appeal can be filed to challenge the denial of benefits. If the denial is upheld, you can file a lawsuit though the lawsuit will be against your employer as your policy seems to be self-funded by your employer. Your lawsuit will likely be limited to the benefits they should have paid you as the ERISA laws that will likely govern your claim do not allow for punitive damages.

    Alex PalamaraSep 12, 2019  #867

  • My father passed away on July 31, 2019 while I was on vacation, then on 08/01, I asked my manager if I could use my 3 bereavement days the following week 08/05-08/07 and take 5 additional vacation days to return to work on 08/14, the request was approved. After that time off, I still was having severe grief and I could not perform my job duties, I was not well enough to do so. I exhausted my bereavement and vacation time before initiating a short-term disability claim. I called my doctor on 08/08 and provided her with my symptoms, my doctor put the claim in for 12 days of short-term disability (08/15-08/30). Sedgwick denied my STD Claim for F43.21 Adjustment Disorder with depressed mood (Complicated Bereavement).

    New diagnosis on 08/28 of Acute Stress Disorder (F43.0) stating that the information provided by my psychiatrist was “subjective”. My mental health is not subjective, the symptoms are VERY REAL. I am currently in the Appeals process with Sedgwick but they are playing games stating they need more information and that they’ve called me even though I have no missed calls or voicemails (this has been going on since 09/03). I’m beside myself because I have bills to pay. I realize it’s only 2-1/2 weeks but my therapist felt I went back to work to early and was forced to do so by Sedgwick denying my claim. Is there any Legal action I can move forward with as mental health issues are not something they should be denying, especially when my company promotes Mental Health Awareness?

    Rose C.Sep 12, 2019  #866

  • Eric, you can sue your employer in small claims court if your STD is denied. Otherwise you will be paying a lawyer too much to sue over 3 weeks of back pay.

    Rachel AltersSep 1, 2019  #865

  • My claim is small only 3 weeks of benefits and was denied. I was unable to find any lawyers willing to take on the claim appeal and was advised to do it myself. I’m not a lawyer and I did my best but knowing Sedgewick my best will be nowhere good enough and I’m just waiting for my denial notice. My job depends on me winning and I know that I’m not going to. I feel like I’ve fallen into the Sedgwick and AT&T trap because it took 4 months for AT&T and Sedgewick to get me a chair that I requested through a accommodation which would of allowed me to work. Now I have no idea what to do with a pending appeal denial and termination in my future. Now that I finally got the new chair I have been able to work but I fear it will not be enough.

    Thank you for your time.

    EricAug 31, 2019  #864

  • Robbie, whether who is right or wrong (I am assuming you are in the right as I see games played all the time by the insurance companies and claim examiners), the next step you must take is filing an administrative appeal to challenge the denial. Please contact us so that we can discuss your claim with you and hopefully help you get your claim approved.

    Alex PalamaraAug 16, 2019  #863

  • My name is Robbie and I have been on LOA since July 23, 2019. I have filed a claim with Sedgwick, and they denied the claim. I was supposed to return my certification back to sedgwick at a specific date. I kept in contact with the sedgwick claimer about my doctor doing further testing on me, therefore, I could not get the form back in time. I kept communicating with the claimers and I told them the situation. In turn, they told me that my claim would be denied, but they could overturn it when I send the paperwork in. But they did not. She told me that I was denied because I did not turn the paperwork in on time. But I did not know that my doctor had finished the paperwork before the due date.

    Now, they had a different due date for me, one was for August 7, and the other is for August 8. So I did not know what date was the right date. Second, I kept the claimers updated on my situation, and they reinsure me that I had enough time to turn it in. Am I in the right?

    RobbieAug 16, 2019  #862

  • I work for Verizon and I continue to get the run around regarding my claim. First my FMLA was Apporved but Short Term wasn’t due to dates. After contacting the examiner because I never was told my claim was denied until I didn’t receive my paycheck I was told to have them resubmit with correct dates which I did. Next they said we are missing medical information which was on the prior paperwork sent. I’ve called over a dozen times asked for manager and they say I will he contacted within 24 hours but I’m never contacted. I submit request online for a call back and nothing. Today 8-14-19 I was told Nicole “the manager” is in however she just stepped away for lunch but she will return your call today, this was at 2:45 Eastern. So at 4:47 I called back and they said the managers all have left for today.

    I’m so frustrated. MetLife never treated me like this regarding my claims. I ask for help and I’m not receiving anything. I honestly don’t know what to do. Nicole- Manager and Jennifer L. Need to be reprimanded regarding their service. They have caused me so much more stress on top of the medical issues I don’t understand why they treat people with so little regard. I understand if your busy and have a pile of things on your to do list however time management and honesty goes a long way in my book. This company is a joke and I would never recommend their services. I was told by my HR rep that many Verizon employees are experiencing the same scenario so hopefully we end our contract with them. Hopefully EVERYONE Terminates Contracts With Sedgwick!!!!

    FrancoAug 14, 2019  #861

  • Eric, if you have an issues with your employer then your need to contact an employment lawyer. We handle only issues with private insurance carriers.

    Rachel AltersAug 12, 2019  #860

  • I was in training from Nov. to mid Dec. 2018. In mid Dec. I was sitting in the chairs provided at work on the production floor and my back started to hurt with pain. My Doctor thought I should request a sit standing station which we did through a work accommodation and it was given to me Jan 4th, 2019. I went back in training for another week starting January 14, 2019 and did not have any issues. During training we would go back to the production floor and that is when I noticed it was the chairs on the production floor causing my back to hurt. I asked my manager at the time for a chair from the training department and was told it would be investigated. At the same time, I went back to my Doctor and we requested a work accommodation for a new chair. The work accommodation was approved by a 3rd party Sedgwick on Feb. 1, 2019. One week I tried to stand for the full week and finally sat down after 4 days of standing and within 10 minutes my back was in enough pain I couldn’t stand. After each episode it would take 6 to 10 days for my back to relax enough for me to get back to work where I would start the cycle all over again. I asked several times for a status of the chair and sent several emails to my case worker at Sedgwick. My new manger even asked if he could go down to training and get one and was denied every time. My employer either denied me getting the chair from the training department or told me they have no idea what I’m talking about when it came to the work accommodation. Sedgwick kept telling me it was approved and waiting departmental review. Meanwhile come early May 2019 I had used all my FMLA time, then was advised to apply for short term disability which was denied. On June 7th I received a call from my employer to see what type of chair I needed. I told them the one in the training department is all I would need. I was promptly advised they would go down and get me one and it was there waiting for me on June 10th, 2019 when my doctor released me back to work. I have not had issues, since then.

    In the meantime, I was using all my vacation time to help cover lost wages and took out loans against my 401k and pension plan to help cover the loss of income. I was willing to let this all go because I was back at work and doing fine, but I was informed on August 5th 2019 that since my disability claim was denied I would have to file an appeal, and win because they said my doctor did not include the missed time in my work accommodation. My impression of the meeting was if I didn’t win the appeal, I would lose my job. I went back and reviewed the forms my doctor filled out and the dates in question are on the forms. My doctor did include the missed time on my work accommodation. Is there anything that can be done? I feel I have been put through a lot of pain and suffering, lost wages, lost vacation time, and lost retirement benefits, all for a chair that was in the building. I finally got the chair 4 months after it was requested.

    EricAug 12, 2019  #859

  • T. Smith, I am sorry to hear all that you are going through. If you have a short term or long term disability insurance claim and would like assistance with such, please feel free to give us a call.

    Alex PalamaraAug 2, 2019  #858

  • I was injured at work from repetition over the 21 years I was employed. I was denied by Sedgwick so ended up using my own medical insurance to pay for three surgeries. I was supposed to have four but after the third surgery I was released to work 1 armed by the surgeon on the third day after the procedure. During my return I injured my back (it’s hard to do work with one arm obviously). So great… another claim. My back injury became so painful I went to the ER. I was diagnosed with sciatica and went to an orthopedic. He scheduled the fastest surgery (after an MRI ) that was possible. I could not even walk. Sedgwick denied this claim as well. One good thing was they didn’t take over 180 days to deny the second claim like they did the first one (sarcasm). So again, I paid and still to this day have received nothing. I could afford another surgery on my hand, so 5 surgeries later they still have not helped me. I am now out of reserve funds to get the treatments I need to be able to have some sort of pain reduction. I am suffering and it has been around 2.5 years since my initial claim.

    The man I was is gone. Depression and anxiety have taken over. The worsening pain is getting unbearable at times. I’m so inactive because of these issues that I have been stricken with other health issues. They scheduled me for two IMEs of which I completed one. They did generously pay mileage for the exams ( more sarcasm). I had to stop all pain management treatment and further surgery because I am out of funds and actually owe medical expenses that are going to collection soon. They spend money on private investigation but won’t help the injured. They don’t seem worried about what they do to honest and hard working people. It’s criminal racketeering in my opinion. No income is a great weapon against someone who has bills. Luckily, I have made it this long. What happens to people that may not have saved for a long time and have little credit? Just imagine. Shame.

    T. SmithAug 2, 2019  #857

  • Mel, I am sorry to hear all that you are going through. We assist people with claims for Short Term and Long Term disability benefits. Please contact us at your convenience and we will gladly give you a free consultation. I will also send you an email. -Alex

    Alex PalamaraJul 31, 2019  #856

  • Yet what appears to be another Sedgwick victim. I was injured at work as a work comp claim. They closed my comp case even tho I was still injured. I’ve had 3 doctors and a physical therapist tell them something is wrong with me but they still closed my case. Now my employer wants me to file short term. I’v been injured and in pain for 3 months now. I don’t even know what yo do anymore.

    MelJul 31, 2019  #855

  • Daniel, I’m sorry to hear that. If you need assistance with a disability claim you can contact out office at 888-729-3355

    Rachel AltersJun 21, 2019  #854

  • I was injured at walmart, possibly a torn MCL. After reporting my injury my manager had an employee wheelchair me to the nearest clinic where they assessed me at the time. Then Sedgwick informed me the clinic my manager had instructed me to go to one of the Segdwick clinics and now I’m stuck with the $4000 bill, all for following instructions given to me by my manager.

    DanielJun 21, 2019  #853

  • Ron, is this in regard to a Worker’s Compensation claim? If so, I suggest you contact a WC attorney in you area to discuss you claim and situation.

    Jay SymondsJun 20, 2019  #852

  • I was injured on the job while employed by the Martin Brower Company in 2014. My experience with Sedgwick was and still is horrible. No matter what treatment my doctor recommends, Sedgwick will deny it. After 4 years of my doctor requesting treatments to my back, Sedgwick removed the doctor from their network. Now i am fighting to see a doctor. There has to be a way to put a stop to their on going denials and hold them accountable.

    RonJun 20, 2019  #851

  • Jennifer, this is certainly unfair and egregious conduct by Sedgwick. I suggest you contact our office and speak with one of the attorneys to address your situation.

    Jay SymondsJun 19, 2019  #850

  • This is my story with Sedgwick starting back in October 2018:( I posted the following on their Facebook page today!

    “This company has been nothing but a JOKE TO ME WHILE I E BEEN OUT ON MENTAL HEALTH LEAVE!!!!

    It has been next to impossible working with TAFW/Sedgwick:( They wouldn’t approve STD as of last week because their nurse manager was playing phone tag with my counselor for 2 days and gave up. So instead he just Denied Claim! Then I begged my case manager to please have the Manager call back my counselor again (my counselor isn’t in office every day and when she is she has clients all day). Finally I got the news that he finally approved it after making some very OFF HANDED REMARKA ABOUT ME TO MY COUNSELOR!!!!HOWEVER he is NOT Honoring the 8 Day Grace Period from when HR and my own Boss and I talked about going back on leave 4/22/19 (my first day off) because HE said I didn’t get an appointment with my counselor right away!!!and there is No Medical Documentation stating that I wasn’t ABLE TO FOCUS AND WORK.. ha! You Dumb asses!!!! I was just on STD for the same Damn Reasons and it was my VERY OWN HR Rep that suggested I use my BENEFITS AND GO BACK ON LEAVE BECAUSE I COULDNT FOCUS AMD I CLEARLY CAME BACK TOO SOON!!!!!! I’ve been battling since at least October! They know this! !!!!

    Well No I didn’t schedule an appointment right away… why???? SCHEDULES didn’t allow….. !!!!!! they are horrible over there ? Since when should an employee be punished for not being able to get into appointment!!!!! and have the 8 Day Grace Period Not start from the First Day Missed Of Work Due to Illness? I can’t believe they can do this?? Does this sound even close to right? I’m losing a lot of pay because of this guy Mike at Sedgwick!! ?

    And here I sit again while they Dink around on my Damn Extension and Ive gone without Pay for 3 damn weeks!!!!!!
    This is just SO WRONG to do this to their mental health patients… who are already struggling with reaching out for help!!!and then we have to try and deal with people like YOU!!! I’d rather crawl in a hole and stay there…..they have Never made me feel like it was okay to be trying to get help:( I’m so blown away by the treatment:(

    The first Leave I was on I was pretty much pushed and pressured to go back by my case manager!!! And my Therapist Said the same thing!!!!

    Do you know how many years or months it took me to even get the COURAGE TO GET HELP?!!!!!! And all I do now while on LEAVE IS SIT AND WORRY ABOUT SEDGWICK AND IF I WILL GET MY PAYCHECK TO PAY MY BILLS?!!!!


    But YOU GUYS DONT CARE AT ALL!!!!’ HOW DARE YOU DO THIS TO ANY PATIENT!!! Let alone your Mental Health Patients!!!!!


    YOU SHOULD BE ASHAMED OF YOURSELVES!!!!!! I truly wonder how much Blood is on your hands ! Especially with The Mental Health patients your are treating like crap instead of reassuring us that you have it handled and we should just focus on GETTING BETTER!!!!!

    Jennifer F.Jun 19, 2019  #849

  • Sedgwick In July 2018 with coordination of Fiat Chrysler Management had forced upon me Medical Leave without Doctor certification and continues to claim legal cause for this action. Furthermore Sedgwick with Fiat Chrysler Officials had paid myself the benefits of total disability all while no doctor certification occurred. Sedgwick Case Manager Toni Walsh refused and denied communication from August 15, 2018 forward to this point in time and continue to commit Illegal acts including ERISA violations.

    Keith KJun 19, 2019  #848

  • Kenneth, I am sorry to hear of all the issues you have had with your claim. Please feel free to contact us for a free consultation. We will request that you send us a copy of each of the denial letters and the policies that are governing your claims. So please start gathering that information.

    Alex PalamaraJun 12, 2019  #847

  • I have filed a disability claim with Sedgwick due to me being diagnosed with colitis. The first rep I spoke to from Sedgwick called me cause my form was filled out incorrectly and that was within the first two weeks of me filing my claim and that rep clearly said I just need you and your doctor to refill out form cause it was filled out incorrectly and I clearly asked the lady do I have to send anything else in with this form cause this is my first time filing a claim and she specifically said NO. So I went along with that. 2 weeks later I get denied saying there is not enough information to support my medical claim so now I had to fill out an appeal which can take longer and I called Sedgwick and advised them I was misinformed that I didn’t have to send anything else in meanwhile now I gotta do an appeal which this is not my fault.

    Meanwhile I haven’t got paid in two weeks so they said the appeal can take up to a month so now I faxed all my medical records, cat scans, my colonoscopy paperwork which I had scheduled in 2 weeks and documentation from me being at the emergency room two times and also documentation from my GI doctor which stated for them to keep me out of work for my colonoscopy later that month and I was still in pain and also I didn’t have anymore personal time cause I had to use it to get paid when I first started my claim which is “THE WAITING PERIOD” so now I had my colonoscopy and a week after that they called me and denied me again and I’m telling them I sent all my medical documentation and I don’t know how I’m getting denied.

    When physicians look over my clain and its takes 3-4 weeks for my inflammation to go down and on top of that I have a colonoscopy procedure scheduled and my doctor documentated for me to have all this time from work excused due to the recovery time and the physician should know that and then they asked for my colonoscopy results so I had to go back to the doctor office to sign off for them to release my results to Sedgwick and they said once they recieve it it will take 5 buisness days for a decision. So now all this time has passed meanwhile I haven’t got paid for a month now and they still reviewing my info and now its time for me to go back to work and they deny me again. Say I should of went back to work and I’m telling Sedgwick how do yall expext me to sick at a desk while my intestines are inflammed and I’m having frequent flare ups and the orginal pain medicine I had wasn’t strong enough and after all this I need somebody else to help me CAUSE AT THIS MOMENT I AM DONE WITH SEDGWICK AND RECOMMEND NO ONE I MEAN NO ONE DO BUISNESS WITH THEM!

    KennethJun 12, 2019  #846

  • Jim, I am sorry to hear all that you went through with regards to your claim. The advice you are giving is very wise. If your claim is ongoing or if there is any way we can assist you, please do not hesitate to reach out to us.

    Alex PalamaraJun 11, 2019  #845

  • I too went through Sedgwick hell from 2012 through 2014. You name it and they tried it. They lied about paperwork and tried to strong arm my doctor. They know every stall tactic and every loophole. The best advice I can give anyone battling Sedgwick is get a dedicated note pad and write down or if legal in your state record everything they say. Make notes on who you spoke to and what they said and the dates. Find a good doctor. If your doctors office doesnt communicate well with you or Sedgwick then find one who will. Most importantly hire one of these lawyers. Sedgwick will not take you seriously until you have an attorney. Dont be surprised by anything Sedgwick tries and understand that you arent the only one going through this.

    JimJun 11, 2019  #844

  • I need to bring to light the despicable nature of Disability Insurance in our country. For the last three months I have been in a never-ending conversation with over 50 different individuals who all have access to my husband’s claim, yet none of them provide accurate information as to what’s actually happening.

    We’ve been dragged through this whole process for three months. The examiner has repeatedly denied his claim based on “missing information”; and when we call them to inform them the necessary forms were sent in weeks prior, they somehow “magically” find them just sitting in his file. After multiple claim denials the examiner finally approved my husband’s initial claim through the middle of June, even though the supporting information our doctors provided listed the first possible return-to-work date as being at the end of August. We’re now having to chase down the doctors from the hospital to obtain further information to possibly extend his claim to the date originally proposed by the physicians. I think it’s absurd that this disability insurance examiner – who probably holds no formal medical training – is able to determine a date months earlier than what a licensed, trained physiatrist determines based on his professional medical opinion.

    We’ve still not received any disability pay for my husband due to the fact that the examiner at Sedgwick, Michael Wolf, failed to inform us of additional information required from a completely different company to process the claim adjustment. Last week we acquired the forms needed to enable Sedgwick to pay my husband and delivered them to the neurologist’s office to fill out and send to the EDD. Once received, the office will take two weeks to process the forms and deliver the results to Sedgwick. Today we just found out my husband’s neurologist left for a two-week vacation prior to filling out the forms. It will be nearly four months that we’ve been a single-income household by the time we see any of the funds rightfully owed to my husband.
    For the amount of control this company has over our daily lives they sure do employ incompetent morons incapable of performing the job they were hired to do. Had we been told upfront all the required information necessary to process this claim, it could have all been handled within a matter of weeks.

    Here we are three months later still dealing with the stresses of trying to figure out a flawed and broken system. I’ve spoken with several people regarding Sedgwick, both the individuals requiring disability and the doctors who have to deal with the disability office, and all parties have no positive words. One employee didn’t receive any disability funds until a month after she returned to work after a two month leave. Seriously? What benefit does this disability insurance company (whose website touts “compassionate care focused on you” – HA! that’s a joke) provide if people are evicted from their homes or can’t pay their bills because of the lack of information provided? The system is flawed… it’s not in favor of the beneficiary who has already payed into disability insurance… and that seems pretty fraudulent to me.

    TJun 11, 2019  #843

  • T, I’m not sure that I see a specific question/request here. I suggest you contact our office and speak with one of the attorneys to address any specific questions you have regarding your situation.

    Jay SymondsJun 4, 2019  #842

  • Worst company ever. I got injured at my job in 2016 and then I got assulted at work in 2017. My case was denied due to the IME saying that it was a preexisting injury. Reopening 16 claim. Sedgewick is asking to close that due to my claim manager is saying it is not work related, she was not there nor is she the doctor. What gives her the right to diagnosis anything. This company has made me lose my job of 5 years. I have lost my place with my kids and living with a friend. Sedwick states that they are here to help the employees get better and back to work.

    HMMMMMM do they pick and choose who they help out.

    TJun 4, 2019  #841

  • R, if your claim was denied by Sedgwick you have the right to appeal it within 180 days of the date you receive the denial letter. I would address all of this in the denial with the help of your doctors.

    Rachel AltersMay 28, 2019  #840

  • I am writing to inquire about the proper process in dealing with the following scenario:

    I sustained a work related injury on the job at a hospital I work for as a nurse. The floor is typically physically heavy requiring staff to do manual patient handling to prevent patients from falling/jumping out of bed. Imaging showed that I’ve developed degenerative disc disease. Through email, my Sedgwick adjuster made a comment that my work related injury did not happen because of the event, but because I was already predisposed because of the degenerative disc disease (DDD). This was before I saw the workmen’s comp neurosurgeon. However when the workmen’s comp neurosurgeon evaluated me, he determined that my injury was in-fact work related. Before the evaluation the Sedgwick adjuster made it seem that my diagnosis would be along the lines of a muscle strain, and that the recommended procedure to elevate the pain from wouldn’t be covered by them or that my claim would be denied.

    I want to know if it is under her job qualifications as an insurance adjuster to make comments that appears was if she is essentially “diagnosing” me, which I felt she had. Or if it is out of her scope because she isn’t a medical professional. If so, what legal or complaints process is there for someone in my position? As I have noticed that the adjuster is not also responding to my emails/messages in a timely manner.

    RMay 28, 2019  #839

  • 6/12/18, I was injured by a sit to stand desk installed by Kroger Speciality Pharmacy facilities employee. Some how it froze and then released and collapsed on my Entire left hand and wrist. They diagnosed me with radial styloid tenosynovitis, de Quervain disease, and mild cubital tunnel. I had surgery to release the tendons and I have been enduring numbness and finger locking. The Doctor release me stating he could not fix that and I never had any issues or history of these problems. At mediation 02/12/19. I requested another physician as I am still having issues. They had 1 week of time to reassign me to another doctor and I have yet to be seen. They are a horrible company the claims lady is never available.

    Tasha SApr 30, 2019  #838

  • Sedgwick handles claims for Target. I slipped in a puddle of water at a Target store and fell really hard. I am not young. This was at the very front of the store, between the doors and cash registers. I don’t work for Target – was just shopping there. Sedgwick reviewed the incident report and said that Target would reimburse me for my medical bills. Just send in all the receipts when my treatment was over. I sent in receipts after 4 months of physical therapy and found out that my claim had been turned over to someone else and now they want FULL access to my medical history and records. Conveniently, the representative that I had been dealing with no longer works there. I’m really not comfortable giving them carte blanche to my medical history so I’ll probably just forget about it and I will NEVER shop at Target again. They should both be ashamed of themselves and what they are doing.

    ShannonMar 27, 2019  #837

  • United Healthcare or Optumhealth employees. I worked in the EAP program and was part of a highly specialized team. I filed a healthcare appeal and had to contact the EBSA; I became blacklisted and eventually demoted although I was a top performer. I had a disability that was permanent moderate to severe shortly after beginning work. Sedgwick and UHG (Optumhealth) ignored the physical health intermittent FMLA and refused to provide my documentation. My experience proved that from the point I went off work the company fabricated a CAP; they said in process although no historical complaints and it shows one year after I was off work. The human capital manager was involved with Sedgwick (she previously worked for them) to make sure my claim was denied. About 15 months later she sent an email to the head of Sedgwick (STD) and The Standard (LTD) and told them to approve my case immediatley. They claim work related issues as their were many privacy violations and breaches taking place. I was emotional as anyone would be so they tagged me and bullied me and used mental health as their mode. I was broadsided by a semi-truck in my last yr of school.

    Sedgwick used medical reports dating back 10 years, yet only allowed me to go back two weeks although the time prior around the time UHG denied the first tx that helped be is what initially led to this chaos. Downright breach! collusion between all companies and the doctors they used would never be allowed to provide services for a client we served. One was a dr who lost his license in 3 or 7 states for drug abuse. He was on Sedgwick’s list as they also use providers listed on SEAK where they pay $395 per year to promote themselves as experts. This is one of the inside experiences. Still fighting, trying to get a attorney to go after the company for a breach and not following ERISA guidelines. I worked with the EBSA when they refused to answer my healthcare appeal which led me to having to go on disability due to the complications they caused in my life. The stress attacked my body!

    STAND UP FOR YOURSELF, ASK TO GO BEYOND HR! INCLUDE ALL ACCREDITING AGENCIES FOR UHG AND COPY THEM ON YOUR EMAILS INCLUDING THE EBSA, IT CARRIES MORE WEIGHT. ONE MORE THING, doctors who review your case are required to be in the same medical field. They had a urologist reviewing my micro-neurosurgical records. Best thing get a attorney…

    Susan H.Mar 3, 2019  #836

  • Marie, it’s great to hear that you were able to get this resolved and get the benefits you deserve.

    Stephen JessupFeb 13, 2019  #835

  • My employer has resolved the issue. They launched their own investigation. This is the first time the employer has used Sedgwick. I truly hope that it is the last. My employer wasn’t aware, they couldn’t pay me until Sedgwick approved my claim. Thank goodness for a wonderful HR administrator to push and the company nurse to follow through.

    MarieFeb 13, 2019  #834

  • Marie, unfortunately Sedgwick makes these types of determinations all the time. They act as if they know more than treating physicians. They are a third party administrator so they aren’t even liable for paying you claim even if you take them to court. Your employer is the one that is responsible for payment. IF you are on good terms with your employer you could see if they could contact Sedgwick to get them to reverse the decision. Otherwise you need to appeal within 180 days. If the appeal is denied you need to sue your employer.

    Rachel AltersFeb 11, 2019  #833

  • My question is, how can a company such as Sedgwick over ride my doctor’s decision to not release me? They are not orthopedic doctor’s. They told me that my condition has not been proven to be a serious enough to not be able to go back to work. Even though my doctor will not release me because I don’t have the control or stability. What can I do resolve this before I lose my insurance? That company needs to be shut down. ASAP.

    MarieFeb 11, 2019  #832

  • Marie, dealing with Sedgwick can certainly be frustrating. However, I don’t see that you have asked a question. I suggest you contact our office and speak with one of the attorneys to address any questions you have regarding your specific situation.

    Jay SymondsFeb 7, 2019  #831

  • Back on 9/4/2018 I had a total left knee replacement. I am still doing Physical therapy trying to strengthen the quads and gain stability and control. It is now 2/6/2019. My doctor is keeping out of work. I see him again 3/13/2019. Sedgwick denied my claim since 1/6/1019. My job consists of standing, kneeling and squatting on concrete while wearing steel toed shoes. 8 plus hours 5 to 7 days a week.

    My doctor has sent Sedgwick all my Records from him and my Physical therapist… I have appealed. Mind you I also have osteoarthritis and a bone spur in my right knee. I can’t stand or sit for a very long time. I have to be able to work in a fast passed environment. I’ve worked for 31 years at this plant. My recovery has been a slow recovery.

    MarieFeb 6, 2019  #830

  • Bill, if your claim has been denied Sedgwick should send you a denial letter detailing the reasons that your claim has been denied and the options available to you to challenge the decision. If you have not received the letter you should contact Sedgwick to request a copy of it.

    Cesar GavidiaFeb 5, 2019  #829

  • Hello I just checked my claim status see any updates happen and know it’s coming up with this kinda of terms I don’t understand.

    Is say that my claim been Status: Open-Terminated-Early intervention Do I have to make a new clam?

    BillFeb 5, 2019  #828

  • Shelly, I’m sorry that you went through such a horrible experience with Sedgwick and were disrespected. Sometimes their calls are recorded and monitored for quality assurance purposes. You may request your husband’s claim file and request any and all audio recordings of all telephone conversations relating to his claim. You have taken the proper action by reporting it to his supervisor and to your HR department. You should do so in writing as well.

    Cesar GavidiaFeb 5, 2019  #827

  • My husband was admitted to the hospital in ICU in a medically induced coma due to heart complications from a previous infection and heart surgery. He was in the hospital for a month. All of the information Sedgwick sent to me was filled out by the Dr and signed by the Dr and nurse practitioner. The forms were faxed to Sedgwick twice. I myself sent a photocopy of the forms to them via email twice. I was told none of the info was received. The day after the deadline, I recieved a call from the examiner saying he had finally received my email but the claim had been denied because it was signed by a nurse practitioner.

    I appealed the claim and after going around and around with them for 2 solid weeks, it was finally approved. However, they ignored the fact that my husband was still recovering from heart surgery and a host of complications from being sedated for 14 days. He is still unable to walk unassisted an has to be transported via ambulance to and from his dialysis appointments (he was on dialysis prior… has nothing to do with the current situation). So they only approved the claim through January 31. I contacted the examiner and explained that as stated in previous correspondence, my husband is unable to return to work and I asked what was needed to extend the date. I was told simply to have A DOCTOR fax in a letter stating that he required additional time. His nephrologist was the simplest solution as he would be seeing her that very day. She faxed them a letter stating that due to his recent hospitalization and being sedated for so long he has been left in a weekend state and is unable to walk or stand unassisted and requires ambulance transport. She requested that he be allowed an additional 4 weeks to recover as he is still under her care along with 3 other specialists (ie cardiologist, pulmonologist, etc). I proceeded to also upload a copy of the letter to their webpage within my husband’s file so as not to have a repeat of the initial forms.

    I received a call from the examiner once again saying they can’t accept what was sent in because it was signed by a nurse practitioner. I told him to look at the letter again. It clearly stated that she signed it because she was the one that transcribed it and the doctor’s signature was right beside hers. So then he goes on to tell me that in that case he can not accept the letter because it doesn’t tell him why my husband needs further time off work. I explained that as stated in the letter he was left in a weekend state and can not stand or walk unassisted. The examiner told me he could care less how my husband has to get to dialysis. His concern is why he will not be going back to work since his claim only covers through January 31.

    I asked if he’d like my husband to take an ambulance to work as well, to which his reply was, “get to work however you can. the rest of us do!” I contacted his supervisor and not surprisingly she gave me the run around too. It has been 2 months since I initiallly opened an STD claim for my husband and we have yet to see a paycheck. We are 2 months behind on mortgage, car insurance, medical bills, all of our regular bills and unable to go to the Dr or get meds filled for my daughter or I as he is the sole income. We are also getting threats of being sued for lack of payment on some bills. I have filed a complaint with HR and been told they will look into it. I want this guy held accountable! I have had to file numerous claims over the years for my husband through other companies that his employer has had at the time and never had a problem like this. This HAS to stop!

    ShellyFeb 5, 2019  #826

  • Linda, you should review your disability policy to familiarize yourself with any limitations that could apply to your claim. Sometimes work related medical conditions are excluded from coverage in short term disability policies. Work performance will be affected when you are disabled from a medical condition and it is not the same as the work causing your symptoms. Your doctor needs to make that clear.

    Victor PeñaJan 31, 2019  #825

  • My company uses Sedgwick to handle disability claims. I am applying for partial short term disability due to mental heath issues (panic attacks). I noticed that on the providers Statement there are questions asking if I have expressed concern over things such as: Conflicts with supervisor, Recent unfavorable work evaluation, Dissatisfaction with the job

    These seem like strange questions to me, and I am concerned that the information could somehow be used to deny my claim. Ie: Could they say my anxiety is due to conflicts with my supervisor or a poor evaluation, and therefore not eligible? I feel like it’s really the opposite, and my mental health issues are the reason for the drops in my performance.

    Thank you for any advise.

    LindaJan 30, 2019  #824

  • In a few months my situation will reach its 2 year mark. One day out of the blue I started having some intense and unexplained medical symptoms. I have been 100% transparent with my employer from day 1 which is probably why I still have a job. I was out on FMLA for 2 months because both my claims for short term and long term disability were denied including the appeals. The reason for denial was always the same, “no diagnosis”. Sad part is that I still haven’t been able to find a doctor who cares to figure out what is wrong. I have learned to manage some of the symptoms and have worked my way to be able to manage working 4 hours a day and usually 5 days a week.

    I was given a temporary job change until medical answers can be found. My medical debt is beyond scary and every month is a gamble being able to pay for bills and food while only making half my pay at best since my primary doctor is providing work restricts due to obvious limitations. My HR rep wants me to try and reapply for short term disability again hoping that the length of time and no improvement will be enough to get my claim approved. Unfortunately, I’m not so confident as my experience with Sedgwick and the medical community has shown me that no one actually gives two @#$%# about me in any way. No diagnosis = 100% healthy.

    And my medical insurance is 100% OOP until annual deductible is met. This really helps when trying to get medical help, right.

    AleciaJan 11, 2019  #823

  • DJ, you should consult with another workers compensation attorney to determine your next best steps.

    Victor PenaJan 4, 2019  #822

  • I worked for Extra Space Storage for nearly 8 years, perfect attendance and a loyal employee. I got hurt at work and told my supervisors who did nothing for 3 weeks. Then the real nightmare began bc Sedgwick was involved. Elizabeth Ayala is my adjuster and she is a drain on the system. She could care less if I get better or not. She wouldn’t talk civilly to me or my wife so I hired an workers comp atty, that was a joke. He never appealed any of the denials. I fired him.

    Now I deal with their attorneys and its a joke. A year has passed and now I am being told my injuries are part of getting older? I have 3 areas of hurt and only 2 have ever been addressed. I am saddened by this clusterfluck of a broken system and need direction.

    DJJan 3, 2019  #821

  • Jennifer and Tim, I hated reading your story. It is the reason why we chose to fight disability claim denials. Please contact me at once. I want to review Sedgwick’s denials and I wish to speak with you about available options. We can also discuss your husband’s potential long term disability claim. – Attorney Alex Palamara

    Alex PalamaraDec 8, 2018  #820

  • Literally the worst experience of our life. My husband woke up one morning and his legs were so swelled he could not walk. He waited and waited to see if the swelling would decrease, no such luck. Went to E.R. then referred to PCP. Then referred to surgeon. We did every single thing that Sedgwick had requested him to do. For no reason at all, they just randomly denied his claim. Never even told us. We had to appeal it to get it re-opened. He had also had a work excuse stating that he was not to return to work until further notice. (Keep in mind his job through COMCAST was a door to door salesman, so he walked miles and miles a day). We turned in pictures, documents, work excuses, office notes, labwork, x-rays. With everything that we had turned in there should have been no reason that he would not have been able to collect his short term disability. After 9 long months of them completely screwing around, no return phone calls, said they couldnt see faxes we sent. ETC..ETC..To no surprise at all, they denied the claim. They called his doctors and made up statements that the doctors had never said. In the meantime we received an eviction notice for our house. Fell months behind on every bill.

    They completely ruined our life. My husband was always a happy, laughing, joking person, loved to be around and with people. He is now depressed everyday. And to top it off, the swelling in his legs has never gone away. He still cannot walk, and five doctors later, nobody can figure out what is wrong with him. In the denial letter they stated that he was supposed to have surgery and never did. But the exact statement from one of our doctors was “surgery may be needed, but not a chance of anything happening until all of the swelling is gone”. The reviewers for his case are supposedly doctors, well any idiot would know that you cannot operate on someone that has as much swelling as he does. His swelling has never gone away. We tried to tell them too that he had lost his insurance through comcast as well after 120 days. So a visit to the doctors would have been all out of pocket. Obviously if we were receiving eviction notices, we had no money. We couldn’t even afford to buy food and we have two children. They would not help us at all. They lied and twisted and changed everything that we gave them. It makes me sick that this is the way people get treated. CAN SOMEONE PLEASE HELP US!

    JENNIFER & TIMDec 7, 2018  #819

  • Greg, since Sedgwick is not an insurance company, only a third party administrator, you would also need to sue your employer and would need a local attorney either in Georgia or South Carolina. I’m not quite sure what your issue is so it would depend on the basis of the claim as to what type of attorney you would need. You can try to contact Nathaniel Bax in South Carolina.

    Rachel AltersDec 1, 2018  #818

  • I want to sue these assholes and cwa for non representation any suggestions for lawyer, I am in Georgia but I was working South Carolina.

    GregNov 30, 2018  #817

  • Vic, we do not handle Worker’s Compensation claims or litigation. I suggest you contact a WC attorney to discuss your options. I would caution you to review your LTD Policy to determine whether WC benefits would be an “Other Income” Offset to your LTD benefit or (possibly) some Policies exclude coverage all together for “work related” injury and/or sickness (i.e., work related disabilities).

    Jay SymondsNov 29, 2018  #816

  • I am currently on long term disability and applying for SSDI , in feb I had back surgery from a fall in 2015 . When I got released and home I fell again and broke my neck. My surgeon said it was a direct result of my repetitive work for ATT. My question is can I still sue them through workers comp even though I’m on long term disability?

    VicNov 28, 2018  #815

  • Cherry, working with any carrier or claims administrator on short term disability claims can be difficult. It sounds like you have a lot going on medically and administratively. I suggest you contact our office and speak with one of the attorneys to address any questions you have regarding your specific situation.

    Jay SymondsNov 28, 2018  #814

  • Sedgwick provides no sympathy to your situation they act like the money is coming out their paycheck!! I filed a claim a few months ago. I did everything I was suppose to. I got deny their reason just a list of complaints no real reason the employee can’t work! How do you dare say nothing is wrong?! I have anxiety attacks, depression, not able to stay focus, crying for no reason, not sleeping at night, panic atracks! Plus more I rather not say! Sedgwick works for the employer not the claimant! I filed an appeal and still waiting on a decision because their hired a private doctor! Who is to say this dr isn’t on their side! I take meds!

    Back in April I got approved for the same exact thing nothing different and now I have a flare up I’m denied! Help me understand how to you approve someone for something and if they need again deny them! Info was sent to my dr to communicate with the dr Sedgwick hired! Since my dr works for me he said no communication will be by phone since they can always lie and say nothing is wrong with her. We sent Sedgwick paperwork dr notes from every visit and every single medicine I’ve taken! I had a history I’m not sitting here making this up! It took a lot for me to even write this! I’m just done tired s d I’ve had enough if the bs!

    CherryNov 27, 2018  #813

  • Jeana, we hate hearing stories like yours and it is why get satisfaction in assisting people get back on claim. Please contact our office so that we can learn more and see if we can assist your sister in getting the benefits she deserves. Please call us at your convenience for a free consultation.

    Alex PalamaraNov 15, 2018  #812

  • My sister worked for AT & T for years until she became disabled with Pulmonary Fibrosis from a lifetime of asthmas and allergies, thyroid cancer and a heart disease which they are trying to diagnose and treat. She also had to have a radical hysterectomy after they discovered large uterine tumors. And Sedgwick can’t stop jerking her around! She fought tooth and nail to get long term disability, and managed to keep it for awhile. But their deviant behaviour allows them drop her like a bad habit every chance they get. They sent critical forms to the wrong address, fail to deposit what checks she did get into her account. And too many other BS tricks to mention! And finally after a 15 sec ECG strip where she did not throw repeated PVCs they have declared her well. So now she has lost her long term disability, her vital health insurance, and her good job with AT &T, and now because she has ZERO income, they have lost their apt. My sister struggles to breathe daily and if it was not for my parents, and my husband and I paying thousands of dollars to help her, they would be homeless! She is the sole support of my teenage niece, and now they have had to move in with my elderly mother. I have paid her car payments, electric bills, rent, for months at a time because Sedgwick gets away with this despicable crap! I am so stressed out from supporting them I want to sue them myself!

    Jeana H.Nov 14, 2018  #811

  • Sedgwick is a complete fraud. I’m in NY and was injured at work in early 2018. I immediately told my HR department of the injury. I was issued a WC number a few days later. After seeing my doctor and getting a referral to see a neurosurgeon I had to wait almost 2 months for the MRI approval. I sat home for almost 2 months with no treatment and my condition worsening daily. My claims examiner denied my claim despite 30 plus voicemail and emails to her. All I received was a letter in the mail saying they denied my claim. Eventually I got in touch with the examiner and she admitted to dropping the ball on my case. She also stated she had too many voicemails and emails to respond to them all. Due to her “dropping the ball” she approved my MRI without prejudice. My case was still be contested however. At the first hearing they conveniently dropped the contesting of my claim and everything was approved. I went back to work a few months later, less than 100%, because Sedgwick didnt issue one indemnity payment while I was out. After 2 months back on the job I reinjured myself. This time they started indemnity payments. About a week ago my employer terminated me because I couldn’t work. Sedgwick filed separation papers and stopped my payments until at least my next court date which is in January! Now I must go through the holiday season with no income to pay bills or eat. Not to mention I have no insurance coverage because I cant afford my cobra payments. First class company they are! Not to mention they haven’t paid me for the first 3 months I was out injured. Oh and they denied treatments I should have had after my reinjury because some random doctor who never examined me stated it wasn’t necessary. Nothing but a scam!

    BryanNov 13, 2018  #810

  • Belinda, although FMLA and short term disability appear related and often run concurrently, both have different rules, guidelines and requirements which are unique to each. If you need assistance with the appeal process please contact our firm and ask to speak with a disability attorney.

    Cesar GavidiaNov 1, 2018  #809

  • I was out for 29 days working at Chase, first of all Sedgwick sent initial paperwork to my job and I was out on disability, I ask to have it faxed to physician, which they faxed to wrong number. I had to keep calling after third day I request to speak to supervisor at that point she sent me the paperwork and faxed to doctor. Now I only had two days for doctor to complete and return, deadline was a Sunday. Monday morning they denied me, doctor faxed paperwork Mondav evening, they reviewed it Tuesday ask for more documentation, doctor submitted 4 pages of his notes. At that point they denied me, said doctor didn’t submit paperwork to support disability.

    I sent the denial letter to my physician at which point he faxed more documentation and I sent it documentation from pain management physician. Now the appeal process is 45 days. I talked with appeal person today she stated they are going to mail paperwork in three days I have 20 days to review and return. This is a horrible company how can they use the same documentation to approve flma but not approve short term disability and this medical issue is a lifelong illness that will never get better and has been documented in my flma file.

    Belinda C.Oct 31, 2018  #808

  • Rob, I am sorry to hear you have to deal with Sedgwick. We do not handle workers comp claims at Dell & Schaefer. I encourage you to contact a workers comp attorney as soon as possible.

    Victor PenaOct 26, 2018  #807

    I work for a large automotive manufacturer in Ca. and after filing a Hostile Work Environment claim against my immediate supervisor, due to this action the job related stress became unbearable and I was sent home by Corporate Human Resources on a Company paid Leave of Absence.

    I eventually filed a Workers Comp Claim against my employer and the claim is being handled by Sedgwick. I was sent request form for my medical records and returned them to Sedgwick.

    My claim was immediately denied allegedly due to a lack of medical evidence to substantiate my illness or that it was a result of my employment. The part that upset me was I checked with my medical insurance provider who confirmed that no one had requested or were provided any of my medical records as of the date of Sedgwick’s denial.

    I contacted Sedgwick who we’re unable to confirm for me if they had any medical of my medical records. I asked them how they could deny my WC Claim without any evidence. I was told that this was just their protocol. I let them know that I was considering retaining an attorney.

    My case worker. From Sedgwick set me up to be evaluated by their QME Psychiatrist. After 2 evaluations in a 6 month period, the first being 9-1/2 hours and the second being 8-1/2 hours, Sedgwick’s own QME Psychiatrist determined that I was suffering from severe stress, anxiety, depression and PTSD and advised that my illness was 90% Industrial and work related. The QME Psychiatrist determined that I could return to work with my employer but under certain and specific accommodations which my employer is not willing to comply with.

    Another thing Sedgwick did was I had been advised by them in February 2018 that they had sent my medical records to the QME Psychiatrist to review. However, when evaluated in September 2018, the QME Psychiatrist advised me that he had not yet received my medical and he documented this deficiency in his final report. This is only one example of Sedgwick’s incompetence and propensity to be untruthful.

    I just received another Denial Letter from Sedgwick stating again that my claim was denied because the QME Psychiatrist who evaluated me was not able to determine that that my illness was work related because his evaluation and opinion about my illness was only a medical decision and not determined legally by “A Trier of Fact”.

    After reviewing the problems on this site others have had with Sedgwick’s incompetence and misconduct, I’m finally seeking legal representation, hopefully with Dell &Shafer

    Rob TSOOct 25, 2018  #806

  • Kimberly, please contact our office to discuss your claim denial and your rights in appealing the decision. Although they may not be of help I would recommend you contact your HR department to lodge a complaint and let them know the grief Sedgwick has caused in reviewing your claim.

    Stephen JessupOct 24, 2018  #805

  • Sedgwick is putting me through more then I could ever imagine. My status right now is I have been off work since 8/24/18 for major depression (suicidal) and anxiety. Was approved for 1 payment, and now I was told by Sedgwick that my paperwork was never received on Oct. 6th and after jumping thru hoops and speaking with my doctors office between the 8th-12th, they kept saying there was nothing sent and payday was on the 12th. The following week I called again to see what was going on and was told we received 20 pages of notes on Oct. 6th. I was floored because of everything I’d been thru the paperwork was already there, and I had to wait for a supervisor to sign off and approve it. And now today was told my claim was denied. You send emails and no responses, you try to speak w/the person that is reviewing your case but once you leave a voicemail same thing no response. I am at my wits end with them and I need help. My rent is overdue and another pay period is coming up. I’ve never dealt with a non professional company in my life. I’m still out of work and I’m getting no answers at all. My mental health is draining again due to this situation and just when I was doing so much better, this has brought me back down. Don’t let me start on all the other things you have to cover that should already be covered under the STD. This place is the WORSE. I’m so frustrated, tired, and just want to give up but I know I can’t. I’ve been paid once, and now they are telling me I was sent a denial letter out yesterday.

    KimberlyOct 23, 2018  #804

  • Lashawja, sounds like you have good representation. I wish you luck with your claim against Sedgwick.

    Rachel AltersOct 21, 2018  #803

  • Hi, my name is Lashawja ans as a healthcare worker for Kindred Hospital never in a million years would I think Kindred would do business with a company like Sedgwick. On 6/4/2018 I sustained a on the job injury. I injured my back, neck, shoulder and right side of my body. I been denied proper testing and treatment. I been auto to a LOA status with my employer due to their in network doctors requiring me to have these test performed so I can get a proper diagnosis. The test consist of a EMG/NCV. As of this day the only thing that has been treated was the herniated disc in lower back with an injection. That was just approved last month which was 9/21/2018. Before than I had to force NP David Walters at Concentra to do an MRI due to the severity of my pain that was 7/12/2018 in which Dr. Dang is the one who pushed for a more complete MRI. I was robotic wanting to chop my neck off with chronic pain all this time until going to see a pain management doctor which was I think about 8/4/2018. He got me straight with control my neck issue, he is also one of the three doctors who stated I needed EMG/NCV. I went through all of this for 90 days working light duty.. After the 90days I was Auto to Light Duty per Kindred Hospital Policy. I was suppose to receive workers compensation since I was placed in LOA due to doctors not releasing me to return to my full duty Job. As a matter of fact I been flagged that Iam not fit to work at this time. I left out important key components to my story for a reason. I pushed for my own MRI due to chronic pain and symptoms. I was working light duty but all I was doing is hanging out most of the 8 hours at work in chronic pain with mental breakdowns.

    I called Sedgwick and threated them for denying my MRI and told them if they didnt approve I would get a lawyer. They gave me the MRI 7/21/ 2018 Ms.Jones at Sedgwick was in the process to shut down my case. But for the God above a Dr. Walter Watters is on Sedgwick network list and its not what he said that made me look at things clearly its how he said it.. you know sedgwick is only paying me for the treatment of your neck.. good news with that is your not needing surgery at this time.. but I want to you go see a neurologist. I recommending that the specialist do a head to toe exam thats so they can tell you about your back as well as treat your other symptoms . Iam recommending this be done before you return to to your regular duty. The nurse case manager proceeded to asked so has the patient reached MMI.. he gave her a look that was like what. I didnt know Kindred nurse case manger was aka Sedgwick spy. I left that day and retained a lawyer I also got rid of the spy… she did something in Dr. Dangs office that made me realize we are not on the same page… I am without a pay check and treatment but I trust my lawyer and he tells me to hang in there.

    Mrs. MurundiOct 20, 2018  #802

  • Sedwick Has ruined my life. I have not been paid since March. They keep on telling me there giving me 21 days for my Appeal. I go to a Doctor a random one. Now this is 5 doctors since January. And they all have giving me work excuse because there is not a chance I can do my job. They had a IPA calling Surgeons that where Referrals instead of the doctor I’m going to. It is now September and I still need 2 surgeries and don’t have money for copays. Did I mention I’m getting evicted any day now. I call and beg them cause I have two kids and I know my excuses are 100% from the Doctor. They don’t have a care in the world cause what can I do. They are horrible people.

    TimSep 24, 2018  #801

  • Lynn, if you have received a denial of your disability claim you may contact our office to discuss your options.

    Cesar GavidiaSep 23, 2018  #800

  • I am about to have my car repossessed even though SEDGWICK had the required information to process my claim to begin with. Nine weeks without pay! I’m very irritated and they are asking me to appeal even though it was processed incorrectly.

    LynnSep 22, 2018  #799

  • Penny, please contact us so that we can review your claim for representation. There is likely an appeal process and a possibility of success in getting the benefits due to you.

    Alex PalamaraSep 21, 2018  #798

  • I was off work for 6 months through 3 surgeries and a staff infection and this group of morons thought I should got off the operating table and gone straight to work, I was denied all coverage I paid xtra for buy up coverage my “Doctor filled out out numerous papers and still I was denied coverage. This company is a scam they take the money and never pay out.

    PennySep 20, 2018  #797

  • I have been on leave since 7/17 for anxiety/depression and saw my primary doctor on 7/25. My primary doctor did not fill out my forms and neglected to treat me properly. I saw a new doctor who agreed that the other doctor was negligent and should’ve filled out the paperwork, plus she filled out the forms extensively. She even faxed over my visit notes and the names of the medications that she prescribed for me. Her visit notes explained that I should have been placed on medication on 7/25 but I didn’t see her until 8/21. Also, I am currently seeing a counselor every week as part of my treatment plan. Despite everything, Sedgwick is refusing to approve my disability claim. They are saying that they don’t have enough objective medical findings to support my claim. They’re approach to mental health is wrong and borderline prejudicial.

    I have been fighting this for nearly two months and I cannot take it anymore. My stress is at its peak and it is only by the grace of my family that I am not living on the streets. I am entitled to every single penny of the money Sedgwick owes me. They are acting like it is their money when in reality it’s not. Life happens and Sedgwick needs to be held responsible for improperly denying my claim as well as anyone else suffering from anxiety and depression.

    Sean D.Sep 16, 2018  #796

  • Linds, it sounds like you need to speak with an employment attorney to determine your rights on account of Walmart’s termination of your employment. If you need assistance contacting an employment attorney please feel free to contact our office and we can assist you in finding one in your area.

    Stephen JessupSep 16, 2018  #795

  • I had life threating surgery. I filed for medical leave 8/8/2018 through Sedgwick: Walmart.. I was off for 5 weeks. I was fired today. Was planning to return to work tomorrow. During the time I was off Walmart completely cleared my schedule. I asked Why? Never got a straight answer. Never heard anything from Sedgwick. I worked for Walmart go 12 yrs.

    LindsSep 15, 2018  #794

  • Almost 6 years ago I was hurt really bad at work. I work for a major clothing retailer. For now I won’t mention. My attorney advised me that after 2 years in New Jersey my chance to collect for my injury would be voided. Every time a doctor that Sleazwick said I had to see sided with me that doctor would be removed from the case. They put me through Hell! When one of their own home call nurses decided to side with me after 3 months she was removed from my case? This company thinks they don’t have to answer to anyone including judges. Well they messed with the wrong Irish guy. I can not wait to load my videos on YouTube. I know my company made it clear they’re going to side with these sleazy dogs and that’s fine. If it’s one of the hire ups in corporate Sleazwick is told to kiss their ass. Hourly workers get their asses handed to them. Well Sleazwick I will help be your downfall, I promise. I should’ve sued the crap outta my company and Sleazwick, when I had the chance.

    FrankSep 1, 2018  #793

  • I work for United Health Group. I woke up one morning and couldn’t move my shoulder. I am required to drive 75% of the time for my job. I tried to work with my employer as long as I could but after 2 months of not being able to drive I was advised they can no longer accommodate my needs and Doctor restrictions. My doctor took me out of work as not being able to drive, limited ROM, neck pain, shoulder pain, arm pain, and migraines affecting my vision. I have seen myPCP, physical therapist, orthopedic, pain management, and a chiropractor. I have submitted over a hundred pages of medical documentation to support my disability and yet my appeals continue to be denied. They do not schedule appointments ahead of time with my doctors for peer-to-peer reviews. I spoke with a supervisor at sedgwick’s to determine exactly what they needed. Got the documentation that they needed explaining how my disability and symptoms or making it unable for me to work, as well as an accurate job description from my employer. My employer was unable to provide me reasonable work accommodations and yet my claims and appeals continue to be denied. I have not had any income since April 2018. As a single mom of four children, I have been forced to apply for public assistance even though I shouldn’t have to to make ends meet. I have been unable to pay my electric bill, my vehicle payment and my rent. I have three doctors supporting that I should only be working 4 hours a day at this point and driving no more than 30 minutes at a time, no more than an hour a day. Even with the new restrictions my employer still is unable to accommodate my needs. I feel very defeated in this whole process.

    StacyAug 30, 2018  #792

  • We are desperately disappointed to this company. My husband been hospitalized since Aug 1, 2018 to Aug 20, 2018 We report the absence for him to file the sick leave and short term disabilty. the y request the paper form and the hospital fax it over. Then, Aug 21 they left a message to call them back and and imforming that it was denied due to question 9 and 12 wasnt filled up the date that until when he will not be capable to work. The doctor just put in unknown and they said it should be filled up with date of return. The doctor couldnt tell for now since my husband still really sick and still under the care of homehealth but their not very helpful. They always promise that someone will call us what to do and nobody does.

    My husband has having anxiety because of this because he’s running out his PTO and our life will be misserable coz how we can pay our bills if they will keep denying the claim. This is unfair for us because this is a legit sickness. They can even verify the hospital. The hospital already faxed the forms that they needed for 2nd time around and the representative said that they already received it Aug 22, 2018 but they still denied it cuz it should be fax altogether with page but when i called before they said it should fax only the question 9, and 12 that they need! So they just trying not to pay the leave!!!! Delaying tactics untill my husband run out the PTO. We will look for the lawyer that will help us!

    Kelly A.Aug 29, 2018  #791

  • Ruthie, I am sorry to hear about the difficulty you are having with Sedgewick, this is unfortunately typical. Call her back and ask for a denial letter as that should explain your rights to appeal the decision. I would get the forms directly from your doctor and send them certified mail to her with a letter so at least you have proof they have them.

    Rachel AltersAug 28, 2018  #790

  • I’ve been out of work on a disability claim since 4/23/18, I was originally set to go back to work on 7/15/18 but my doctor agreed that I was not ready to go back, Sedgwick sent more paperwork to be filled out and returned by my doctor, stating it had to be received by 7/31/18, which it was. A week later I received a letter stating that the form was incomplete and needed to be updated and returned, I went to my doctors again, she fixed the form and sent it back in. Last week I received another letter from Sedgewick that stated they never received the paperwork on 7/31, I called my doctor, she definitely sent the revised copy on 8/13 but said she would fax it over to them again, that was on 8/22.

    Today I got another letter from Sedgwick which states that my claim has been denied due to my not submitting certification paperwork. I calls them immediately, this is ridiculous, it’s been sent three times now! The woman was very short with me, she said she tried calling me both on the 14th and 22nd because to corrected forms were not initialed by my doctor. Really? She sent it over twice! And I did not get any calls from here on the 14th or the 22nd, no voicemails were left either. I asked her what I had to do now, she said to call my hr Dept to see if they’ll take me back because as far as this claim goes, it’s been decided and there’s nothing more she can do. I’m beside myself.

    I’m still not well enough to go back to work, and now I don’t even know if I have a job to go back to since apparently I’ve been off work on a denied claim since 7/16/18. I don’t see any information to appeal this decision either, I don’t know what to do but the stress is not helping. That woman was so awful, what can I do?

    RuthieAug 28, 2018  #789

  • Eric, I am sorry about your denial with Sedgewick. You should have 180 days to appeal the decision. Make sure you file the appeal within the allotted timeframe. You should ask your doctors for assistance with the appeal land to make sure their records are supportive of your inability to work.

    Rachel AltersAug 28, 2018  #788

  • I was just denied for short term disability due to insufficient medical doc. I called several times and reached out to my case examiner. When I called all I could get is it’s pending and the examiner never got back to me at all I was asking if there was anything else needed not a peep. Then I wake up after 22 days boom denied. Then with 10 am I’m getting a call from work telling me I’ve been out on a unapproved Leave and have to come to work.

    Now I’m in a pickle with no money no real options except for a work accommodation that I’m not very confident in. But all they needed to do was community with me and I could have gotten what they needed but no wait tell I’ve been denied then tell me why and tell me it was my responsibility to get the forms and supporting docs to them which I did but to not tell me they needed more is just wrong.

    EricAug 28, 2018  #787

  • Nikki, this is not an unusual situation. I suggest you contact our office and speak with one of the attorneys to address your specific questions regarding your situation.

    Jay SymondsAug 28, 2018  #786

  • Sedgwick, is full of $h¡+. I’ve been on STD since May of this year. Recently, I had to extend my STD; however, they denied the claim, stating my dr didn’t send in the requested paperwork. When I called them out on their lie, they said they needed 24-48 hours for the information to enter the system. Then, it turned into something else. Funny thing is, they emailed me a letter saying it was denied on the same day they received it. Doesn’t make sense does it? Everyone seems to have a different answer, but it’s cool one way or another, they’re going to give me my money.

    Nikki S.Aug 27, 2018  #785

  • Mike, please contact our office and ask to speak with a disability insurance attorney.

    Cesar GavidiaAug 26, 2018  #784

  • I am a splicing technician for AT&T/, my duties include carry and lift up to 100 lbs/climbing telephone poles & 28 ft ladders. That weigh 60 lbs/pull and throw cable lines over trees & poles/reach above my head frequently/ drive a company truck. Now I found out by mri I had a torn rotator cuff injury and had surgery for it/ Sedgwick approved my disability up to 6-weeks after day of surgery. I had my doctors office send documentation for continued disability and Sedgwick case mgr kept stating we received no updated information. I had confirmation with date and time stamp on fax I sent myself back to back info on the day of end of approval. It stated I am to be in a sling for 6-weeks from post op day continue to take meds for pain(oxicodon)!

    I told the case mgr I have another dr appt in a week/ it did not matter, he said I am denied benefits and he is terminating the claim. Now it’s impossible for me to return to the type of job I do, I have limited range of motion in my right arm still some pain when moved at times, I was put on restrictions of no lifting of any weight other than my arm /rehab/and it’s illegal to drive if I take pain meds! I have not received any written report as to why I was denied and was told you can appeal/ but it seems that that will be a waste of time.

    MikeAug 25, 2018  #783

  • Kim, I am so sorry to hear you are having so much difficulty with Sedgwick. This is very typical. You need to make sure you appeal the claim within the time allotted or you won’t be able to file suit. I hope you are able to get them to approve your claim.

    Rachel AltersAug 19, 2018  #782

  • Hi my name is Kim and yay I get to vent. I had 2 car accidents due to falling asleep at the wheel in 1 month. I have sleep apnea and using a cpap machine but it’s not working. I have even fallen asleep at work. My Dr. Says I have severe hypersomnia can’t work or drive. My manager is very understanding. I totalled my car had to get a new one. Sedwick already denied my claim in 2 weeks before my Dr got the paperwork even before I was able to see my pulmonologist. I am appealing. The pulmonologist says I have a large uvula which is cutting off my breathing issues talking eating life threatening. Sedwick says not enough information to turn into their Drs so now they want my sleep study. They said once they get that then they will send Everything to their Drs to see if I can be approved.

    I am not getting paid until this gets approved. My insurance is going to drop me since I’m not getting paid which means they are not getting paid. I have had 3 panic attacks may lose the car and home. If they need to do surgery Im screwed. I should have said screw my health just keep working. If I get denied again Sedwick and my Employer win. I will go back to work against my Drs wishes. I never will do this again.

    KimAug 18, 2018  #781

  • James, sounds like typical Sedgwick behavior to me. They are super difficult to deal with and they are pretty much incompetent. I hope you were able to get them to approve your back benefits they owed you.

    Rachel AltersAug 18, 2018  #780

  • I had to leave work (walmart) back in January after complaints of shoulder pain. I was sent home and told I was not allowed to come back, as it was clear something was wrong and I needed to get my shoulder looked at. I didn’t file a workmans comp claim, like I should have, because I didn’t know how to prove that it was a repetitive stress injury. As if that wasn’t all bad enough, I am the sole provider for a family of six, so I was immediately tossed out without anything but a small amount of disability pay. Then I got stuck dealing with Sedgwick.

    My leave was approved at first, then at every opportunity, it seemed, they had reasons to try denying it when I was submitting medical as I had doctor visits few and far between. I was at the mercy of when I could get in, setting appointments for physical therapy, and waiting for results. When it was deemed necessary that I would need surgery after an MRI, I went through all that process, only to keep having to fight them about my medical need to be away from work. After my surgery, they immediately tried to send me back. When I was given the restriction of 15lbs. I was told I still couldn’t go back to work, as they expected me to lift 50lbs. with my right arm (that I’d had surgery on) not both arms together. (Walmart’s expectation is 50 unaided) I was told at my post op visit to continue physical therapy and do no heavy lifting until September, the doctor’s office sent their notes to Sedgwick, and I thought that was good enough.

    Apparently not, they denied my claim at the beginning of July, said they never got any additional medical. They denied the entire leave all the way to the start. When I learned this in August, I went back to the doctor, got clearance to return to work. Sedgwick then said they needed doctor’s notes proving my need for being deemed disabled from July to August. They do that, but then Sedgwick denies receiving this paperwork again. Sick of the whole situation, I quit my job, as my fiance found work. The night of, after business hours, I receive a text from Sedgwick suddenly having recieved my doctor’s notes and approving my leave.

    JamesAug 18, 2018  #779

  • After two and a half years fighting this horse s**t company they settled but I have to quite the job that I loved. The should treat us injured people better.

    LoriAug 16, 2018  #778

  • Travis, have you contacted Apple HR to discuss the problems you are having with Sedgwick? Sedgwick acts as the third party administrator (TPA) for Apple’s short term disability plan, which means that Apple is ultimately responsible for the payment of the benefits. Please feel free to contact our office to discuss the claim denials and your rights going forward.

    Stephen JessupAug 8, 2018  #777

  • Literally impossible to get a response regarding Sedgwick scheduling and paying for my reoccurring medical reviews. Which are required to keep my LTD payments in place until the contract of the award letter expires? I feel intimated because I am on a fixed income.

    Lisa M.Aug 8, 2018  #776

  • I have had a back issue for over 5 years now. I have been working for apple for almost 3 years and I had to take a leave do to the back pain and the neuropathy in my right leg.

    First off I called Sedgwick to open a claim and the sent the form to my doctor for stress leave when the issue is with my back. By the time I found out it was the wrong form I called in. They then told me that they will get someone to contact me to get the correct forms sent to my doctor.

    I then get a call that stated that they were not going to send any forms as they are all the same they just included the section for mental health. My doctor looked at this and filled it out the nest she could but did not understand why that form was sent. So she filled it out stating that she was not approving the leave for the stress. When I spoke to my doctor she asked me why that form. She thought it was form my back issue. I told it was supposed to be.

    Sedgwick then told me that because the time has passed with the original paperwork that I would now have to file an appeal on the claim and they only wanted documentation from the time I took leave. They mentioned that if my doctor had put dates of leave on the paperwork that Apple would have approved the leave on their end just not the state. This would not have been an issue if they sent the correct paperwork the first time. I told her that this was a recurring condition and that I don’t have too much new paperwork from doctors as im starting to visit them again on my leave.

    My pain doctor and my primary agreed at the time that I was not capable of working at the moment. The appeals doctor looked at my record and agreed that I have an issue but did not warrant the time off. Said that I can not sit more than 30 mins or stand more than 30 mins. The issue is that I cant sit more than 5 without the leg starting to go numb and burn.

    How does a doctor determine your level of pain by an image when supporting notes from my doctor and pain management doctor (which I have had many injections) stating that I was not able to sit or stand for very long without the pain.

    Now I’m waiting for someone to do my return to work paperwork that has almost been a week. Have not had any form of paycheck in 3 months.

    TravisAug 7, 2018  #775

  • AJ, unfortunately, since your disability claim stems from a mental nervous disorder. Sedgwick will likely not continue paying unless you provide them with the notes from your doctors’ visits supporting your inability to work. If you do not feel comfortable having your doctor send the actual notes, they will often accept summaries of the sessions form your doctor in lieu of the actual notes. But they will not approve the claim on your doctors word alone that you are unable to work. They want to see that you are treating on a continual basis and have restrictions and limitations preventing you form working.

    Rachel AltersAug 4, 2018  #774

  • I have yet to get to the point where I know whether or not my claim has been approved. I am on a short term leave due to severe panic attacks, depression, and anxiety disorder. When I initially filed my claim, Sedgwick requsted documentation around my mental state that already seemed extremely intrusive, which I had my physician and therapist fill out. They both commented on how uncomfortable they felt completing the intrusive questions due to privacy. Nonetheless, they did and faxed it over and my request. I called to check on my claim a today and it is still not approved. Sedgwick is claiming that they need the actual doctors notes from my appointments with my therapist and doctor. I spoke to two representatives at Sedgwick and stated that I did not feel comfortable having my doctors provide notes about what we talk about in therapy sessions, and let them know that my Doctor said that what he provided (diagnosis, treatment, and reasons I cannot work) should be more than enough for FMLA, to which he responded, this isn’t FMLA, this is Apple leave and they require more. My medical doctor has already sent over 9 pages of private appointment notes, because they basically threatened me stating, if they did not receive them by Aug 7th, my claim would not be approved. I have not been paid in almost 3 weeks at this point. My Therapist has not yet sent over his notes because he and I do not feel comfortable.

    What should I do? Do I have a case due to my employer and sedgwick violating my HIPPA privacy rights? Do my rights even apply here? I live in CA.

    AJAug 3, 2018  #773

  • I was hurt in a Harris Teeter store. Still in hospital. I have read many complaints and am scared. I was wondering why we as a public do not boycott all the businesses that hire Sedgwick. If I had known what I know, I would not shop at a store insured by Sedgwick and I certainly would NEVER work for a company insured by Sedgwick.

    LisaJul 30, 2018  #772

  • Dealing with Sedgwick is exhausting. Without stating my employer I want to share my experience. I filed for Short Term Disability (STD) and according to my employer 21 days for the doctor to respond to Sedgwick. Sedgwick case manager claimed contacted my doctor, and said did not receive the information denying my claim in less than 2 weeks after it was opened. They completely ignored the 21 day allowance for my doctor to respond, and my doctor confirmed they were never contacted by Sedgwick. I considered it a “he said she said” event. I contacted my employer and filed a complaint where my employer reviewed and agreed my claim was mishandled, and said there have been multiple communications issues with Sedgwick that they are aware and trying to work with Sedgwick to improve. My claim was changed to “Approved” the same day I reached out to my employer where I did not have to file an appeal. However, Sedgwick’s case manager I have caught in several contradicting and inaccurate information. One example is my surgeon claimed to have sent the case manager at Sedgwick my return date anticipated as 9/08/18. Sedgwick case manager stated my return date 8/2/18 and that date was a result of following my employers guidelines on my return date based on the type of surgery. I asked my case manager if she is a medical professional or my employer and said no, and I asked then how can you decide my return date? The answer was no I’m not a medical professional, but we have specific guidelines. I am now in another dogfight with Sedgwick as they have not yet updated their records to the return date my surgeon lists and has shown me it in writing. Yesterday I had another visit with surgeon who said return date is now pushed back to 9/17/18, but could take a full year for my recovery.

    Another instance of bad communication occurred when I spoke to the case manager at Sedgwick because I was getting no where with the case manager on the return date, and after several complaints I filed with my employer was when finally got a return date as 8/2/18. The Sedgwick Case manager said during my numerous follow-up attempts I could have the surgeon call her directly or I can and gave an extension number. I called it back later and was not any good, then called Sedgwick’s main number and they said no claim manager has a direct extension, it was a darn right lie by my case manager. Both my surgeon and family doctor have both claimed Sedgwick’s case manager made no attempt they know of in contacting them after the case manager claimed to contact, I had to Chase down Sedgwick to finally respond. In other words Sedgwick decided my return date without confirming it with my surgeon. I asked the surgeon’s office and they said it happens all the time and very frustrating. My surgery was 6/8/18, and Sedgwick has yet to do any follow-up with the surgeon’s office who said this is very unusual why they have not been contacted, and that is as of yesterday.

    Lastly, and I do not know the full details, but I think should be mentioned. An employee I worked with I talked to stating I had to go on leave for medical. He warned me at that time about Sedgwick as they had denied the claim of a co-worker in his department and seemed the denial was unreasonable. This caused me to be very cautious, and when I was denied in a unreasonable manor I did not hesitate to take action to file a complaint with my employer.

    I decided today to look online to see if the mishandling of claims was common with Sedgwick and finding it is very common. My employer has a specific department dedicated to handling complaints about Sedgwick’s handling of claims means that this is a significant problem. My guess is this department was established to help prevent the kind of issues I am personally having brought to social media and legal reviews.

    My only hope is that somehow after reading about all the other complaints filed is that some day employers or third parties are held accountable for there actions. But I realize its all about money to the employers and third parties handling claims and in aggressively attempting to get the employee back to work when not medically ready or creating loop holes or other measures to deny claims. It is very sad this is happening, and the added stress dealing with the claim while trying to recover from surgery is very difficult.

    JimJul 18, 2018  #771

  • Justin, I am sorry to hear about your lawsuit for disability benefits with AT&T. Hopefully the outcome was favorable. If it wasn’t, there may be avenues to appeal. You should speak with your attorney about the appellate process and make sure they file any appeal notices in a timely manner.

    Alex PalamaraJul 9, 2018  #770

  • I had to recently take at&t to litigation. The entirety of their defense was based on a question about atendance policy of which the Sedgwick answered as if she was able to speak on behalf of att regarding attendence policy. I was so scared by the whole litigation process and depended on my lawyer to do the right thing I allowed the Sedgwick representative answer those policy questions, and now am so upset I didn’t cross examine her myself. That was the entire issue with my whole termination in the first place of how att management always referred to Sedgwick for policy questions but the Sedgwick employess always said they can’t answer my questions because they can’t speak for att on policy issues. I’m so mad at myself for being weak and not calling her out at the time but I believed in my union appointed attorney but apparently he was as stupid as the att attorney. I want to sue Sedgwick so bad for screwing me over! Any help?

    Justinholt123Jul 8, 2018  #769

  • Edward, I’m sorry to hear that you had such a bad experience with Sears. Unfortunately this is not my specialty so I cannot give you any advice.

    Rachel AltersJun 8, 2018  #768

  • Update 5/ 31/18

    Those of you who have been victims of this horrible company practicing negligently and willfully destroying your car should file a complaint with the Consumer Division of the State of Illinois Attorney General against their insurance company SEDGWICK Claims Management Services Hoffman Estates, IL who is aware of this and does nothing about it. Ask for Jenna Jones Corporate Manager (901) 415-7896

    This is what occurred at this location. You be the Judge! I took my car a 2004 G35 Infiniti, 2 door coupe, which is in immaculate condition, for a front end alignment. Prior to my appointment, I requested that ANTHONY an employee of Sears not touch my car. This request was made based upon suspicion of malicious behavior to my vehicle. I previously filed a complaint with corporate on this employee. Prior to this appointment I had a front end alignment done and returned for another.

    Upon arrival to the current appointment Anthony was not working because again, I requested not to be anywhere near him. When I arrived they did the alignment but, did not give me paperwork to prove it was done. Therefore, three days later I had to return. Unfortunately, the same employees who worked on my car were not in. However, Anthony was. He was very nasty and rude toward me. At this point I had no choice but, to allow him to do the alignment.

    Three days later, my car totally SHUT down. Yes! My engine froze and would not start. I called Sears. They had their insurance agent call me. Of course, like all SCUM bag insurance agencies, they are trying vehemently, to wiggle their way out of it.

    Whoever is reading this look at all of the other reviews, especially, the one where a woman and her family got into an accident after Sears worked on their car. Is it coincidental, or does Sears have malicious and unqualified employees working for them? And when you file a legitimate complaint their insurance company listed herein above, like all or most, try and wiggle their way out and use inexcusable reasons as to why they’re not liable. Thus, this is why they need to be investigated. The Insurance company is their for these type of matters. And the owner of Sears as disingenuous as he is knows this is going on at this location and does not lift a finger to resolve the issues.

    Edward E.Jun 7, 2018  #767

  • Lori, whether or not you are eligible for a Cost of Living Adjustment (COLA) depends on your LTD policy that is governing your claim. Most group LTD policies do not give a COLA increase. But to answer your question we would have to review a copy of the LTD policy that is governing your claim. If you can locate a copy, do not hesitate to contact us for a free consultation.

    Alex PalamaraMay 30, 2018  #766

  • My LTD is a group Policy from 3M and with Sedwick. I have been on LTD for 8 or 9 years. I have yet to recieve any Cost of living raise. Am I entitled to that raise? I collect no SS income.

    LoriMay 29, 2018  #765

  • Yani, only your employer and LOA administrator can provide you with answers.

    Victor PenaMay 25, 2018  #764

  • Hello. I’ve been on a Personal LOA since November, was Terminated in December and reinstated in January but was still on LOA. I just had my baby in May 15, have been trying to get my maternity leave but Sedwick examiner said that I have been on maternity leave since my LOA in November and I had told him that that was for a personal leave not my maternity leave and that I just had my baby and she said that my FMLA paperwork that I had sent over on the 15th was approved in February and I have no paperwork from my FMLA in February and that I would not be getting paid for since my leave was in November and I had talk to the escalations department through people services and she said that escalations department said that being on Loa had nothing to do with my approval for my maternity paid and being on loa since November had nothing to do with me getting paid maternity. I need some answers please. There’s some miscommunication in between the line and I need some answers. Thank you.

    YaniMay 24, 2018  #763

  • Got injured with shoulder issues on 4/14/18 and took a month of time wasting doctor visits and was sent to physical therapy even they had no idea what was wrong with my shoulders. 1.5 months later got a MRI showing bicep tear as well as some rotator cuff tears and massive arthritis… so of course they blame arthritis for my shoulder pull not mentioning the rips and tears and still playing the blame game and doing nothing. I am sure will be denied soon… unbelievable how not only Sedgwick but the doctors and others involved can sleep at night…

    BobMay 23, 2018  #762

  • Walter, you should contact our office and speak with one of our attorneys to discuss your options.

    Victor PenaMay 8, 2018  #761

  • My company tells me I cannot return to work without my doctor’s approval. My doctor says I’m not able to return to work now and prescribed physical therapy. Sedgewick is denying my claim for STD. I cannot afford the $100 per appointment without getting paid. I am frustrated, afraid and confused about what to do and what are my rights. I think I may get fired and have no benefits whatsoever.

    WAlterMay 7, 2018  #760

  • Raymond,

    I am assuming you are dealing with Sedgwick, which is never an easy or fun process. If you would like assistance with you claim you can contact my office for some guidance.

    Rachel AltersMay 4, 2018  #759

  • I work for AT$T and I’m currently on STD. I have not been paid in 3 weeks. Every 2 weeks IDSC is asking to renew my claim usually only giving me a couple days to renew. Needing chart notes and letters stating that I’m outta work. My neurologist states I’m out of work for a few months at a time but that is not good enough. The still need constant approval. My copay is $50 for specialists and I’m getting killed in cost! Like I said I haven’t been paid in 3 weeks. To top it off AT$T was taking my insurance payments out of my check, never got notification they stopped never seen an increase from them not taking it out. Now I owe them X amount and they want to arrange a payment plan I cannot afford! They can’t give me a straight answer on the months I owe. Seems like they just made up a number. I’m depressed and worried. I have no money and are the head of my family. Looking for help and guidance!

    RaymondMay 3, 2018  #758

  • Melissa, I am sorry to hear of your issues with Sedgwick. We hear similar stories all the time. Please feel free to contact us for a free consultation to discuss your claim.

    Alex PalamaraApr 25, 2018  #757

  • My complaint about Sedgwick if that they can cut you off without putting you in a program to get you off opiates that they started you wan. I appreciate the fact that my pain level has dropped severely but I still feel a lot of the pain because I don’t absorb the medication. And I don’t understand how some doctors can just look over my files and say nope she doesn’t have pain and yet nobody’s ever talk to me. I know my chronic pain doctor 100% believe me because He’s told me so and he’s comforted me when I’ve cried because I hurt so bad. And he feels bad because everything he’s ever suggested to Sedgwick has been denied. He even suggested putting me on a morphine pump so that I could get pain relief but they denied it. And he’s so busy running between five or six different offices through Concentra, he doesn’t put the time in to do the denial letters or for instants last year when they denied my medications he didn’t do the letter within the 30 days because he he’s told me so and he’s comforted me when I’ve cried because I hurt so bad. And he feels bad because everything he’s ever suggested to Sedgwick has been denied. He even suggested putting me on a morphine pump so that I could get pain relief but they denied it. And he so busy running between five or six different offices through Concentra, he doesn’t put the time in to do the denial letters or for instants last year when they denied my medications he didn’t do the letter within the 30 days because he didn’t even get it. So my complained about Sedgwick is that they don’t give a rats patootie. We are not people to them. We are not patients who live in pain every day. We are just money that’s being sucked away.

    Melissa S.Apr 24, 2018  #756

  • For about 10 years, Sedgwick had paid for my medications which included morphine oxycodone methadone and Percocet… sometimes all at once, sometimes only three of them. But that’s because after gastric bypass surgery I only absorb 7 to 10% of the full amount of the medication because it just literally goes right through me. Then all of a sudden last January 2017, they said no more and I actually cut my own self down from taking all 4 to just taking one of the prescriptions and I cut that in half as well because I was just sick and tired of having to take all these pills. Now, I have a legitimate chronic pain in my neck from herniated desk’s and I’ve had three surgeries. One of which is Sedgwick denied and I had to go to court & I won.

    My hardware failed and I had a 9hr surgery w/ a halo screwed in my head during the surgery. The recovery was hell. I cry thinking about it. But all of a sudden now they’ve cut me off they are supposed to put me on a weaning program but they didn’t so for 14 to 15 months I’ve been paying for my own methadone and now the program I go through which is called Blink (adiscount program is no longer part of any pharmacy for opiates) and now I have to pay a higher cost. I don’t know what to do because I got a letter in the mail 3 to 4 weeks ago saying no more but we will again put you on a weaning program… someone will get in touch with you like a nurse or doctor.

    I’ve been paying for my own methadone and now the program I go through which is called blink with discount program is no longer part of any pharmacy for opiates so now I have to pay a higher cost. I don’t know what to do because I got a letter in the mail 3 to 4 weeks ago about a weaning program but nothing! They say they’re going to do something but then they don’t and how dangerous is it to leave somebody without prescriptions that are opiates so that they can go into a severe withdrawal but they don’t care.

    Melissa S.Apr 24, 2018  #755

  • Jenskii, I am sorry to hear that Sedgwick is being difficult with you. Unfortunately, we have no way to know why they have decided to stop communicating with you via email. I do not believe it is a new policy they are now implementing for every claim. Also, I do not think it would be a violation of any of your rights as I have never seen any law or policy language requiring them to communicate via email. Hopefully they are less difficult going forward. If you have any additional issues or if your claim gets denied, please do not hesitate to contact us.

    Alex PalamaraApr 9, 2018  #754

  • Can anyone explain to me why Sedgwick will not communicate with a claimant via email? We received a notice in the mail today stating that Sedgwick has blocked our email and will not communicate with my husband by email anymore. There was no explaination in the correspondence. In the past they stated privacy concerns and they were protecting our PPI; however, when we told them we waived our rights to privacy under HIPPA and wanted to use email they refused. Isn’t that a violation of our rights?

    JenskiiApr 8, 2018  #753

  • Minhesh, I’m sorry to hear of your troubles, though they are certainly not uncommon for those dealing with Sedgwick. Be sure to send all written communications and document submission in a manner that can be tracked and confirmed. As for receiving documents of other claimants, that can be a serious privacy breach and can/should be reported.

    Jay SymondsMar 29, 2018  #752

  • Sedgwick has made the leave process a living nightmare. No paperwork is faxed on time. Every single time I need an answer, a different person gives me different information. I also have spoken to representative who was not confident in their answer to me and actually told me that. This company has sent over faxed paperwork of CLIENTS WHO WERE NOT ME. In my opinion this company is very disorganized and does not care for their consumers.

    MinheshMar 28, 2018  #751

  • My Company offered me STD. I pay for long term disability. I have been running around faxing papers to Sedgwick for a month. They finally approved my claim but are telling me I will receive no payment because I am getting CA State disability. My representative never explained this to me the entire time. The benefits dept. is not taking any responsibility. I was never offered to pay extra for STD. I was told I am an hourly employee and I am not eligible for any extra. In CA retail mgrs are all hourly. I am so confused and upset. I ran around faxing and paying drs when I should have been recovering. I was told I have Anthem STD and the point is to keep my job.

    They had the CA pay all wrong and I had to send it to them. And was still told I get nothing.

    C. HilgerMar 20, 2018  #750

  • Marisa, I am sorry to hear of these issues. We would like to look into your claim closer. Please call our toll free number and one of our disability insurance attorneys will gladly give you a free consultation to see if we can be of assistance.

    Alex PalamaraMar 8, 2018  #749

  • My boyfriend had an accident at work after working at s company for 6 years and it’s been over a year of this nonsense in April 2018. They only paid benefits once to him– an amount that was significantly less than what he would’ve been paid had he been able to work. Sedgwick repeatedly kept claiming that they needed more documents and more documents to show that he was unable to work even though both he and his company were doing everything they needed to do to get him cleared to work. Every time we called, they kept giving us different numbers to call– the old run around.

    This is strong language, but this company ruined our lives.

    MarisaMar 7, 2018  #748

  • Lauren,

    We hear the same stories from many claimants dealing with Sedgwick. It is important to keep all your correspondence with them in writing and establish a paper trail.

    Victor PenaMar 5, 2018  #747

  • I have had a similar experience to those who have written below. Although I had told Sedgwick through their online email system, that email was the only way to get a hold of me since I would be overseas, they continued to call me. They denied my benefits because they said they didn’t receive the correct forms from my doctor, but wouldn’t tell them which documents they needed, and they couldn’t get a hold of me on the phone. They have also claimed that they are unable to email correspondence to me although another analyst who was not assigned to my case would reply to me within 48 hours.

    When I filed an appeal, the same thing happened. They appeals group was incredibly hard to get on the phone, would not pick up when I called, did not leave detailed voice messages as to why there were calling, did not compile to arranged phone call meetings, and did not email me requesting additional information. They denied my claim again, stating they weren’t able to confirm the diagnosis with my doctor. When I finally spoke to a manager on the phone, she stated the analyst cold called the doctors office and was put on hold (b/c the doctor was seeing patients in the middle of the day) and the analyst hung up after two mins. They did not inform me about difficulties about getting my physician on the phone or I would have arranged it, since it was this doctor who supported my medical leave of absence. ughhhh. I am now filing an appeal with the NY State office since I am now out a months worth of pay.

    LaurenMar 4, 2018  #746

  • Denise, this is typical Sedgwick behavior, we see this all the time. Sedgwick is never in a hurry to approve claims and they are definitely incompetent. I’m so sorry you and your husband are going through such a terrible time. If your husband would like a free consultation you can both call the office and ask for me.

    Rachel AltersFeb 28, 2018  #745

  • My husband was diagnosed with glioblastoma and had surgery on8/21/18 at university of Miami, he was put on short term disability for 26 weeks which ended 2/18, originally this was handled by Met Life and we were told it could be extended. After gathering all information needed we were told Sedgwick has taken it over! As he is still on another stronger dose of chemo, in addition to vision, balance issues and can not drive and was told by the oncologist he can not return to work as of yet he applied for long term disabity in October when his job had there open enrollment. He is now going thru hell as Sedgwick is taking there time to get this approved! They lie, fail to get Dr reports and are extremely incompetent! Yesterday in the mail was a letter stating std has expired and still waiting for Dr reports for long term which they need from the surgeon going back 5 years of records. He only saw this Dr 2 times once for surgery and at discharge! My husband is suppose to be taking care of himself and in addition to brain cancer he is going to have a heart attack with anxiety as well as myself! He has been working for Verizon for 26 years. Never called in sick once! He was a lead engineer. We are beside ourselves with this useless company and don’t know where to turn. His recent MRI shows improvement but he needs additional medical care! Please if you can offer some advise it would be greatly appreciated. Much thanks. Denise B.

    Denise B.Feb 27, 2018  #744

  • Eric, I would have to agree with you. Sedgewick tends to deny legitimate disability claims with no reasonable basis. If this has been your experience, the you should definitely call an attorney.

    Rachel AltersFeb 25, 2018  #743

  • Sedgewick is the most unprofessional company. If you get hurt at work avoid dealing with Sedgewick and lawyer up quickly.

    EricFeb 24, 2018  #742

  • Tony, I am sorry to hear of this horror story, but unfortunately it is not unique. The ERISA laws do give them deadline to respond to an appeal. Please contact us to see if we can assist you.

    Alex PalamaraFeb 22, 2018  #741

  • Mygmy, unfortunately, there is no clear answer to your question.

    Victor PenaFeb 22, 2018  #740

  • Wow, it’s crazy to see all of these complaints, when you are going through the same thing. I have heard horror stories from a few of my employees, and now I am also experiencing the same issues. I thought I had sent Sedgwick all the paperwork they needed, and according to my case worker, it was sufficient, until near the deadline. I had a follow up with the doctor, 4 business days before my deadline to determine next steps. An extension was decided upon, since I had upcoming appointments with a Neurologist and NeuroSurgeon, and still no solid answers. My doctor sent in paperwork, unfortunately with the incorrect date, and missing office visit notes. I called Sedgwick and what a shock, my case worker was not available to speak, so I left her a voicemail, stating the extension was faxed in, and that I wanted to be sure there was no additional information was needed. I received a call back, 1 day AFTER my claim was denied, stating that my doctor had the incorrect date and did not fax in the visit notes, but she had already denied the claim so I had to file an appeal. I was also told that the amount of time I had to wait to see the specialist was unacceptable to them.

    I filed an appeal immediately, and feel that I have been screwed over even more by Sedgwick. With my appeal I sent them all doctor visit notes, all referrals, and all MRI results, etc. I call them to advise of a follow up appointment, and still of course cannot reach my case worker in the appeals department. I was asked when my appointment date was, and they would then extend the due date to get my paperwork in before sending to an independent physician. This happened twice before I called over and over before I could reach a managers voicemail. I finally got them to send it to a physician which spoke to my doctor 10 days ago, and still no update. I am now going on 2 months without any sort of pay, and being the only parent that brings in income, this has really put me in a hard place. I truly believe that I will not see this money. I got to a point where I begged my doctor to write a return to work letter, so I can try to get back to work and try to address my medical issue as well.

    Sedgwick should be ashamed of themselves!

    Tony SFeb 21, 2018  #739

  • Hi. I was just hanging out trying to find out how long it takes to get a settlement check or a offer from Sedgwick, because I’m really in need of some help financially Ii have had 3 spinal fusions, can’t handle any work or do anything being disabled. I pray I get a settlement check soon so I don’t lose the clothes off my back, thank you.

    Mygmy1Feb 21, 2018  #738

  • Caitlyn, it sounds like they are requiring an estimated return to work date. You should contact an attorney who has experience handling FMLA related matters to answer questions related to your FMLA leave.

    Victor PenaFeb 20, 2018  #737

  • Last month my mother went into cardiac arrest and had a seizure, and was in a coma, when I called out of work they told me to call sedgewick to file my FMLA claim. After weeks of hounding the doctors I got it filled out and sent off, a week later they called me to tell me that one of the answers were “wrong” the question was “estimate the beginning and end dates of incapacity” the doctor put undetermined which is accurate. They told me it wasn’t about my mother’s recovery time but about my return to work date. None of that portion of the paperwork is about me, it’s all about her. So here I am 350 miles away from my home with no income, trying to take care of my mother, while they try to stress me out with paperwork.

    CaitlynFeb 19, 2018  #736

  • My husband worked for Apple, Inc. from 2013-2017. After suffering a stroke his mental condition was not 100%. Sedgwick handled his initial LOA claim in July of 2016 at the time of the stroke. During this time we nearly lost our house and would have gone without food had our family members not stepped in to assist. After a few months of continuously fighting with Sedgwick while they “lost paperwork” and “were unable to reach a doctor” we finally gave up and my husband returned to work against medical advice. In January of 2017 he suffered a mental breakdown as the result of doing so and again had to request a LOA. Once again, we dealt with everything from not receiving pay, the case not being documented appropriately, failure to communicate, and then finally them sending him to see one of their so-called doctors. It turned out that their “doctor” was actually a forensic psychologist with absolutely no training in post-stroke mental evaluations. During the middle of our appeals process, Apple Inc. fired my husband for job abandonment on the basis that Sedgwick claimed they had already denied the appeal. (They had not.) We were in constant contact with my husband’s manager and the HR staff at Apple all the way through. There was absolutely no job abandonment– only a long lists of unethical business practices at play. This company should be taken down and their day-to-day practices placed under heavy scrutiny and yet, they continue to ruin lives.

    Lindsay T.Feb 13, 2018  #735

  • Deborah,

    I am sorry to hear of the difficult time you are having, particularly with Sedgwick and your employer. Unfortunately, if Sedgwick has made an adverse decision, such as deciding that you are not entitled to benefits, or that you are only entitled to a partial benefit payment when you should have received the entire amount, your recourse would be to file an administrative appeal with Sedwick. In its letter explaining why you are not entitled to benefits they would have explained how much time you have to appeal, which can be as short as 30 days or as long as 180 days, depending on your short-term disability plan. Please feel free to contact our office and speak directly with an attorney who may be able to offer you assistance.

    Cesar GavidiaJan 30, 2018  #734

  • I have never been thru a company like Sedgwick, I work for Walmart going on my fourth year,had hep-c. Went thru my second treatment while working at Walmart. Had to take six month short term disability due to having severe pains in the back of neck, blood not clotting,bruising or bleeding out all the time,liver very dizzy all the time lost weight unable to keep it on, liver cirrhosis, and they tell me that their medical team feels its not enough to give me at least half of my pay, in so many words you give me this time off, pay me for four days I was off prior to going out on short term leave for going to the emergency room for my back, for being out for four days, but not for my short term, I don’t understand how they can pay me for those days off, I mean they approved it, but not for the same medical issues and other medical issues.

    I have no income now, and so far I believe I have tunnel syndrome in both hands and arms and nerve and muscle damage in back, I still have problems with other medical issues, but they send you a letter stating that when you do come back your job position might not be here or hours and the store I work at will have to see if they have a opening in their store great.

    Deborah D.Jan 29, 2018  #733

  • Maria, as your claim is related to a Worker’s Compensation claim, you will need to consult with a Worker’s Compensation attorney to best assess your claim. Please feel free to contact our office and we may be able to get you in touch with a Worker’s Compensation Attorney.

    Stephen JessupJan 28, 2018  #732

  • I have been dealing with segwick since Nov 2017. I slipped at work on a wet floor. I had a concussion, neck pain, shoulder pain. I got paid regularly in Dec. I had returned to light duty. I have not recieved a check since jan. 2. I have now been told after my 90 days of light duty I must be fully released or I will be on l and I only and can not return to work until fully released. I am still waiting on approval for an mri since I am still in pain. I don’t sleep due to discomfort. Now I received a letter stating I have to go to an independent medical appointment. No idea what that is. I have finished all my therapies but still can’t use my right arm fully.

    MariaJan 27, 2018  #731

  • I am currently employed by AT&T, Sedgwick is of course the third-party claims processor. Currently we have several agents in our call center jumping through hoops with short term disability claims!! It appears claims are being approved for 1-3 months but anything after is denied. Agents are being encouraged to file for ADA for time off which is magically being approved?! In short the company is saying no you don’t disability but contradicts themselves by saying yes we’ll approve ADA for temporary time off because you in fact have a disability! Any thoughts on this would certainly be appreciated I am gathering up as much information as I can to take to our Union. Thank you!!!

    ShannonJan 26, 2018  #730

  • I was out of work from 11/13 to 12/27, started out as one medical reason and turned into several. All of my physicians have faxed or called Sedgwick multiple times but my disability claim was denied. I received ZERO pay for the whole month of December. Sedgwick claims that their medical team that looked over my paperwork did not feel that it was serious enough for me to be off work for 6 weeks. Every doctor I saw wrote a note for me to be out of work. Now I am appealing their decision. I went to a clinic for my medical information, and stood there as they faxed it to Sedgwick (I saw the transmission report). Today I get a call that they still don’t have any supporting documentation………. I am done with these people!

    BJMJan 18, 2018  #729

  • Sedgwick ruined my life, I have lost everything, and still not able to work, they misplaced records, did not communicate with me on anything, I called them continuously, and they always had no information or did not know what they were doing it has been under a year and still I want to destroy them and Walmart for what they put me through and denied me. I worked for walmart 10 years and paid for insurance only to be denied and loose everything I worked so hard for. I hate them. I have anger that cannot be settled till they burn in hell. I want them all to loose everything like I have and I want to be there to watch them cry their selves to sleep every night the way I do.

    MichelleJan 18, 2018  #728

  • So Verizon just hired this Sedgwick company to handle our disability claims. Already they’ve started out on the wrong foot bullying employees into coming back to work going against doctors orders and God knows what else is to come. They just started on January 1, 2018 and already I despise them. It’s simple for ALL companies, treat your employees better and with respect and you won’t have an absence problem, it’s not rocket science.

    Jane DoeJan 11, 2018  #727

  • Sedgwick loves to tell me that they have 3 days to process my claim after receiving new clinical notes, and they wait until the end of the 3rd day every single time before calling me.

    Well what recourse do I have when they don’t.

    I’m out due to an arm injury, coincidently I needed some cancer removed while I was out. I needed a week extension because I wasn’t able to see my injury doctor until 3 days after my disability was set to run out (due to cancer visit the previous weeks). I called weeks in advanced, left several messages with my claim rep and his boss. Neither would call me back.

    My disability ended mid December, half way through a pay period, I got my new notes in that same week, still no call back. I finally get a call the day after Christmas from Jason Mcquay , my case worker, and he claims he will call me back the next day. But he doesn’t, it’s a week later and I still have no clue what is going on, Jason won’t call back, his supervisor Scott will not call back. What can I do!!??? Not counting holidays and not counting weekends, my new notes have been in there for 6 working business days. This is the second time this type of thing has happened. What’s my legal recourse?

    It’s ridiculous to me, to put someone through this at this time of year. A lot of stress for someone battling 2 injuries, stress that was completely the fault of Sedgwick.

    Rob M.Jan 2, 2018  #726

  • I work for a VERY large company that uses Sedgewick. I have worked at my company for 14 years. I gave a lot to my employer. In 2011, while giving a training session, I had extreme facial pain. A few months and a LOT of tests later I was diagnosed with Multiple Sclerosis and Trigeminal Neuralgia (aka the suicide disease).

    Fast forward to 2016… It finally gets the better of me. I had to take FMLA for a few weeks to try some procedures. Luckily at the time we had salary continuation so the Sedgewick delays didn’t impact me.

    1 year later, new doctors and new procedures. I have a slim chance to regain my life….. So I took it. I took FMLA and STD, because now we have a new system with Sedgewick, no salary continuation.

    My FMLA started 11/1. My paperwork for FMLA was “Not Received” by Sedgewick for long enough I almost lost my job. I finally had to call them AS THE DOCTOR FAXED IT and suddenly, they FOUND every copy.

    Few weeks later, after emails that state I am 100% approved, I get an email and call on 12/22/2017 saying my STD is NOT APPROVED. I got this all AFTER the doctors office has closed. I missed 1 check on 12/14 but was told that was a mistake and it was being fixed.

    So 3 days before Christmas we are broke, cant finish Christmas shopping, and my job is in danger. Again. One of my daughters got very little Christmas because of this.

    I fought back. On 12/26, 12/27, and 12/28 my doctor faxed all Sedgewick requested information. 3 times!!! They always said “Wait 24 hours for us to receive it”.

    Fortunately my company helped me a lot. I ended up getting a hard copy of everything on 12/29 and personally emailed it. I separated it by treatment days. I called as I sent the 2nd set. Guess what? When I called they didn’t see anything. Then I told them I was emailing it all, it was being copied to corporate, and I would NOT hang up until I was approved and paid, they suddenly saw ALL 3 FAXES AND MY 1ST 2 EMAILS!!!

    I was approved quickly. Their system shows my pay has been sent. My company confirms it has been sent. However, it ain’t in my account yet. Hopefully tomorrow so I don’t lose my truck or home….

    If they screw me anymore, I will likely have to get an attorney. My medical benefits are suspended because they haven’t paid my premiums since my LOA started.

    Hopefully all is well by the new year. Because I am scheduled to return to work on 1/8. 2 months I have been fighting while getting at least 1 procedure a week.

    I would have been better off taking vacation but due to my health I didn’t have much left. I say that because in the last 2 weeks I have spent 20+ hours minimum dealing with Sedgewick.

    DougDec 30, 2017  #725

  • My husband told Sedgewick on 12/13 he will be out on disability from 12/13 to 1/22 or maybe longer cause he has thyroid cancer and will have high dosage iodine treatment and the surgery was on 12/18. They said will give a case manage. We gave them doctor name and number on surgery day, they claim they called doctor on 12/19 and 12/22. They could not get any one… so my husband did not get paid and we can’t pay our rent or bill cause these monster did not approve the disability. We talk to this Adriana Miranda today and she claim they sent check and we won’t get it until 1/9. Then I check the email and she sent a email indicating was approve only for 12/25 to 12/31… so the time from 12/13 to 12/25 no pay and time from 1/1 to 1/22 or longer if he has to be from iodine treatment he will get no pay and we lose everything. I want a law suite brought against this company and action take… right now.

    Robert/Angela H.Dec 30, 2017  #724

  • I am a Walmart employee and I have been dealing with Sedwick since August 14, 2017. I have Fibromyalgia, along with arthritis, high blood pressure, and other issues, but the main reason I went out was for Fibromyalgia because there are many days I am in severe pain, very fatigued because can only sleep a few hours and have to get up and try and move around because joints and muscles are very stiff. Every month they want new and updated information and I have been denied twice because not enough medical documentation. For starters my Dr has stated my condition has not improved and have several limitations that my job will not accommadate me with. It is a constant hassle and now my benefits are delayed again which may result in a denial again.

    So they approve me one month and deny me the next month but my condition has not improved. They have no problem approving me for a non paid leave of absence in hopes that my medical condition will improve, but they don’t want to pay me. I have incurred hundreds of dollars in medical expenses seeing drs every month and going to physical therapy every week which is an out of pocket expense. I stopped going to physical therapy because I can not afford the pmt for every single visit, so I do the physical therapy at home. If I was trying to get paid for disability and was being dishonest why would I incur all this medical expenses, to prove my disability. This whole process is a nightmare!

    Kathern W.Dec 26, 2017  #723

  • Jay, was your disability claim reinstated? If not, you would have rights to appeal the decision. Please feel free to contact our office to discuss your claim in greater detail.

    Stephen JessupDec 22, 2017  #722

  • As a C-Suite executive that recently experienced a medical hardship for the first time in 20 years, I have never felt more discouraged. Sedgwick is the worst administrator of disability benefits. My claim was approved and then denied when Sedgwick made an error in processing my claim. Their expertise in reviewing claims is awful. It’s no surprise that my employer, a global financial institution, selected Sedgwick to administer their Short Term Disability program.

    JayDec 21, 2017  #721

  • Frank, I am sorry that you are having difficulties with the website. As I do not know what your situation is I am not sure what advice/guidance I can provide here. If you would like to discuss your disability claim please feel free to contact our office to speak to one of the disability attorneys.

    Stephen JessupDec 20, 2017  #720

  • What’s going on with your website, I’ve typed everything out twice and when I’m almost done everthing disappears. This is like working with Sedgewick. I’m not typing it out again. I was really hoping to get some advice or representation still want to put my claims manager on this. Sherry hauke she has misled me lyed to me and kept me from getting paid fully.

    FrankDec 19, 2017  #719

  • Sann, I am hopeful that you will not need legal assistance, but if you do have any issues with Sedgwick please feel free to contact our office to discuss.

    Stephen JessupDec 7, 2017  #718

  • Its unreal how Sedgwick waits two days before your pay period ends then say you need more paperwork when I have been keeping up with the claim online and they receive the doctors notes a week ago. They approved the medical leave but they don’t want to pay. Its always a problem when it comes to getting paid, what the purpose of paying for short term and long term if something happens you can’t get paid recovery from a back surgery. That wasn’t successful, is no joke than you has to worry how your bills gonna get paid because they are slow on their jobs.

    ForrealDec 6, 2017  #717

  • Shelby, Sedgwick will have to send a formal denial letter setting forth the reason for denial. It may potentially be they are denying the claim for a lack of medical evidence (meaning they don’t have all the records) as opposed to a lack of evidence of restrictions (meaning they have all the records but think she can work). Depending on the basis of the denial will determine the course of action. If it is the former basis it may be that getting them the updated medical records could get the claim reinstated. Regardless, as soon as you receive the letter please feel free to contact our office to discuss further.

    Stephen JessupDec 6, 2017  #716

  • My husband suffered a stroke at work 2 years ago which left him permenantly disabled (no use of left arm, walking only with assistance). We’ve been dealing with Sedgwick ever since. He is now on SSDI but still receiving Health Insurance through PepsiCo. He was denied employment with reasonable accommodation. Sedgwick reviews his LTD claim every six months where they request medical records and wait till the very last minute to initiate payment for said records causing us to miss the deadline and be denied. We have requested medical records ourselves, paid for them and dealt with both the medical center/offices and the 3rd party copy company ourselves. His disability is up for review again this month and will determine whether he can ever work anywhere again.

    SannDec 6, 2017  #715

  • My wife had a spinal fusion, back in February and everything went well with here short term through Sedgewick. Fast forward to November she is still in terrible pain, her doctor sends her for test and finds out that there is cyst growing on her nerves in her back cause this extreme pain. He immediately begins the process to set up surgery and tells her to go ahead and take off work and put in for short term. Here we are her out of work since November 14th and sedgewick notified us last night that she is denied due to insufficient evidence even though the doctor has pushed for it. I am wondering what can be done if anything to fight this denial.

    Shelby W.Dec 5, 2017  #714

  • I’ll share my experience with Sedgwick. In August 2015 I went on disability due to a rare brain tumor which had to be removed by a specialized neurosurgeon in another state. After comprehensive testing, I had the surgery in September. The surgery was successful; however I had serious complications which required 10 days of hospitalization.

    When I finally got home, Sedgwick had already cut my benefits. The representative wanted reports and she wanted them now! I faxed many,many pages of reports. She was overwhelmed I hope, but I seriously doubt she even looked at them. She approved a short extension. I had to explain to her that I had brain surgery – I couldn’t bend, climb, stretch, carry or sit for long periods of time, not to mention drive. My job (onsite technical) required all of this, plus more. It wasn’t just a “sit at the desk, paperwork” job. Most of the time my job required extensive physical work.

    I developed a serious complication after I got home which would have killed me if not for intervention. I lost an enormous amount of weight, couldn’t sit, couldn’t eat, couldn’t do anything. This lady persisted —calling,calling,calling pressuring me to return to work. My physician completed all paperwork that she requested. She either didn’t understand or didn’t want to understand and just kept calling ,asking when I would return to work. Keep in mind that my employer, AT&T, provided comprehensive disability benefits (up to 2 years), yet she didn’t care. AT&T paid my salary – – not Sedgwick. No one at AT&T was pressuring me to come back to work – – just this person at Sedgwick!

    She was like a robot….same thing all the time. Finally I got tired of it. She wore me down. I was still sick. My doctors completed all the paperwork requested. I gave up. I knew I would not be able to return any time soon so I just retired. I am certain that I would have died on the job had I returned to normal duties.

    As I said before, my people at AT&T wanted me to get well and return to work when the time was right. You would have thought Sedgwick was paying my salary – – not AT&T. The only fault I have towards AT&T is that they hired this company to do their HR work. Such a mistake.

    AT&T paid my full salary for almost 6 months. This has been over two years ago and yes, I am still seeing doctors for this disability.

    WynnNov 30, 2017  #713

  • Eric, if your policy ends at age 65 there would unfortunately be nothing we could do to assist you in receiving additional benefits beyond that date.

    Stephen JessupNov 27, 2017  #712

  • Hello, I’m a former At&T employee. I suffered a back injury on the job in 2002. I have been on long term disability since 2005. I have a back operation in 2004 (fusion spine surgery). I received LTD payments from At&T Sedgwick climbs management since 2005. I recently received a letter stating my LTD payments will discontinue because I’m turning 65 in March 2018. At this point I have no other income. My disability payments are approximately 60 to 70 percent less than want I would have normally earned annually.

    Eric S.Nov 25, 2017  #711

  • My claim with sedgwick has been denied because of my doctor’s office has not responded to their requests, that’s what they say. But I was there when the notes they were requesting were faxed . I’ve heard this from them many times I’ve had to go out on sick leave. But when you tell them you faxed over the doctors notes they sometimes say oh we got that but we needed this instead. I have spinal bifida, my spine is a mess. I have bulges at everyone of my lumbar disks. and I’m scheduled for a fusion of my s1 to my hip. I suppose that’s a treatment plan if I ever heard one, right? I have threatened them that I will have a lawyer get the money they owe me. I don’t have one but they don’t know the difference.

    I’ve gone 2 months without a paycheck and they are making it very difficult for me to pay my bills. I am waiting for my benefit rep To contact me. I work for gm 10 years and no doubt gm is having sedgwick delay paying me. How can so many incompetent ppl work in one company. I have some teenagers that need a job! I’m frustrated I’m angry, I’m worried, I’m beyond pissed! What kind of recourse does one have towards sedgwick and their employer for the pain and suffering this company is causing me?

    Michaela R.Nov 13, 2017  #710

  • Robert, under most Short Term Disability plans, even those funded by an employer, Social Security benefits are a source of Other Income subject to offset. You will need to review your policy, but if it is there the repayment would be enforceable.

    Stephen JessupOct 28, 2017  #709

  • This is the worst company I’ve ever dealt with for disability! Its been over 2 months and I haven’t been paid, everyone there gives me the runaround, my claims examiner is NEVER THERE so I can never get in touch with him, I can’t get a straight answer for anything. I have been off for 2 months for a metatarsal bone fracture in my right foot, and they have made everything incredibly difficult for me. Not to mention it is costing me money just to send them paperwork, I’ve spent almost 200 dollars faxing them paperwork from my doctors office.

    I submitted more medical work for pending review to extend my leave, since my doctors appointment isn’t until next month to allow the bone to reconstruct and heal. I work at Starbucks so there is absolutely nothing I can do that will work with a broken foot, ie. slippery floor hazards while on crutches, small spaces, extended walking/standing/lifting all of which I can’t do. I haven’t even been cleared by my doctor yet for anything but Sedgwick decided to screw me over by telling me on oct 27th that I will be contacted about going back to work on October 30th… WHAT???? Not to mention I also have a driving restriction and I’m not able to drive to work, as it is my right foot thats still very much broken.

    Not only did they only give me 2 days to try to appeal, but they made it so that no one is available on weekends to talk to. I’m fed up with this company and am running out of options if they don’t approve further leave without a release from my doctor. This has to be illegal somehow. I’m confident Starbucks cant accommodate me sitting but I find it completely ridiculous at this point that they are already shoving me back into work without a follow up doctors appointment. On top of this I may need surgery. What are my options? They were also sending paperwork to my primary care doctor even tho they know I’m being treated by a podiatrist for my fracture… please help.

    AndreaOct 27, 2017  #708

  • I worked for 17 years for my employer, one of the 2 big soda companies. I went out on short term Disability, I have several heart conditions that did not allow me to return to work and there for my Short Term turned into long term. I was just awarded my SSD. I knew that I would have to payback the money that I received for long term but not my short term as I was under the impression that the company I worked for provided me short term disability. In the 17 years I worked there I have been out on short term before and never had to pay it back, but this time I was not able to return to work because of my health. Now Sedwick is saying that I have to repay short term money that I received and are going to take 90% of the back pay I received from Social Security Disability.

    Robert F.Oct 27, 2017  #707

  • Beth, I am not sure how we can assist you. We only handle claims for disability insurance benefits, and it seems as if yours is related to getting treatment approved. If that is the case, we would unfortunately not be able to assist you. If you do have a disability claim please feel free to contact our office to discuss.

    Stephen JessupOct 5, 2017  #706

  • Bea, some policies create a duty to meet with a representative of the insurance company or a third party administrator (such as Sedgwick). You would have to refer to your policy to see if yours contains such language. If it does have the requirement and you refuse it could potentially negatively impact your claim.

    Stephen JessupOct 5, 2017  #705

  • I work for Walmart and have been diagnosed with breast cancer. I submitted the forms to Sedgwick and am having problems getting the approval for biopsy, results, MRI, preop, surgery and recovery from surgery. All ongoing treatment will be affected because of they demand that only ONE doctor can be involved in the time needed for the full scope of treatment. My primary care physician ordered the biopsy and results consult, my surgeon scheduled the MRI, pre-op, surgery and recovery. I would suppose it will be my medical oncologist that will approve the chemo, the radiology oncologist that will approve the radiation and any treatment/leave and each doctor/oncology specialist will handle any needs I may have for either time off or restrictions. Sedgwick demands that only one doctor fill out all forms. My primary doctor has no idea how my recovery from surgery will go. My surgeon’s office said I was not a patient of theirs before referral after the biopsy results were known. My primary sent a letter to them for the biopsy and results (dates I missed from work) however the letter had all the doctors in the practice listed on the letterhead. THAT is not allowed either. They are demanding that I designate only ONE doctor for my treatment of breast cancer. They will not accept multiple doctors submitting the documents pertaining to one condition.

    BethOct 5, 2017  #704

  • Returned to work after a lengthy botched & mostly unpaid STD claim. Sedgwick determined accommodations & restrictions were medically supported. Employer decided they couldn’t accommodate & removed me from my position. HR says I can file for STD again. Like before, it’s a nightmare.

    Sedgwick now says a Field Case Manager must come to my house to discuss conditions & treatment plan, and attend all my doctor appointments.

    Can they require this for a STD claim that’s not worker’s comp related? I think it’s invasive and unreasonable, but worry they will deny the claim if I say no for failure to participate, or some other excuse.

    Also seems a conflict of interest. A Sedgwick employee is interfering in doctor appointments I’m paying for, which are intended to treat my condition, and will be using it as an opportunity spy on me and argue with my doctors (because we all know that’s their intention).

    BeaOct 4, 2017  #703

  • Cathy, we only handle claims under disability insurance plans. You will need to speak with a Worker’s Compensation attorney. Please feel free to contact our office and we can assist you in finding one near you.

    Stephen JessupOct 4, 2017  #702

  • Michele, please feel free to contact our office to discuss how we may be able to assist you in filing any potential appeals.

    Stephen JessupOct 3, 2017  #701

  • My husband works for one of the Big 3 in Michigan. He has been fighting Sedgwick for years always doing what they say following their rules. Now after his 9th surgery in his upper extremity they sent him to a IME Doctor. I went with him to the first 2 and was shocked at what I witnessed, this last time I couldn’t go with him so he privately taped the doctor visit. I was equally shocked when I listened to his visit. My husband has 2 separate issues and has a lot of restrictions making him unable to work according to them although he had a desk job for 6 years all of a sudden they have nothing for him.

    After going to this so called Independent IME doctor the company said his restrictions have changed and his benefits are cut off until he see the plant doctor which will put him back on the line. He takes opioids for pain but they won’t care. I want him to hold out and sue because being S & A he is being discriminated against because the have people on WC with more or same injuries as him just sitting around collecting a paycheck. I think its criminal watching him be in such pain and they do nothing but put him back out there again. What should I try to talk him into doing because it is straining our marriage….. Desperate.

    CathyOct 2, 2017  #700

  • I was denied my short term disability claim; which would have lead to enough time to receive long term disability. In order to have a procedure for my permanently heart condition I had to travel out of state. It’s only performed in a select number of hospitals. I was required to be local to the surgeon for the entire month it took from the initial appointment thru the requested testing and the final surgery date; not including recovery time.

    The denial was because I was technically physically capable to work for the in between time. The fact that I was required to be out of state to have this critical surgery was deemed irrelevant and I was told they could not take any doctor information prior to my first date missed for this incident into consideration. I have a permanent heart disability and there is a long list of related medfical information.

    Michele M.Oct 2, 2017  #699

  • My heart breaks for all of you in need and struggling with Sedgwick. I pray for all of you and your loved ones.

    They only approve for me 2 months each time, but twice Sedgwick has approved my STD claim for chronic heart failure, i.e. Dilated Cardiomyopathy. I have an Ejection Fraction of 20%. I had a Defibrillator and Pacemaker implanted in May 2017, and by June I could no longer cover for all the days I missed from June 2016 to May 2017. Consequently, I filed for STD in June 2017 and it was approved in late July. My employer is Hewlett Packard Enterprise (HPE).

    Reading all these stories leaves me lacking confidence in how they will handle my claim going forward. My condition is non ischemic, meaning there’s nothing that doctors can correct. My condition has not improved in spite of all applicable treatments having been applied. I will not be able to return to work, ever. If I have to sell everything, so be it.

    Prior to filing my claim, I spoke briefly to Victor of Dell & Schaefer. He advised me to ensure my claim and attending physician statement included specific restrictions related to my job, and to iclude the medical documentation of tests that support the symptoms which necessitates the restrictions.

    If denied, I will immediately hire an experienced attorney, perhaps from Dell & Schaefer.

    Michael JSep 27, 2017  #698

  • Kimberly, please feel free to contact our office to discuss your claim in greater detail. Sedgwick is a nightmare to deal with and Apple’s long term disability carrier is not much better.

    Stephen JessupSep 18, 2017  #697

  • Cynthia, Sedgwick would not be under an obligation to provide you with a report unless your claim was denied. We have been successful in the past in getting insurance companies (or third party administrators) to send a copy to a treating physician, so you can request they send it to your doctor, and then secure a copy from him/her.

    Stephen JessupSep 18, 2017  #696

  • Sedgwick has been a nightmare for me since I started working at Apple. I have Complex Migraines due to my CMT-2C. That being said sometimes I just can’t function; physically or mentally. Sedgwick has worked with Apple and I am approved time off and a huge job accommodation; but they refuse to pay my disability claim to pay me for the almost 3 months I was out. I have to fight appeals each and every time I go out on LOA. I normally win; but this time the objective clinical findings say no .. yet the time off was approve and the job restrictions.

    How can this company put so much stress on a family, my PCP and Neurologist both agree I should be on full SSDI, but that is just not possible since I take care of my family. Now I’m w/o pay for months, I’ve returned to work and I still can’t get my back pay. I truly despise these people. The case managers always seem to call between 430-500 so you never can call them back and they always seem to go to my voicemail, I never hear the phone ring when they call (SlyDial much). I wish HIPPA was never a thing so that companies did not have to use third party companies like this. How is anyone supposed to feel better; or regain their health while dealing with all this stress.

    Kimberly K.Sep 12, 2017  #695

  • Sedgwick sent me to a psychologist and a psychiatrist for exam. The report went back to them stating that my condition is as I told them and the report gave recommendations that are in my favor. However, Sedgwick will not send me a copy of the report, they are stating that they are abiding by ERISA and FEHA law which says that they only have to provide me a copy in the event that my benefit is denied. These are my records that my primary doctor would like to have to future assist with my condition. Do I have a right to these records?

    Cynthia M.Sep 11, 2017  #694

  • In spite of the fact that they are not doctors, and have never examined the claimant, they think they know more about how your injury/procedure/surgery/disability should be handled, and they try to make it as hard as possible for you to draw your short term disability.

    It is NOT their place to prescribe treatment… they should follow the DOCTOR’S diagnosis and treatment plan… but, they are in the business of screwing people… just like any other insurance company…

    My doctor approved my leave until Sept 5, 2017… I got a call today, saying they would only approve my leave until Aug 28, 2017… and, told me I would have to go BACK to my doctor and get more paperwork…

    Can these people not READ???

    Tim A.Aug 9, 2017  #693

  • I am currently 38 weeks pregnant. My doctor wrote me out of work at 32 weeks for sever back pain, leg numbness and light headedness. This claim was approved from the write out date to my due date. A few weeks into my claim my employer switched to working with Sedgwick, at this time they honored my previous approval for a week then denied my claim. They told me my doctors option was subjective not objective and so there was no evidence that I could not work, even though my doctor had stated the only resolution to my symptoms would be to give birth. My pregnancy was also complicated due to being over weigh and I am currently being sent weekly to a specialist to have a non stress test performed. Sedgwick is denying they see this advanced treatment request in my medical notes and have stoped the income I require to be able to afford the co insurance on this requested weekly test. I have gone back and forth with this company for over a month now. I am 18 days away from my due date with no income and unable to have the weekly requested testing done on my unborn child. A joyful experience has turned into one of extreme stress and has put me in a place where the ability to take care of my unbor child is now out of my hands. It is a shame.

    SarahAug 3, 2017  #692

  • I’ve worked at Walmart for 18 years and about a month ago filed for FMLA for the first time ever. After MRIs etc. I discovered that I have a degenerative spinal condition. Sedgewick is the most inept, confusing, aggravating thing I’ve ever encountered. My physician sent her forms twice and Sedgwick kept saying that they had not received them. The third time she called and spoke to an actual person, sent the statement again and received confirmation that they had the statement. That was Monday. Today I received an email from Sedgewick that my claim is denied because they didn’t receive the statement. They are unprofessional, unhelpful and if not dishonest then stressing out the very people that they are supposed to be serving. I hope that I never have reason to use them again and I feel very sorry for those who do.

    Mary C.Jul 27, 2017  #691

  • I have been disabled since March of 2017, it took at least two months to receive any payments. Sedgewick
    employees do not answer any of my calls or emails, and when my doctor office contact them about my extension for my therapy they are not responding. My Therapy has stopped without any notice because they are not complying. They sent me to one of their doctors and the doctor noted me as permanently disabled and i need continuance of my therapy and they are still not responding. i’m still in pain and i need my therapy but they are not extending it. It is very frustrating when i have no any source of income, after the doctor claimed me perm disabled they sent another letter to their doctor asking when can i return to work and the doctor ruled that i have to sit with limited work with my arm. my job does not require any sitting.

    Royston T.Jul 26, 2017  #690

  • Jennifer, have you discussed the issues you are having with Sedgwick with HR for Honda? As Honda would be the entity that would be sued (or more accurately – its disability plan) they may get involved to avoid same.

    Stephen JessupJul 25, 2017  #689

  • I work for Honda and I’ve been out twice before now on STD. I unfortunately have 3 auto-immune diseases and they’re causing a lot of problems. The previous two claims have been approved and paid. This claim, that I’ve been out on since May 4th was denied, and the appeal was denied and they told me I have no other appeals allowed and if I want to do anything I have to litigate. Same diseases, same problems and same Dr information. How can a company approve leave two previous times and now deny? Also, because my fmla is out I’m now being threatened by Honda to be fired if I don’t return within X days. I had a FCE done and it was determined I could no longer work. Sedgwick is now only adding to my stress and making my flare up even worse. I feel hopeless and frustrated. I’ve sent my info to your attorneys and I’m hoping you can help me.

    Jennifer M.Jul 20, 2017  #688

  • I was awarded STD January 2017 by Sedgwick. On June 26, I was notified that my benefits were denied with the reason given as documentation was not received. Physician’s office had sent needed documentation to Sedgwick with notes of fax received. Documentation was resent, benefits were reinstated.

    On July 1, 2017 documents for LTD was received because my STD was within its final 30 days. On July 14, I was notified of STD being denied. Sedgwick called my physician’s office and had a secretary read my last visit notes and determined my eligibility from what a secretary could relay to them.

    My last visit to this physician had nothing to do with my diagnosis/reason for STD. I had a Total Hip Replacement with subsequent emergent abdominal surgery. I am currently halfway through my THR rehabilitation/physical therapy with benefits denied.

    Fool me once, shame on me. Fool me twice, contact an expert attorney.

    Good luck everyone.

    Karen T.Jul 16, 2017  #687

  • Kristina, it sounds like your claim with Sedgwick is for Worker’s Compensation. If it is in fact worker’s compensation you will need to consult with an attorney that handles such claims to best be advised as to your rights.

    Stephen JessupJul 7, 2017  #686

  • Roberta, please feel free to contact our office to discuss your claim in greater detail.

    Stephen JessupJul 7, 2017  #685

  • I have been dealing with Sedgwick for almost a year now. I work for Boeing and have nerve damage in my Right arm. I’ve seen 2 orthopedic surgeons, which say its permanent nerve damage, and I went to their independent medical study, the doc told me not to get surgery that it wouldn’t improve. He told me to switch jobs because continuing my current one would only damage it further. My regualr doctor didn’t feel comfortable putting me back to my job, and has kept me on light duty. I’ve been waiting to see another surgeon for 2 months!

    Recently I was working my light duty job, and ended up with a nasty cervical muscle strain. So bad I can barely move and its been a month! It’s caused reversal of my cervical lordosis. I’ve been to all of my appointments, and have been attensing therapy. Today I recieve a letter from Sedgwick telling my I’m not complient because I haven’t gotten a second opinion? I was never told I needed a second opinion. They are very difficult to deal with and always seem to want more and more with no real help or answers to the injury at hand.

    KristinaJul 6, 2017  #684

  • Sedgwick has caused me financial damage as well as a great deal of stress. I am on short term disability for breast cancer surgery. My claim was approved but improperly handled. The case ”specialist” put that i was to be paid my PTO that i had specifically marked that those hours were not to be used. I did that to cover intermittent absences while going through treatment. Because of this my state disability was denied. I will have to go through treatment which will include additional medication along with the treatment copays, unpaid. My state disability would have paid for my time off while I’ve been recovering from surgery. It does not pay for intermittent absences. My anxiety is through the roof, how am i going to pay for my cancer treatments going unpaid? I would appreciate any help.

    RobertaJul 6, 2017  #683

  • Danica, what is the status of your claim? Did you file an appeal of the denial?

    Stephen JessupJun 22, 2017  #682

  • I have MS and my neurologist took me off work. They ignored my valid paperwork and sent in a cancelled surgery that was cancelled due to my lung issues, just so they could deny my claim. I’m originally off do to cognitive issues verified by my neurologist and psychologist that performed my test. When my short term is denied my long term is denied. Meanwhile I’m dealing with bilateral atelectasis (collapsing lungs).

    DanicaJun 20, 2017  #681

  • I worked for Walma/t back in April 2017. I was fired for two many absences. I told them I couldn’t have unless you are counting my medical days. Sedgwick said they never received my paperwork from my doctors stating that I needed these days off. My doctor told me they faxed the paperwork back to Sedgwick and Urgent Care could not get the paperwork to go through on their fax, so I had them fax it to the human resources office at Walmart. Then Val at Human Resources faxed it to Sedgwick. I called Sedgwick and was told that there was a discrepancy on my doctors paperwork and if it was her she would have called my doctors office to verify. Since they didn’t those days were counted against me. The dates for Urgent care that the human resources faxed was apparently never received either. The last time this happened I was almost fired also. I called Sedgwick that time and my paperwork was put under a employee with the same name in a different state. I have been unemployed since April 7, 2017 and was denied my unemployment. Obviously Sedgwick is working for the employer, not the employee.

    Terry H.Jun 20, 2017  #680

  • Temporarily Disabled, please feel free to contact our office to discuss your denial and your rights to appeal.

    Stephen JessupJun 13, 2017  #679

  • I’ve worked for a utility company for over 20 years. After leg surgery my surgeon told me standard recovery time to walking would be 12 weeks. I advised Sedgwick. They’re response was that they could only approve 6 weeks at a time and suggested I simply call back for approval of the remaining time. When I did they requested a doctor’s note confirming the recovery time and that I would be non-weight bearing. I sent it to them. They told me it would take a few days (it took a week) and sent a claim denial to my employer. When I called the examiner she said that she had “plenty of coworkers that come to work with broken legs in casts” and that I should be able to drive and return to work while admitting that she wasn’t a medical professional. In the meantime my employer has stopped my STD sick pay that I’m entitled to under union contract at the advisement of Sedgwick. BTW, most of us don’t have cars in NYC. How can Sedgwick employees give medical advice without a license? Is this legal? This shady organization uses unethical business practices for sure. Their Business License should be revoked. How can I contribute to that process?

    Temporarily DisabledJun 11, 2017  #678

  • 1 of the most difficult companies to work with. They requested extra notes from my surgeon’s office, they got their extra notes and told the nurse I’ve been approved. I call in to check my approval and they say it’s still pending that I should call back later. If you have a case manager shouldn’t they be calling you to let you know what the status of your short-term disability is?

    My doctor originally requested 8 weeks off for me. They claim they can only approve one month at a time so now I’m going through the entire process again. I’m so sick of this company just to prove it the one time and leave me alone so I can heal!!

    FelicityJun 5, 2017  #677

  • AT&T worker here, at first Sedgwick was all nice and helpful in getting my claim going. They promised how if any issues arise my examiner will call me so we can get things sorted out. Well after my first payment, they required a new medical due date, fine. My Dr submited my MRI papers to them, I was the denied with disability terminated. I was never called or informed, neither was my Dr. I happened to look online all see it. I called, and the reason was when the Dr submitted MRI papers, they didnt say I can not work. Well nothing has changed at all, or else it would have been noted. My manager has already contacted me about being forced to return to work. I am injured, can not move to perform my duties, what happened to no job is so important and no service is so urgent that we cannot take time to perform our work safely, huh AT&T?

    Angry ATT workerMay 18, 2017  #676

  • I have been on short term disability since August of 2016 after a period of intermittent leave due to multiple medical issues. Sedgwick has been a nightmare from day one, and continues to be to this day. I had hydrocephalus develop in the fall of 2015, coinciding with debilitating back pain. Typically it would take 2 weeks to get leave approved or denied, though my case took nearly 6 weeks due to Sedgwick filing the incorrect type of claim. This resulted in my having to go the process twice. During this delay, I had Papiladema and my optic nerves were hemorrhaging blood due to the amount of swelling in my brain. I had no choice but to play by Sedgwick’s rules, as if I went on leave before it was approved, I would have violated attendance policy and been subject to termination, thus losing my insurance. While my leave was eventually approved and I have been able to address these issues, I have some level of permanent damage in my vision. Several doctors are in agreement that it is likely due directly to the delay created by Sedgwick.

    Unfortunately, I had complications with the first surgery to fix these issues, and needed to be redone twice. In addition, I was in need of a spinal surgery. This resulted in my going from an intermittent absence to short-term disability. Throughout this entire process, Sedgwick did EVERYTHING in their power to get me denied, month after month. They played many dirty tricks routinely, including not sending proper paperwork to physicians until a day or two before the deadline, or even not at all. They would give me specific information needed from physicians in order to accept paperwork, only to deny the paperwork for the same reason. They would set my disability end date to coincide with follow-up appointments with physicians, and contact my employer claiming that the physician had released me back to work prior to appointment even occurring. They would routinely contact me and claim that they had spoken with the physician and I was released to go back to work, only to find out that there was never any communication with the physician.

    Now, they are trying to deny my claim, due to my Optometrist not being able to submit an attending physician’s statement, despite my primary doctor, neurosurgeon and neuro-ophthamologist submitting one. An Optometrist is not a medical doctor, claiming that they are legally not supposed to submit this type of statement, though Sedgwick is still insisting.

    Sedgwick has taken the most difficult time in my life and brought it to an entire other level of stress. The main thing that I have learned is that Sedgwick will lie constantly and play any dirty trick necessary. You have to not hesitate to call them on the lies, and be PROACTIVE. You have to stay one step ahead of them and you will have to fight them until your last day of leave.

    JMLJRMay 3, 2017  #675

  • I see I have commented before but that was several years ago when husband had neck issues. Now 6 yrs later, my husband is off work with back issues and Sedgewick denied short term disability after a month and a half even tho our dr was still running tests and could not release him to do his job. Their dr disagreed (without seeing him) that he could return and cut off short term disability and our pay. We have now been 3 months with no paycheck and now 3m has put him on leave of absence against his knowledge therefore cutting him off of Ins. so he cannot get the treatments so he can return to work. We have contacted a lawyer…

    Pam W.May 2, 2017  #674

  • Filed claim with Sedgwick in January, was diagnosed with with pancrentitus ,while in the hospital it was discovered I also had urinary retention and had to have a catherter inserted. Both my urologist and primary Dr. wrote that I could not return to work for fear the bag would catch causing great harm or my bag could break while at work or in clients house. I was denied by Sedgwick telling me there were no specific reasons given. I was hospitalized again due to a infection throughout my whole body due to catheter.which unfortunately caused me to have my testicle removed. I was left with an open wound that had to be cleaned and packed everyday. My health insurance even authorized in home help. Mr Rios at Sedgwick still denied me. At that time they had to put in a super pubic catherter which is basically a hole in your stomach . I spent 5 weeks in hospital, Sedgwick paid me for one week and denied everything else. We sent all hospital records to them and many many Doctors notes only to be told time and time again it was not good enough. It is almost unbelievable. We have no choice but to seek legal counsel at this point because they sure know more than doctors.

    Henry W.May 1, 2017  #673

  • So, I have been out since march 2017 due to overwhelming stress and overload without proper training (repeatedly asked), on March 2nd had a “stress seizure” due to no sleep and stress. I had something similar in 2006 while in nursing school and facing extreme stress. So that morning I asked my daughter to take me in to the doctor. I am a case manager and big part of our job it is to educate members on the use of emergency rooms. It took 7 days to get an appt with the neuro and “20” days to get an EEG & MRI after the incident. PCP wrote no work or drive until cleared by neurology, the neurologist did not want to be bothered with paperwork so refused to sign anything and said I could work but not drive, meanwhile she won’t sign a release to either…

    So on the 24th I went back to work unable to drive (my job requires driving to homes). Still no word on the 24 HR EEG to clear me to drive, my employer is on me for late assignments and received a verbal warning, AND of course Sedwig denied my short-term disability claim and it is making it impossible to have docs fill out a “proper” FMLA form. All my medical claims have been denied and when I attempted to file workman’s comp claim Sedwig asked me questions like: “Do you speak any other languages?” “Are you single or married?” when I refused to answer until I spoke with a lawyer, they stopped the recording and hung up.

    plmcfoxApr 20, 2017  #672

  • Sedgwick has canceled my short term disability, in spite of the Doctor’s office bending over backwards to get information to them.

    Dr has fax receipts on record showing they sent thorough records, sent three different days with different information.

    This is making my anxiety worse, we’re out of savings, and I don’t know how we’re going to manage rent.

    I am NOT cleared to go back to work, and Krystal (who represented herself as my ‘case worker’ ) just cut everything off. I don’t know what we’re going to do, I’ve already sold most everything of value.

    Anonymous - might want to move forward with legal actionApr 4, 2017  #671

  • David, please feel free to contact our office to review the denial letter from Sedgwick as well as to discuss any potential new claim filing.

    Stephen JessupMar 28, 2017  #670

  • How do make it so segwick can’t deny my claim. My HR has also told me that I need to file FMLA for Doctor Appts on personal time.
    They claim it non repetitive re occurring treatments. They know what Doctor and the reason for the appt. I never disclosed the Doctors name or the reasons I saw him.
    Sounds like protected information is being share without authorization.

    David A.Mar 25, 2017  #669

  • I was told that I needed surgery and I told my HR that I need time off. Was granted the sick time. Took 22 days to recover. Came back to work with a release from my Doctor. Then told I have to file a claim with segwick. Completed the forms and faxed to them with in 3 days. Never heard back. My next pay check the company took back all my sick time and gave me a negitive check stating I was denied. To date no communication from segwick or my employer. No denial letters nothing? I am now looking at a new diagnosis and I have over 250 sick time hours and 4 weeks vacation. How do I make this work for me? This is very large company with over 125k employees.

    David A.Mar 25, 2017  #668

  • I was out on stress leave and put on medication. My doctor raised my dosage and at the end of the month of being on stress leave, he extended it by three weeks. The case manager received all of the paperwork needed on the first day of the extension. After 9 UNPAID days, no one would return a call no mater how many messages I left and when I asked to speak to a case manager, they kept telling me that someone would call me back. The case manager never called me back, I almost got evicted because of these people. When I told them that, one of their condescending managers was silent and then said “well it is a process.” I almost cursed her out horribly but I didn’t want to raise my anxiety. Still waiting on their lazy, incompetent people to let me know what is going on. They have caused me more stress in trying to get this done than the reason I was on stress leave. A bunch of lazy people with zero compassion for anyone else…or is that just the ones that handle the Apple Inc. cases? I still do not have a straight answer. They are not here to help and as a veteran of the US Army I am looking for a lawyer to help me with this. 

    MilaniaMar 20, 2017  #667

  • Sedgwick was the greatest company for the first 2 weeks after my car wreck driving for Fedex. The other driver was cited, case closed I thought. Nope, 28 months later I have been allowed for sprain strain of lowback upto neck. Now that its revealed I have 2 herniated discs they fight. Two of their IME doctors barely did an examine only to find the issues were already there with 0 complaints prior. SEDGWICK IS HORRIBLE!!! I now have anger towards Fedex because they hired these crooks.


    MikeFeb 26, 2017  #666

  • Walmart also uses Sedgwick to shaft employees. 11/30/16 I suffered a spinal injury. 12/2/16 I suffered a heart attack. After 13 years of loyal service – 12 time winner of employee of the month, Walmart stopped paying me while I was out on leave because Sedgwick said I have not been in contact. My wife, and HR Benefits Admin. Proved to them several times with fax receipts and emails that the information was alyways there on time. No response to this proof – instead they cut off my benefits (ONE of my live saving medicaltions alone costs neary $1,000.00 a month without coverage.)

    They nearly killed me, and to date, I still have not gotten back pay or any sort of explaination. My wife calls them three times a week, only to get jerked around. Can I sue them — and how?

    Todd M.Feb 24, 2017  #665

  • During one year (of 12) with the same employer, I suffered major family losses (deaths). At the same time my organization collapsed which resulted in a major change of job assignment. For years, I had been receiving care for chronic depression. With the recent life events, I began to experience crying episodes, could not remember people’s names, had panic attacks, etc. My job was customer facing and I could not remember where I was in conversations with clients. This all escalated having severe vertigo and significant memory loss. Panicked, depressed, and hopelessness overwhelmed me. My Doctor “ordered” me to go home, continue medications, and to take short term disability. I was advised I had to call a third party disability company. I called Sedgwick crying and the man that took my call said, “What is wrong with you”? I said, “what”? He said, well did you lose a limb (an arm or leg)? Then, “what is your diagnosis”. I said my Doctor ordered me home and that she would need to provide the medical diagnosis. He said, “oh, ok, you go to mental health”. I’ll have someone contact you. For three days I heard from no one. I called back and spoke with a woman that was VERY rude. She outlined the specific requirements my physician needed to take in order to comply with time-lines, forms, etc. Now remember, I couldn’t remember names. This was very overwhelming. I forwarded all of the requirements (in writing) to my Physician. And then it began. The tactics of never receiving documentation, faxes sent three and four times, general comments of not having sufficient documentation. Finally, they requested that my Doctor have a consult with their physician. She did and he deemed me completely enable to perform my work. The next contact resulted in the case person saying my Doctor didn’t have a consult and that my claim was still denied. After proving the consult, they said even though their Physician made conclusions, they still had the right to deny. My Doctor sent me home to get well in April and it was now July without one dollar from STD. As an individual that was advised to rest and have treatment, all of this exacerbated my condition. It made it worse. Someone going through severe depression doesn’t have the capacity to perform, fight back, nor deal with these horrific injustices. I finally resigned from my company and never filed an appeal. I was to distraught and, at the time, felt I would rather work for minimum wage than go back to a company paying nearing $200K a year that treats its employees this way. Almost two years later, I can now look back and see how horrible this is. I can’t regret my decision because I was not in a position to make any at the time; however, things must change. Sedgwick must be accountable for their actions and large corporations must respond to information being sent to HR departments reporting how Sedgwick is treating their own employees.

    NancyFeb 17, 2017  #664

  • Edna, we would need to see your policies and the denial letter to determine if there is any assistance we can provide. Please feel free to contact our office to discuss your claim further.

    Stephen JessupFeb 13, 2017  #663

  • I have severe compartmental osteoarthiritis in both knees and back and have gone for years taking medications and half treating my medical needs due to the need to work. In addition, I have diabetes diagnosed first in 2012 that continues to progress and diagnosed sleep apnea, severe compartmental carpal tunnel, currently waiting for surgery in 03/2017. I stopped work 08/02/2016 at the age of 66 to start treatment for my osteoarthiritis which required strengthing prior to additional treatment due to suffering severe pain whenever I took a step. I was also dealing with bladder incontinence that was getting worse. I have worked for ADT since 12/1998, first as a temp with hire after about 6 months. When I applied for short term disability through Sedgwick, I was denied payment due to chronic illnesses according to the manager at Sedgwick. When I was not able to return to work, Sedgwick and ADT Human Resources continued to extend my FLMA without pay which also eliminated application for long term disability which I have paid for since employment with ADT. I went in on 02/01/2017 and resigned because the osteoarthiritis will not go away so I have to continue to work on strengthing after my injections in 12/2016 and 01/2017. Recently started a new medication for the bladder issue and continue weight management for my diabetes. I have also been helping to manage my elderly husband’s medical and financial affairs due to onset of alzheimers dementia and placement in a nursing facility. Do I have any recourse with respect to appealing the firm position that Sedgwick enforced. I have received a letter from the new Vendor giving me the right for assistance if I felt my rights were violated. I had contacted Etna prior to resignation for a job accommodation but the representative taking the call and asking me questions told me he was sending me a form to apply for short term disability and another form in addition to the short term disability from from 08/02/2016. What I received was a letter telling me to contact the agency if I felt I had been treated unjustly or discriminated against.

    Edna T.Feb 10, 2017  #662

  • My toe was debrided, basically a partial amputation, my doctor assessed 10-12 weeks for healing, no driving, my medical insurance has a nurse coming to change dressings through 10 weeks. Sedgwick informed me yesterday, due to my ” condition” the medical review is 5 weeks. They said a RN reviewed the 3 page submittal completed by my doctor and in order to extend, the nursing staff will review “doctor information” objective notes, office visits, chart notes and tests. They explained this is an “incremental” approach. My button was pushed whdn they first informed me they are looking for a return to work form. I feel harrassed to be told to go to work when my doctor says dont drive.

    PattyFeb 9, 2017  #661

  • I forgot to mention I have a mitral prolapsed value that was being triggered by stress heart doc said and put me on a bated blocker

    JessicaFeb 3, 2017  #660

  • I work for the best company in the world and takes good care of there employees. I’ve been with this company for 5 yrs. I work tech support over the phone which is very stressful at times. I filed a claim with Sedgwick because my manager and he’s manager said I need to destress and go see my doctor. I went to see my doctor because I was stressed out I was dizzy gain weight and was tired all the time. When the doctor saw me she saw my blood pressure was high and my heart rate was 139 she was concern and did a EKG which show I was in sinus t. Then she referred me to a heart doctor. She was putting me out of work for 12 weeks. I called Sedgwick told them, I was told paperwork had to be in on certain date. I made sure the doctors office sent it. Sedgwick says they only got half. So I had my doctors office send it again. I called back Sedgwick and they said they received. I was also told that a Rep would be entouch with me.

    5 days later I heard back from a claims person that said my claim was approved up to 2 weeks date. I explained that the doctor put me out for 12 weeks the Rep acted like I didn’t know what I was talking about. Then he had the doctors wrong I told him the heart doctor didn’t fill the paperwork my med doctor did. He still didn’t believe me and said it was approve until this certain date. Then he said my doctor would have to file a extension when the paperwork said return to work in 12 weeks. It’s like he didn’t even look at that. Then after my 2nd appt with my medical doctor I told her that they want a extension. I had my doctors office fill out the paperwork and send back to them. Sedgwick claim they didn’t get it. So I had my doctors office send it again.

    This time I wait for 3 weeks with no answer I called Sedgwick and they said a medical case examiner is looking it over for approval. Here I am stressing about pay once again. So I called and bugged the mess out of them. Then the claims rep calls me and says my extension has been approved until 2 weeks. The stress this company puts on people is unreal and awful and is not in the best interest of the worker. Plus some unkown nurse is going to call me doctors office and say My job is not stressful ! So I have a heart doctor appointment on feb 16 and they only approve me until feb 2 so I will have to ride the Merry go around again. So I don’t have lost in wages before returning to work. I have been keeping a log of everything and record this company has given me more stress by there BS.

    What legal actions can be taken about this ?

    JessicaFeb 3, 2017  #659

  • Sedwick was great with handling everything when I was on leave for a surgery. They inform you that you can view all your document submissions online too as well. Very happy :) -Alexandra Lunan

    Alexandra LunanJan 31, 2017  #658

  • The reason Att hires this company rather than using its own in house, and possibly compassionate HR department, is so they have another layer of denial between them and the employees it’s screwing. A true Hr department helps and supports the employees. Att treats its customers and employees the same..Like garbage! I work in a call center. We have “sick days” in our contract, however, if you take asick day you’re written up. Seems backwards to me.

    RJ MarkJan 30, 2017  #657

  • If you thought it was bad before I know at least with AT&T in their Summary Plan Description AT&T Corp. Eligible Former Employee Medical Program page 4 “Program Responsibilities” ” Your Physician or other health care Providers are not responsible for knowing or communicating your Benefits. They have no authority to make decisions about your Benefits available. The Plan Administrator has delegated the exclusive right to interpret and administer applicable provisions of the Program to Program fiduciaries. Their decisions, including in the claims and appeal process, are conclusive and binding and are not subject to further review under the Program. Neither the Program, it’s administrators, nor its fiduciaries make medical decisions, and they do not determine the type or level of Care or Course of Treatment for your personal situation. Only you and your Physician determine the treatment, care and Services appropriate for your situation.” I know for a fact this is bad because I have been a victim of Sedgwick for years as AT&T is paying my LTD base on my work related injury because the physicians I was seeing refused to complete any documentation to assist acquiring any needed benefit, just lost my LTD health coverage via AON as this is Medicare, which I all ready have, now your physicians have an “out” to not be accountable Thanks AT&T and Sedgwick.

    LSharpJan 17, 2017  #656

  • Hi. In April of last year my mom was diagnosed with cancer. I began an intermittent leave to go to treatments with her. Little did I know that was the beginning of my nightmare. I have been seeing a psychotherapist since August, once a week. I also see my doctor every 2-3 weeks. At first my claim was approved. Walmart told me I had to return to work by 10-9-16 to maintain my full time position. So I went. That lasted 3 weeks, after having multiple anxiety attacks in front of co-workers and customers, I went back out. Well this time they denied my claim. I’ve appealed it, and was denied again. I have not 1, but 2, completely different doctors both agreeing my depression and anxiety are keeping me from Walmart. I have not been paid since November 2 2016. One more thing, I am the carrier for health insuarance. My therapist has told me there are multiple triggers for depression to set. I’ve had 7 of those happen since April 2016.

    Rhonda T.Jan 10, 2017  #655

  • I am currently dealing with Sedgwick now for the second time. I am 39 weeks pregnant with epilepsy and a heart defect. The first time I simply requested extra non paid bathrooms breaks, I had to constantly go back and forth and provide over three notes to explain why I needed to use the batbroom more and it was denied over 3 times in five months. After spending hours on the phone and months stressing my local Hr finally took care of the matter without Sedgwick. I now have a open claim for maternity/disability bc of my issues I took off two weeks early before my due date and provided all of the necessary paperwork exolaning why I needed to be off and it was still denied. So now I am in the process of spending hours on the phone fighting with them and putting myself in hell for no reason what so ever. They should not be able to put this kind of stress on someone who is pregnant or who isn’t pregnant for that matter. Just a living nightmare.!!!

    AngelinaJan 5, 2017  #654

  • My husband has been thru hell dealing with Sedgwick. His pay was stopped at least 2x, so that means insurance was cancelled because of Sedgwick. His last knee replacement of July 2015 got infected after he went back to work (FRITO-LAY) for almost 4 months, so the infection was in February 2016. Sedgwick denied paying his extra long term disability that he took out stating it is pre-existing. He actually was tested for infection in November and that was negative – they had one of their doctors look at all the info, but still refuse to pay!!! And this is after my husband has worked for FRITO-LAY for 28 YEARS!!

    NancyJan 3, 2017  #653

  • I am feeling so exhausted, confused and drained… been really sick since before 11/22/2016 when I applied for short term disability, was even hospitalized and my employer Capital One Bank declined my short term disability benefits… currently going through an emotional appeal that according to them could take 45 days; this is what we pay for through countless deductions and years of loyalty to get a kick to the side… needless to say my Christmas was ruined and going into the new year with uncertainty. Will be applying for long term with social security , but it will be a while for that battle as well I suspect although my doctor is behind me 100% and even suggested due to my sickness… Has anyone had this happen with an employer? How can we protect ourselves? I suspect this is not only a Capital One issue through the benefits company Sedgwick, but the reviews from that company alone are alarming (known for denying legit claims).

    LizDec 30, 2016  #652

  • These videos are exactly what I have experienced. I’ve been with walmart 24 years and they allow a company like sedgwick to treat people this way. I broke my leg in 3 places and tore the meniscus in my knee. In the first 4 months of recovery I was denied once, won the appeal but went without a check for 6 weeks, they forgot to hit submit twice so 2 times I went 4 weeks between pay checks. Meanwhile the lull in paychecks have cancelled my insurance briefly in now 4 occasions and has caused all sorts of problems. We complained about caseworkers numerous mess ups and 4 days later our claim was denied as we wait for a surgery date, we appealed this obvious case of retaliation they have til Feb 6th to decide. This cancels my switch over to long term. I have 3 children and a wife, they win for now. I have to go back to work to provide for my family, but this isn’t over yet.

    Rowdy2344Dec 29, 2016  #651

  • In OCTOBER of 2016 I was denied a short term disability claim (three times, mind you) due to supposed paperwork issues ranging from ‘not received’ to ‘not enough information’ (for example, my doctor didn’t tell Sedgwick that I live in a disgusting, fruit-fly invested apartment because my depression is so severe that I cannot handle everyday chores any longer.

    I have just now received a third phone call ‘offering’ me an extension. They ‘have hope’ that this will allow plenty of time for the paperwork to be received and ‘typos’ to be corrected. Typos.

    After my claim was denied the company also stated that because it was denied they would continue to deny my short term disability even though they were approving my leave time. So because they didn’t think that I was doing enough, rather than tell me what they thought I should do to get better they instead would say what I was doing wasn’t ENOUGH, and not disclose that once they denied my short term disability claim they were ALWAYS going to deny it.

    I was forced into returning to work before I was ready, as there was no choice in the matter- I was going to starve. Sedgwick will likely deny this claim after they’ve made me wait for MONTHS (this is now December of 2016) for them to finish reviewing the process. Because that’s what they do. They have ‘nurses’ review paperwork- nurses who don’t see me, live with me, or physically assess me. They run you through the ringer and hope that you’re going to eventually give up. They’re awful, and I will never EVER deal with them again if I can help it.

    AGDec 28, 2016  #650

  • I’ve been on std for about a month. My account manager Michael Tierney never responded to my calls or emails days approaching Christmas….. He called me 2 days after Christmas informing me he was off for the holidays….. While I’m here with 3 daughters and sedgwick managed to screw up my pay the week before Christmas……. So no pay and no explanation other than letting me know that he was off for the holidays. I think is a terrible shame that I have no other choice other than to deal with this incompetent company…. I work for Pepsi… And this is what I have to deal with. Thanks Sedgewick……

    MadhansonDec 28, 2016  #649

  • I’m a breast cancer patient. I had surgery on November 7, 2016. Discharged from the hospital November 9, 2016. My surgeon has released me to return to work January 3rd 2017. My Doctors office has given them all the documentation they asked for, twice. They cut off my benefits on December 16th, 2016, so I appealed in a letter yesterday. I’m a working RN , and am looking forward to returning to my position, which is covered under FMLA until January 3, 2017. I am also supposed to start 16 treatments of radiation, 5 days a week, with the first treatment starting possibly at the end of December, 2016. I can’t believe with some of the complications I have had post surgery, and the seriousness of a cancer diagnosis, that they can make a decision like this. Now I have to go into my savings. I can’t use a benefit that I am supposed to have available to me.

    JaneDec 22, 2016  #648

  • oh and furthermore I was forced to leave and going to stability because my department couldn’t handle my narcolepsy symptoms even though they’re all under FMLA certification. So not only had I been discriminated from the moment that I have been diagnosed I was forced to leave on disability and then I have to fight for my own money

    danielleDec 7, 2016  #647

  • I have been out of work for over a month on disability leave Cedric after failing to inform me that the disability or the payment part of the claim was a separate claim. Then after calling them to figure this all out advise me that the original disability claim rep no longer work for the company and get the second claim rep never contacted me either. I finally had to contact a disability supervisor he is shored me that this last Friday he would have the information submitted to payroll and request a manual check I called payroll Monday they said it should be processed by Wednesday. I called again today to payroll they said that a manual check was never requested and that it would be another week or so to get paid. This is after going back-and-forth having doctors call having all of this stress put on me for no reason just to get them to do their own job and they still can’t get it done right. I need help and I need it now I am going to be late on my rent and I’m gonna have those fees to deal with I only get 75% of my pay on disability as it is and yet it’ll be a month and a half before I get paid I need to eat I need gas money and I need my bills paid I need help now,

    danielleDec 7, 2016  #646

  • Denied by Sedgwick – for not submitting paperwork … my doctor was out sick I couldn’t submit paperwork. I submitted paperwork from my next appt. but my status didn’t change. Very soon after I received a letter to return to work by a certain date or terminate my 18 year employment with At&t. I filed an appeal for the denial, Sedgwick used all 45 days allotted to them only to uphold their denial. The reason this time was the paperwork doesn’t support my disability.

    RosaDec 2, 2016  #645

  • I have worked for AT&T for 10 years and recently had a total hip replacement. I have been denied short term disability 4 times all causing loss of pay just to have them approve it again. I am now in a pending approval awaiting the second physician review. I do not understand the reason behind so many denials and pa reviews all for same reason. Doctors have sent in everything including the fact I am unable to return to work. I am out of fmla hours and received a call basically stating if my disability is not approved then I will lose my career. It is beyond stressful and has caused depression. It is ludicrous that a company can treat me this way.

    JakeNov 28, 2016  #644

  • Luckily my employer knows sedgewick is difficult to deal with. All though I have been approved for short term disability my examiner does never approves what my doctor sends in. So with that i get paid probably once a month and its definitely not what its supposed to be. It sucks because im sick I have to miss out on spending time with my family for the holidays, sit in the dark and freeze because Im not getting paid a regular paycheck to pay my bills on time. Working with them is far from a benefit. If losing my fiancé was not a enough this would definitely be a cherry on top of the worst sundae ever. This past 5 months my utilities have been of twice and threatened for eviction once. My car has been repossessed. The way they treat sick people is unbelievable. I have been in psychiatric facility and my doctor info is still not enough. Death is probably easier than dealing with this unreasonable company. If you want to measure your strength go through a short term leave with this company and watch your life crumble further.

    Sharita M.Nov 23, 2016  #643

  • “Sedwick causes stress”, unfortunately, we do not handle FMLA cases. That being said, does your employer provide short and/or long term disability you could file claim under?

    Stephen JessupNov 21, 2016  #642

  • Been with Sedgwick 3_4 months now. Had one adjuster she either quit or got fired. Therapy delayed for 3 weeks without any paperwork being sent to me. They gave a PA they sent me to hell for not getting them paperwork but they found it much later in Convo over phone. Lots of paperwork gets misplaced or thrown in with bunch of other people’s. Got referred to nurse case mgr/ med director to handle coordination of treatment. Basically she tried to say I didn’t report incident in timely fashion which I had. Set up appt with Md specializing in occupational med. Who only works work comp companies. He did hands on eval. After multiple times telling that can’t do lots of movement due to pain he asks well if i can move it why can’t you. Got shifted to different adjuster still no paperwork claim number so u can check in line. Had to give complete med history tho most has nothing to do with claim. They should all be fired company closed down

    MariaNov 17, 2016  #641

  • Since July of 2016 I have had extreme migraines, 2-3 or even 4 times per month, among other lesser symptoms. Been to the ER several times. Put on various meds. I have been working with my doctor for diagnosis and treatment. End of July, specialist found I had a severe cataract (only 47) probably caused by multiple series of steroids. Had surgery but migraines got worse. Now in November, after 3 CTs, 2 MRIs and a spinal tap… we realize my psoriatic arthritis has gotten into my spine, specifically my cervical spine. Spinal Stenosis. We have exhausted all non’surgical options. I am now on almost 24 hr valium, trazadone and looking at opiods for pain. High blood pressure meds from stress. My job is my only source of income, so I kept trying to work (3-4 days and then my hands went numb and spasms in my back) Now I have nerve damage and facing surgery. Sedgwick repeatedly denied claims, refused to review my PCPs records, lied about not getting records, the right records, etc. They approved and then cancelled FMLA orders, and denied Short Term Disability claims and changed them to intermittent FMLA. I have been out this time for almost 2 months and they only approved 5 days as intermittent FMLA, notified me that I have exhausted my FMLA benefit. Which means my employer can now fire me, I lose my health insurance and down to $132 in checking account and $0.32 in savings. I borrowed from my 401K while dealing with them and still haven’t paid all my med bills, so my credit has tanked, my HSA is exhausted and Jan 01, my deductible and out of pocket reset IF I still have insurance … Today, it took calling 5 different lawyers to find one that MIGHT help here in West Virginia. This after using my employer’s liason and filing THREE formal complaints about Sedgwick with my employer as per their process. I can say goodbye to my car, no money to pay car insurance or loan payment. I am living on a friends couch and he feeds me. But no assistance because “I’m employed and have a claim open under appeal”.

    Sedgwick causes stress...Nov 17, 2016  #640

  • I was 8 months pregnant at 38yrs old. I was at high risk because of my age. My ob/gyn Doctor put me on light duty I was restricted of 25Lbs to lift. My employer put me on a job where I had to lift 41LBs skids. I could no longer do that light duty job. I went back to doctor and he then put me on STD I had sciatica sever pain. He gave me a doctors prescription to be under his care until 6 weeks post-partum. I applied for benefits and got denied.
    I am currently filling a appeal!

    Kristi M.Nov 16, 2016  #639

  • Scared, please feel free to contact our office to discuss your claim. The issue with why an attorney may not be able/unwilling to take your case at this point is due to the nature of the law governing your claim- ERISA. As of the date of the final denial no new information can be added to your file to present to a judge, as such it can be very restrictive and hard to litigate a case when the attorney did not have the ability to prepare the appeals.

    Stephen JessupNov 7, 2016  #638

  • I have been sick and can’t return to work, the first time I dealt with sedgwick they sent me the forms I had to ask for, by the way and I had filled them out to the best of what I could do at the time , I had an emergency visit to the hospital due to respiratory problems I was diagnosed with Aspergillus and I spent 7 something days in an isolation chamber at the hospital, they thought I had TB .I have Walmart insurance , and I have everyone who ever entered the room sign the papers for sedgwick , they were faxed over and on the 5th of the net month they released me. Two days later I received a letter from Walmart saying If I didn’t contact the store I was terminated I had three days to reply that letter was sent to me on the third day at 430 no one responded to my call. It seems that Sedgwick denied me on the 5th, I had no way of knowing because they mailed me I never got a letter but found it on the website WalmartOne. I called BlueCross Blueshield , and with the help of a caseworker, I was able to get in touch with the Sedgwick ,we both had to ask for a supervisor on the phone, and they reopened the case I was sent 200 dollars ( fortunately I had income tax return to fall back on) so I didn’t lose my home. In August I fell Ill again only this time worse, I filed with sedgwick and they waited a grace period to send me any money they paid me for two weeks , and stopped I sent a fax they said they never got, I sent another fax from the original doctor that diagnosed me, Sedgwick said they never got that fax , I had my doctor send a fax too, I called they and they told me that all I needed was to send them ( Sedgwick) was footnotes from the doctor saying I was still ill and not able to come back to work , my primary doctor did this , and when I called Sedgwick again they said they needed a fax on their fax letterhead. I went to my Primary doctor and we filled out everything they needed , and I called my Bluecross Blueshield caseworker to make sure she got copies I sent them to her too. I got a called from Sedgwick case worker saying she still didn’t get the faxes she needed to proceed with my payments..so far the whole month of October without a penny from them, I called my caseworker and we called sedgwick , the caseworker there said she got some fax but the last three pages said error and didn’t come through, I’m not making this up, no one called me or contacted me. Meanwhile Walmart because I was not paying the premiums ,cut off my RX card, and my heart Doctor canceled my appointment, I am diabetic and I can’t get my Insulin , I also still have Aspergillus so I need the antibiotic or I will this will continue to get worse ..my casework at Bluecross is waiting on Sedgwick to approve my disability, but now I am getting behind on my lot rent and my lights and phone are going to be shut off if this is not resolved by the 7th .. I am SO stressed out and it’s making things worse I can’t go to see a doctor my insurance card has been suspended , this park I live in will start eviction within one week of non payment , I have a 12 year old daughter who is watching me whittle way , I don’t want to be homeless because they are lazy and incompetent, please help.

    Paul CNov 2, 2016  #637

  • I am an Employee of Frito Lay-Pepsico for 19 Years. Have multiple Spine Neck Nerve Problems etc. Been Denied LTD by Sedgwick Filed My Appeal and been Denied as Sedgwick says Not Sufficient Medical Evidence but My Doctors Medical Staff says Sedgwick Never Called and Never Requested Medical Proof that I Submitted. Now Attorneys do Not seem to be Interested in My Case. I am Asking Why??? It is what it is. I Am Sick and Cannot Work and Sedgwick is Fraudulent to My Claim

    ScaredNov 1, 2016  #636

  • Carol, unfortunately, under the law if your claim is formally denied you will have to undergo and wait for the appeals process. Please feel free to contact our office to discuss your situation in greater detail.

    Stephen JessupOct 27, 2016  #635

  • Pasted Angry last Tuesday:

    I am a disabled veteran. I have take short term disability twice before without a hiccup from Sedgwick. Both times were for the same reason. Now, it has been three months with being denied stating that my medical records from the VA doesn’t support my claim for the exact samew reason as before. I have panic attacks, anxiety and PTSD with flashbacks has part of my service-connect disability. This stress of being denied only exacerbates my condition.

    Somehow Sedgwick cannot deal with fitting a round peg into a square hole. They are use to civilian doctor and not the VA process. I have tapped family and friends for money and they are now tapped out. I feel that my company, which employs Sedgwick, claim administrator, gets a kick back for the claims they deny. I don’t have much faith in their supposely third party doctors on their payroll, who has never interviewed me, can make an opinion and discount the opinion of doctors who are just,or even more skills, then themselves.

    AppalledOct 24, 2016  #634

  • I have severe generalized anxiety disorder and major depression. I have a strong history of inpatient hospitalizations for this, but was able to heal to a large degree, go back to school and get licensed as a Licensed Clinical Professional Counselor, and have been working in the behavioral health call center for United Health Group for the past 8 1/2 years. The nature of the calls are very crisis-oriented. Because of some recent personal crises – including a flood in my home, displacing me in a hotel for 2 months, while at the same time having a couple breast lumps, shingles, and oral surgery, I had a relapse of my mental health issues, severe anxiety, sometimes jumping or jolting when I take calls in the queue at work and intermittent suicidal feelings. 3 of my providers are recommending short term disability and Sedgwick is denying. I feel that it is totally inappropriate for a mental health professional in somewhat of a crisis and with active mental health issues, to be working in the field at this time, when I’m barely, if at all, any more stable than the callers/clients at work who are in crisis and themselves often suicidal. Sedgwick needs to review my case differently than they do, say, a person who works in tech support or some non-mental health capacity ! But, my FMLA has run out and I either have to jump back in with the sharks on the phone, or lose my job, healthcare, income, etc. Sedgwick has been terrible to work with and they have backed me in a corner. I have to decide in 1-2 days whether I should try to go back to work. MY one psychiatrist is submitting some more paperwork, but so far Sedgwick is telling me they will deny. I need immediate help with this issue! I can’t wait for the appeal process as they’ll definitely fire me.

    CarolOct 23, 2016  #633

  • I was approved for short term disability due to several health issues. Sedgwick paid me a month and a half of short term disability pay then I received a letter stating my medical conditions was not enough to qualify for the benefit. I have called them several times to find out why. They either say the computers or down or I need to speak with someone else and that person will call me back and they never do. I do qualify for the benefit and Sedgwick is denying me unjustly!!! I have a Dr that actually wants to put me on long term disability. So how does a “nurse” have more power than the doctor that puts you on the disability???? I need help and I’m calling the Attorney General.

    RachelleOct 19, 2016  #632

  • I have been out of work since 09/16/2016. I went To surgery 09/16/2016. Since then I have been living a Sedgewick nightmare. No matter how many times I file for STD/LTD I get nowhere. Meanwhile the creditors are calling and I feel bad that I cannot get Sedgewick to pay. My illness is cancer of the tongue and I should be able to go back in about a week.

    Charles W.Oct 19, 2016  #631

  • Curious, any occupation will be defined in your policy and typically read any occupation for which you are qualified for based on training, education and experience. Some policies contain an earnings provision that requires the occupation to pay a certain percentage of your prior earnings (typically 60%)

    Stephen JessupOct 17, 2016  #630

  • Desperate, if your claim is denied please feel free to contact our office to discuss how we can assist you in appealing the denial. I recommend you have your OB send all records and a strong letter to Sedgwick as to the complications and risks with your pregnancy in the meantime. It may also benefit you to get back to the psychiatrist or have the psychiatrist submit information in the off chance your policy does not cover for pregnancy.

    Stephen JessupOct 13, 2016  #629

  • Another thing that i dont know and afraod to ask provider is that that there comes a time that i cam do something gainful do they look and see maybe an opening or two that would suit me then tell me they are cutting me off and what if i wasnt chosen as my age (51) is older amd they want someone younger.

    curiousOct 13, 2016  #628

  • Can you please explain what it means to be accepted to any occupation. What happens. If they find at one point you can work for some thing would they make you take a lesser job.
    I had an ect and found that my memory isnt good. It could be medication as well. I am nowhere near ready but if i ever am would the make me work at McDonald’s. I now have another (dr only diagnoses) not confirmed by ct or mri but do they accept new injuries. I suffer from 33 arthritis diseases. Thank you for any ligjt you can shed

    curiousOct 13, 2016  #627

  • I’m currently 34 weeks pregnant. Early on I started getting really high blood preasure readings. My job is very high stress and high paced. I became stressed , anxious and that made me depressed. My psychiatrist started treating me and filled out short term disability paper work. It was all ok however recently I became overwhelmed and it was also physically draining and stressful to keep all three appoitments with all doctors so I prioritized to seeing my Obgyn and high risk pregnancy specialist. I figured they could take over paper work as I was labeled high risk. My anxiety and stress was low now too due to me being off work, I only had to focus on my pregnancy. Well sedgwick denied my claim as soon as my OB attempted to take over on the paperwork. I became so stressed that my blood preasure went up at my OB visit and Dr sent me to triage to be admitted. Dr said if my blood preasure didn’t go down he would have to deliver at 33 weeks. My blood preasure stabilized over night at the hospital and I went home the next e being. Dr ordered I stay on bed rest to avoid an episode. He sent in paper work again and claim remained denied. I’m currently not getting paid, my anxiety level is high again, my blood preasure is kept down my an increase of medication and bed rest. If claim is still denied in a few days I will be asked to go back to work or get fired. I’m lost. I’ve worked for the company for over 15 years and I don’t want to lose my job. I alot don’t want to go into preterm labor and risk my child being born with health issues. Please help.

    DesperateOct 8, 2016  #626

  • James, as your claim appears to be under Worker’s Compensation laws and not an employer provided disability insurance policy I would recommend you speak with a Worker’s Compensation attorney. You may also want to speak to HR to see if you do have additional disability insurance coverage to determine what your rights are under any such policy.

    Stephen JessupOct 3, 2016  #625

  • I am a physician. I do not do workers compensation because it is impossible to deal with claims and payment is ridiculous. But I have a few patients who became disabled and I did not want to abandon them to a workers comp medical treatment factory. My most recent experience with these compensation middlemen is with Sedgwick.

    Sedgwick does not like how often I contact my patient despite the fact that it is life preserving and despite the fact that they pay almost nothing for my services. Sedgwick has suggested that my patient find another physician despite my 30 plus year relationship with her. Treating her chronic illness, Sedgwick insists that I re-apply monthly for authorization for the pharmacy to dispense the exact same medication at the same dose. It is common practice elsewhere to approve prescriptions up to a year at a time. Sedgwick is willing to let the pharmacy withhold this life saving medication if they do not get their forms on time.

    Sedgwick has now tried to buy out my patient’s case, which is a lifetime medical coverage judgment handed down in court. I guarantee that the buyout will favor Sedgwick and punish my patient if she is foolish enough to accept it. Their harassment of the patient and myself is disgusting and outrageous. It violates their mandated responsibility to provide workers compensation. I would consider testifying in a class action lawsuit if it would result in reasonable punishment and improved patient protection.

    Michael G.Oct 3, 2016  #624

  • Sedwick is a joke how can a nurse practitioner evaluate a mental issue they don’t have the right people determining the claims. And they leave people hanging I got no answer on my claim for 4 weeks. Then they tell me they denied me I had no clue what was going on I didn’t know what they wanted they don’t tell you what they need. They tell you that you will get an answer within a seven day period the no one contacts you cuz your adjuster is on vacation I had to use all my PTO and all my available time just to survive for 5 months. If you’re like me and have a mental illness and not know it and have no help they don’t make it easy. I lost everything.

    Lynn wungnemaSep 30, 2016  #623

  • Kevin, please feel free to contact our office to discuss your claim and Sedgwick’s denial to determine what we may be able to do to assist you.

    Stephen JessupSep 29, 2016  #622

  • I live in California and am unfortunately dealing with Sedgwick as I broke my foot at work a month ago and Sedgwick is still investigating my claim. They are investigating if this is work related? They suggested I file for SDI as I have not worked since the injury as we have no modified duty where I can just sit with my foot elevated. My employer (Securitas) has supposedly reached out to my claims adjuster to see why my claim has yet to be accepted the answer was they have 90 days to decide to accept or deny my claim. They finally got me to an orthopedic after two referrals after a month. Is this normal or should I be considering consulting with a lawyer, this is all very confusing to me?..

    JamesSep 29, 2016  #621

  • I have been out for almost 3 months now, it took a long time for my health insurance to approve an MRI which 2 weeks ago revealed I have congenital spinal stenosis. I have a hard time sitting or standing without a ton of pain. I’ve been denied and now I’m appealing. What can I do, I have no income.

    Kevin O.Sep 27, 2016  #620

  • Gina, your employer has contracted them to act as the administrator of the benefit plan to determine eligibility for benefits. That determination is predicated upon your medical information. If they don’t have sufficient medical documentation to support the claim there stands a greater than likely chance they will deny the claim on account of same. If you are not inclined to sign the authorization I would strongly suggest you provide all the medical information yourself.

    Stephen JessupSep 16, 2016  #619

  • Oh boy… These memos are scary. Just got injured at Amazon they have Sedgwick. So far I am getting 60% of my pay but, I have only been off work 45 days. Sad thing is I don’t think I will ever be able to return to do the job. Is this going to be the same battle?

    SnedecorSep 16, 2016  #618

  • I live in California and am out on a “pending” (says Sedgwick) medical leave. Not work related. I sent them the first set of papers they asked for –physicians statement etc. Now they are asking my doctor for my medical records. I don’t believe they are entitled to those records under HIPPA, correct? They are a third party, not paying me a dime. Why should they be entitled to my personal medical information?

    GinaSep 14, 2016  #617

  • I had back surgery in Jan. Was released to go back to work in March stepped right back into 12hr.days. I was fine running the stacker not to much bending are lifting. Then they put me back on quality which consist of a lot of lifting and bending. In June my back gave out again an I’ve been off work since,was released to go back to work on 8-22 with restrictions. No lifting over 10 lbs an no bending which IP could not accomadate so they wouldn’t let me return to work. IPs HR specialist said my STD would pick right back up and I have been released to go back to full duty on 9-29. Sedgwick has denied my claim from 8-22 thru 9-29 cause they said they didn’t receive any updated medical on why I was on restrictions. I have scaitica an degenerate disc disease along with arthritis the bending an lifting aggravates my condition the STD specialist says pain is not a reason not to work. I couldn’t believe that was said to me an I told her when your pain is dibilating is is absolutely a reason not to work. So I’m in phase 1 of the appeal process an haven’t been pd in a month it’s like pulling teeth with Sedgwick an it’s my money that they are paying me . If my appeal is denied I will be fried due to pointing out. So everyone that is dealing with these rude people I know what you are going thru an good luck to you.

    Gayle R.Sep 11, 2016  #616

  • I work for a large insurance company. I had surgery. sedgewick approved less than 2 weeks without any clinical information. They “called and got the code from the office person”. My surgeon said it would be 5 weeks at least before I could work at capacity. I immediately called post surgery explaining this amount approved wasn’t enough. They said to have MD Submit paperwork provided. He did immediately. I also called and confirmed they were in receipt of needed paperwork. Date came and went. I call daily. I am told examiner wants to know if I need extension. I answer daily yes and you have MD/surgeon’s request /confirmation. Examiner waits 4 more business days to call back and leave another message asking SAME question. Then she isn’t available two minutes later when call back. Now for two days I have asked to file a Complaint (“there is no procedure for this”), expedite claim, reassign claim and asked for someone/anyone to help with any of the above. There have been no supervisors, no team leads, no operations manager, no other disability claims specialist available. No complaint has been registered. I am 5 days past expiration. Not working. No pay. No recourse.

    JENNIFERSep 8, 2016  #615

  • I had a stroke at work…I was being treated by my employers first responders. My boss told the responders not to call for a medical squad because she went through my lunch bag and seen my migraine Medicine and assumed that I took too much of it. So even though I didn’t know my name and then went unconscious. No one called my family and it was hours later before I received medical care. Since then I have had to use FMLA and short term disability. And every time I applied Sedgwick denied me and I would have to fight them. Several of my providers have expressed how difficult it is dealing with this group. There were times I was denied over a mistake they made and they blamed it on me and or my doctors. I am back in the same situation now. The representatives can be very rude and uncaring. It’s the last thing a sick person needs to deal with. It’s a shame how they treat people. I know of several associates that lost their job due to Sedgwicks errors. And the company does not hire the associate back. It’s just not right. I do not trust this company at all and believe action should be taken against them.

    RachelleSep 4, 2016  #614

  • Sedgwick is a nightmare! After falling and breaking my arm at work and being out a year they required me to return to work, with restrictions, 3 weeks before my surgery for the removal of some of the hardware that was put in when I broke my arm. Now a week after I had the surgery my attorney still has not receive notice if Sedgwick is going to pay me for being out even though they approved the surgery and knew the date of the surgery. On a side note AT&T, my employer, has conveniently messed up the 2 checks I was supposed to receive after returning to work. First check I was told they were not notified I returned to work even though I called Sedgwick twice and told them I had returned.

    KrisSep 3, 2016  #613

  • I worked for Walmart, back in Tire and Lube, which is a fast paced job. Our air compressor had gone out that day, and it proved to be strenuous on my old injury. Needless to say, I wasn’t aware of what it actually was, all I knew is that I got home, got to a stop, and two hours later was in the hospital. Let me tell you guys something about my hospital here in my town. You could have a broken hand, and they will say they can do absolutely nothing for you. So when I go in there, and they say it’s Arthritis, I’m 19 by the by, and he spends most of his time talking about his kids and the sports his kids play, I’m not entirely convinced. So the next day, I go in begging to have an exception made so that I can go visit an actual doctor. Here in my town, there are no doctors, other than the hospital, open on the weekends. This happened on a Friday, transitioning to Saturday, and I had Monday and Tuesday off as I believe, and the Emergency Room note states I shouldn’t have been returning to work until that Tuesday, but that didn’t matter to Walmart or Sedgewick. So, I had to request the days off through Sedgewick, and then got caught in paperwork limbo, fighting the company, and my doctors office to get everything right so that I could return to work. Only for a month and a half later, and returning to work for two weeks, to have Sedgewick approve every day except for the two days that I asked off. In which they declined, and caused me to point out at Walmart. This has caused Undo-stress, among many other problems financially.

    WilliamAug 21, 2016  #612

  • I am currently having a problem with Sedgwick I had surgery on the 28th of June and was out until the 1st of August I work part day the fist day and 7 hours on the 2nd day until I couldn’t because of pain and bleeding from surgery! I contacted doctor and she extended my disability but unfortunately they denied me because I couldn’t get in to the doctors again until the 10th Wednesday the 3rd til Wednesday the 10 th is 8 days apparently !

    JamieAug 19, 2016  #611

  • I have been on a leave of absence and had to go on short teem disability. I have many neurology problems and have tremors. I am a cake decorator and fell at work. I have been under the care of a doctor and neurology specialist. I cant work due to my medical issues. I have lost 15 pounds and most of that is muscle, my eye sight is going, bladder control is about gone. They think I have Multiple Sclerosis and also have Fibromyalgia. I received a call from Sedgwick stating that they thought I could go to work and had to have my doctor have a phone interview with a doctor who works for them. I told them I didnt think I would be able to return to work and they asked why I was wasting their time and I should just quit my job. I have never been treated so poorly. I pay for the enhanced short and long term disability. Right now that is my only income and they find every excuse not to pay me. I am very fed up.

    Fed up walmart EmployeeAug 18, 2016  #610

  • Sharita, I am very sorry to hear about your loss. Please contact our office with a copy of your denial letter to discuss what your rights are.

    Stephen JessupAug 17, 2016  #609

  • I am on Short Term Disability and have had nothing but problems with them. My doctor is 100% sure I have Multiple Sclerosis. I lost most of my muscle and my balance is about gone. My doctor told me I cant work and my employer told me I am to high of a risk to work. I got all my paper work in from my doctor and a neurologist specialist in. They told me today that I am not disabled according to their nurse. I didnt know that a nurse knows more than a Medical Doctor and a Specialist. I am so frustrated with them.

    LisaAug 16, 2016  #608

  • I have been dealing with depression and anxiety. I was on FMLA because of this. On May 21st i lost my fiance/girlfriend of 8 years. This made my depression so much worse. Before she passed I had an appointment scheduled for a psych eval. When my fiance passed my appointment was canceled. Then i filed for short term disability through my employer because mentally i was not in shape to work. Throughout this whole experience i have been working with my primary care dr. Who could verify treating me for depression and anxiety. They notified me on July 24, 2016 that my time was denied from July 10, 2016 – August 1, 2016. On August 10, 2016 I was admitted to a psychiatric facility for 3 days. Because of that they approved those 3 days and the remaining time is pending even though the pschiatrist says i was not in stable condition to work from may and will not have me return until Sept. 1. Of couse since i have not been paid over a month i have now fallen behind on everthing. Eviction notice, disconnect notices, even at risk for repossession. Everyone knows it can take almost 3-4 weeks to get into a psychiatrist office even with a referral. They do not care about my situation and takes nothing into consideration. Everything is about paperwork. Im clearly not stable enough to work. I have cried everyday since May 21st. I have been to a psychiatric facility. How much more proof do they reall need. This is my life they are playing with and taking their precious time to approve anything. Also throughout this process I have contacted my employer PayPal who basically said it is out of their hands which I don’t understand because I work for them. What can I do?

    Sharita M.Aug 16, 2016  #607

  • Sedgwick is a shockingly corrupt organization. As a physician, I have seen their cherry-picked “evidence”, followed by absolute nonsense rationalization, used to deny claims by patients. Then their physician reviewers cherry pick “guidelines” that are often out of date, or simply do not apply to that patient, in order to rationalize denying what had previously been very successful and still appropriate medical care.

    While bandying about the term “evidence-based medicine”, they cherry pick the “evidence” and then leave out two thirds of the principles of evidence based medicine as originally described by Dr. Sackett. Their grip on the legislation governing workers compensation insurance allows them to do this with impunity and with no recourse by the patient.

    Physicians who review for them are told, in essence, that since Sedgwick pays them, they will write what Sedgwick tells them. And they do. And the treating physician’s recommendations and prescriptions are ignored with no recourse by the patient, Sedgwick being completely sheltered from responsibility for the consequences of their decisions by carefully crafted legislation. The system is so blindingly complex that patients simply are lost sheep in it. I suspect that some patients’ suicides were likely a direct result of the despair generated by these insurance denials pushing them over the edge.

    Independent studies indicate that Sedgwick and similar third parties, do not save money on healthcare. They add to the cost of care, while delivering less. No small part of their success is due to successfully and carefully steering “reform” legislation to gradually give them more and more absolute final authority. So they can charge the premium payer and the tax payer hundreds and thousands of dollars for supposed management of cases, while not delivering any real healthcare. For example, hundreds of dollars of review to deny an old lady a $5 monthly prescription, all couched in terms of, “look how much money we saved the carrier.” (She would pay $5. They likely paid less than $1.)

    A review of the financial underpinnings of Sedgwick and others is equally disturbing. Company bought for $1.1B then flipped for $2.4B to another venture capital firm. I may have the details awry, but the principle is accurate. That transaction raised the cost of healthcare $2.4B and didn’t buy a band-aid. But some investors and senior management made millions. This is what governs healthcare insurance, and workers compensation insurance in particular, today.

    If the rest of us did a tiny fraction of what these people do, we’d be in jail. But these institutions have carefully crafted legislation and government influence so that they can legally do what is a crime for anyone else. The workers lose. And so do all of us.

    WAug 6, 2016  #606

  • Robert, I would recommend you consult with a worker’s compensation attorney.

    Stephen JessupAug 1, 2016  #605

  • Sedgwick claimed to need my medical information to process my claim. I was asked about my hobbies, my education, and when I told her the questions were rediculous- she told me i was refusing to answer her medical questions. and called my manager at work.

    I gave her my permission to call and ask my doctor all the question she wanted, but she would not call my doctor, instead she wanted me to relate “me complete medical record” over the phone. 603 complaints and no class action law suit? what is wrong here?

    TS kingJul 30, 2016  #604

  • I was injuredbadly, damaging my neck, wrists\hands through repetitive strain my employer blew of my concernes. I kept working with bilateral wrist pain and sore neck for several additional weeks. Resulting in an additional injury. A torn clavical muscle in shoulder.my employer acted illegally by denying me access to medical attention. Resulting in perminant Nerve damage and crippled hands. .ultimately he fired me instead of offering medical care or accepting 2weeks notice once i stated this isnt what i was told upon acceptance of position . I was hired under false pretense into an extremely hostile enviroment as a scape goat.(the old bait and switch)On and on violations galore. I filed law suite my layer appointed Dr. Recognized my condition clearly, he began ordering the criticly important tests\proceedures needed to discover the severity of these overlapping damages. Sedwic handled my claim. Denied me evrything except medications.almost 2years they denied me MRI’s, EMG physical therapy.I was Flat out called a lier. I compromised and released out of my lawsuite.in order to get help.6 body parts injured. there was no compromise just a release. No future medical. in order to abtain help through covered californa i had to free myself from SEDWIC.i was starved of medical attention by this entity.these denials put my credibility in question causing me a overwhelming struggle for awsers, Life changeing injuries have taken my Quality of life away.im permanantly damaged physically and suffer from severe PTSD..SEDWIC allowed this to happen.. i remain angry angry and in pain 5years later.getting care slowly and inadequately through medi-cal pleeding with the government to believe me..i need assistance…SEDWIC ruins lives inforceing there policies in order to protect the bottom line…avoid workmanscomp if u can…the process was written unfairly and sides with your boss not your bulging discs crushed wrists or whatever your condition is..

    RobertJul 30, 2016  #603

  • Velisia, please feel free to contact our office to discuss your claim.

    Stephen JessupJul 27, 2016  #602

  • Fred, as Sedgwick is the third party administrator of your company’s disability plan, your employer, or their designated plan name would be the party legally liable for the payment of your claim. Please feel free to contact our office to discuss how we may be able to assist you.

    Stephen JessupJul 27, 2016  #601

  • I AM SICK AND TIRED OF SEDGWICK!!! EVERY TIME THEY CALL MY HOUSE I HAVE ANXIETY!!! Soooo Sedgwick just called advising they haven’t talked to the doctor that was treating me BUT they had spoken to the nurse practitioner. However, they wanted me to assist with getting the doctor to call them back. Well, I called the hospital where I was being treated and spoke to the nurse practitioner who stated she advised Sedgwick that the doctor treating me was no longer there & Sedgwick advised that they could talk to her. What is pissing me off is that the case workers & internal doctors are not on one accord. If Sedgwick already knows the doctor that was treating me is no longer there & accepted information from the nurse practitioner what do they need from me? Needless to say, after talking to Sedgwick I had an anxiety attack, so my husband called Sedgwick on my behalf to figure out what’s going on… No it wasn’t pretty… My husband was upset as a result of the call and it could be heard in his voice. The call ended up in the case worker hanging up. I have NOT been paid during this entire process and this just seems to be another stall tactic before they deny my claim. I NEED AN ATTORNEY!!!!! I’ve already had a previous claim denied & it looks like this one will be too.
    I’ve been diagnosed with major depressive disorder. Mental health is VERY serious but most people, those that don’t understand, think of it as a mild headache. This incident today has me shaking at this very moment & I’m fed up! I’m tired of the bullying and inconsideration. I need representation…HELP!!!

    VelisiaJul 21, 2016  #600

  • I am a 53 year old male with Rheumatoid Arthritis, Fibromyalgia and Carpal tunnel. I had a severe flare in March of this year. I was out 16 days while new meds were being administered. I was on Humira and had a reaction months earlier with 13 days of 103-104 degree temperature. I quit taking Humira. My dr prescribed Embrel, another biological treatment. Mr PCP and I discussed my being off a couple of weeks to allow the new meds to work. I was also prescribed other meds that made me very ill. Well, Sedgwick denied my STD saying my Dr did not give a good reason why I should be off. I appealed. When I called to see if the paper work was received my appeal rep quickly told me my appeal was denied ( 1st 30 seconds of our conversation). I provided her with certified mail receipts. It sat at their post office around 10 days before they picked it up. In my appeal I provided additional from two other Dr’s who had been treating me during this time. I was informed again today that my claim was denied due to the medical information did not support my absence. One of the Dr’s I treat with said a Rep from Sedwick called last week and asked if I was able to go back to work! I went back to work on April 13th!! Long story short, I have three (3) doctors that provided information stating I should have been off and one processor at Sedwick denied my claim. If you are an attorney reading this and want to help me please leave a message. The handling of this claim wreaks of Bad Faith. As a career insurance adjuster I know bad faith when I see it!

    Fred H.Jul 20, 2016  #599

  • Darlene, your GM policy likely allows them to apply an offset related to the SSDI pay you receive. I would request a detailed explanation of the financial breakdown of the benefit being paid.

    Stephen JessupJul 12, 2016  #598

  • Derron, did you appeal the denial and provide all of your medical records?

    Stephen JessupJul 12, 2016  #597

  • I am a truck driver and was in a GM truck delivering GM parts picked up from a GM facility being delivered to a GM facility and Sedgwick has tried everything to block compensation. I have had trouble with 2 employees making fun of my name and lying to the state of Michigan. The latest thing involves taking SSDI benefits from the comp/disability pay. When they do it they try to make it look like they are paying the full disability but in reality they have decreased by over $500.00 for social security. The amount they add as stdnfica is the amount I should be getting not the amount I am getting from them/….I can only assume they think they will get by with paying less in comp…They are paying me over $600. Less than I should be getting but claiming they are paying over $500. More than I am actually getting – is this even legal?

    DarleneJul 9, 2016  #596

  • I work for Apple. I started having issues with my ears. I have allergies, and have developed sinus infections, and upper respiratory infections. Apple asked me to file short term disability so that I could get my restrictions listed, and apply for another department. That was back in December 2015. I received some payments for the anxiety the whole issue has caused. Then some payments for the ear issue, I originally filed for. I have been denied since February 2016 for disability and my restrictions. I have had to go thru the appeal process because it says I can’t hire an attorney until I go thru the steps in my benefits handbook. In the meantime, I am approved for unpaid medical leave for the same condition that I am denied benefits and restrictions for. This has been going on for longer than I physically worked for Apple. I keep calling Sedgwick who tells me they are waiting on my doctors office. I call my doctors nurse and she started keeping the fax confirmation because of the times they stated they didn’t get something. They also state they are waiting on Apple, and I have to go thru my manager at Apple who is being told by HR they don’t have anything with Sedgwick. I am the one having to do all this calling and gathering information. Every time my doctors office fills out paperwork I have to pay an additional fee. I don’t have the money for the doctor let alone more and more paperwork.

    TinaJul 8, 2016  #595

  • January 2015 I was in a train accident. Suffered mild back trauma and hand injury. USC had Sedgewick. I filed for short term disability while I go through physical therapy. Sedgewick denied my claim syaing they were unable to get progress notes from the doctor. However, when I told the doclor, him and the nusre said they received a call but they failed to send an authorization for records. Sedgewick kept calling me for progress notes and I told them that I am not a doctor so they have to call the doctor to get that information. They never contacted the doctor and I was forced to go back to work to receive in income.

    They are foul and do not know what they are doing. I would have lost everything if I had not have went back to work.

    DerronJul 8, 2016  #594

  • Jeanne, has your claim been formally denied? If so, please contact our office to discuss your rights and options.

    Stephen JessupJul 6, 2016  #593

  • Seth, unfortunately, I would not be able to speak as to any potential action against your doctor or the hospital with respect to getting paperwork to the proper parties in a timely manner. Are you being terminated by Wal-Mart? If so you will need to consult with an employment attorney.

    Stephen JessupJul 6, 2016  #592

  • Aaron, is it a Sedgwick administered disability claim or worker’s compensation?

    Stephen JessupJul 6, 2016  #591

  • I work for sams club. I become sick with cancer first then two years later I can barrie walk also my hands go numb for hrs. I got paid from Segwick only two time. My Dr has me out till sept 28 but they want more information. I’m going through a lot of test but I need money to lI’ve on what should I do?

    Jeanne H.Jul 4, 2016  #590

  • I have been working for Wal-Mart for about 2 months before I started going through grainal pain, it started getting worse and worse to where I was unable to work, eventually I was recommended to use sedwick and take a claim of leave of absence, so I did, on the 28th, I had set up a doctors appointment before I did so but it was seceduled for the 7th, when I got done with the appointment they told me I could go back to work but did not give me any paper work instead they sent it to sedwick when I called Wal-Mart they told me that I was still missing some paper work and I need them to fill it out, now at this point I have ran out of money to go pay for a nother trip up there, and I was doing every thing I could to get back up there, a week goes by and I am able to get the paper work that is needed up there, and I call Wal-Mart and tell them they should be filling out, now the doctor’s office told me that it would take 7 to 10 days, I said fine as long as it wasn’t before the 21st, because that was the dead line. On the 21st I call them to make sure it was turned in, they told me no it wasn’t turned in yet, now they were telling me it was going to be 7 to 10 business days, they didn’t say that when I turned it in, now when i had to wait another 5 days, so on the 26th I called them and asked was it turned in yet now. Their answer was no not yet, at this point I am steaming mad because it should of been turned in on the 21st not the 26th, anyways they tell me it was going to be 10 to 15 business days in total. On the 29th I finnielly get fed up and head down there to get the paper work so I can send it in my self, by this time, I have missed 3 weeks of work where the doctor’s approved me to be able to work, when Sedwick gets the paper work they denie my claim. I did everything right, I shouldn’t be forced to lose my job because of the hospital not doing their jobs right the first time. So what do I do? Am I being discriminated? And if so should I sue both the hospital and Sedwick?

    Seth A.Jul 2, 2016  #589

  • Heres my issue i went to the doctor for a dizzy spell.. work said do not come back till follow up appointment after being cleared for work. This was on june 22 2016. At 2 pm. I left returned to my place of work on the 23rd to find my badge was disabled. Now sedgwicks dragging there feet. The labor unions dragging there feet and i have no pay..

    There saying we dont want you to faint umm i worked there since 2014 like this..

    AaronJun 30, 2016  #588

  • Deb, have you received your formal denial letter? If so, please feel free to contact our office to discuss your claim.

    Stephen JessupJun 28, 2016  #587

  • Will, do you have a current pending claim because of the cancer diagnosis? Please contact our office to discuss your STD and any pending LTD claim.

    Stephen JessupJun 28, 2016  #586

  • Velisia, typically they would want to know an attorney’s name as companies will typically only communicate through an attorney if a claimant is being insured. I do not know if you are under any obligation to mail it back, but wouldn’t be surprised if Sedgwick tried to play games with you if you didn’t.

    Stephen JessupJun 27, 2016  #585

  • So I am on disability. I had a decomposition of my L4-L5 spine on 5/9. I don’t heal. I have had infection in the surgical site. I did go back to work but it was two much and in bad pain. So the doctor took me back off. They are denying the claim. How can they do that?

    DebJun 27, 2016  #584

  • Wow, I had rt. hip-implant a couple years back, off work for three months because if I didn’t. I was told over the phone that I would loose,My position in the meat dept.For those 3 mos.Sedgwick never sent me a dime of disability benefits.Me and my son live off top Ramon noodles,To this day Sedgwick has never paid Sedgwick call me last year, after being back to work with a 40.00 check.I went to personnel-office at Walmart demanding Walmart notify Sedgwick to send me 3 mos. of disability benefits.Walmart personnel told me that I would have to take getting paid my benefits, from Sedgwick myself.So now I have blood cancer and can’t work and still can’t, Obtain disability benefits LTD,what’s wrong with this picture, I guess when your’e company is in bed with Sedgwick,The DUTY To ACT in a reasonable manner toward other,is thrown out the window.

    Will S.Jun 27, 2016  #583

  • ATTY Jessup… Sedgwick did claim they had no information about my treatment so I watched the nurse submit all of the information in my chart. My case manager confirmed with the nurse she got it. Now my decision date has been extended to 08.05.16. Sedgwick sent me a certified letter advising me of the extension & one regular mail. The one I got in the regular mail was just the standard preformatted letter without the dates inserted BUT this letter also included another clients personal information!!!! I made Sedgwick aware of what they had done but wouldn’t give them any information on what they sent me…i.e. Clients name, case number Etc. My case manager called and told me I needed to mail it back to them. (Lol really!!!) I told her I gave it to my attorney (that I don’t have). Am I obligated to mail it back? She also wanted my attorney’s name.

    VelisiaJun 23, 2016  #582

  • Diana, please feel free to contact our office with a copy of your denial letter to discuss how we may be able to assist you in appealing the denial.

    Stephen JessupJun 21, 2016  #581

  • I got denied my short term disability from3/3/16 through 5/9/16they said my medical information didn’t meet the standard of there std. I than appealed it and just got told today that they was upholding the denial. My Dr sent them information on how she double my bp meds put me on heart medication and we found out in late April that my EKG showed I had a heart attack. My Dr. Still has not released me to go to work BC they can’t get my hood pressure below 90. But yet this does not meet there standards. What can I do to see why. They said that when the appeals people make a decision it is final. I think that a heart attack at 38 and extremely high hypertension meets criteria.

    Diana T.Jun 20, 2016  #580

  • Sedgwick is one wicked company who just doesn’t want to pay STD or LTD claims. I was sick for more than 3 months and hospitalized. First they took too long to process my claim and then they denied my claim. I appealed and still they denied and had guts to tell me I can go to lawyer and this is their final decision and they are denying my claim. They knew I would loose my job and won’t have enough money to hire attorney nothing is going to happen to them. They are robbing people. I hope somebody would have some better solution for these
    liers. Don’t even buy LTD because you would loose all the payments if something happens they would just deny your claim for one or the other reason.

    JoyceJun 15, 2016  #579

  • David, you will need to consult with a worker’s compensation attorney. Should you need assistance in finding one please feel free to contact our office.

    Stephen JessupJun 9, 2016  #578

  • Velisia, I highly recommend that you do not trust Sedgwick to obtain all of your treatment records and that you provide all the records to them so they cannot claim you are not receiving adequate treatment. In the event they do deny your new claim please feel free to contact our office to discuss how we may be able to assist you.

    Stephen JessupJun 8, 2016  #577

  • I was injured while working for Nestle Waters. At first I thought that I had a badly pulled muscle in my back that would heal in a week or so. That week has turned into nearly a year now. MRI results have shown some major damage and more than one doctor at this point have told me that surgery is the only option. Sedgwick denied the surgery several times. Since being off of work, Nestle fired me (they conveniently got rid of my position) so i lost all benefits and no longer have a job to go back to once this nightmare is over. I am 35 years old with a wife and 5 month old son. Sedgwick has paid me, mostly on time, the reduced salary compensation and I am grateful for that, but they are also trying to strong arm me into walking away so that they don’t have to pay for surgery. They have dug into my past (which I was open about with them anyways) and sent me a 3 inch thick packet of previous medical history just to let me know they are looking into it. I have had back problems in the past, but the bottom line is I worked for Nestle for a year and a half with zero issue until the day I was injured. I have nerve studies, MRIs, multiple doctors opinions and recommendations, but Sedgwick would rather string me along (will be a year in July) and do nothing. We had to leave our home and move in with in laws because I can’t work. We are stuck, unable to do anything because without a taxable income we can’t even look for a cheap apartment. I can’t even get my prescriptions without submitting them five days before they are due and then even still having to try along with my nurse advocate to get ahold of the adjuster to try and get her to call the pharmacy back. They even denied a tens unit. This has been a complete nightmare for my family and something needs to be done. Sedgwick is no more than a deny deny deny insurance company that hopes you will just walk away…well I’m not going anywhere until the issue is resolved!

    DavidJun 7, 2016  #576

  • So my appeal was denied & I was forced back to work only to relapse. Sedgwick says I can only appeal the denial once & then must retain an attorney. My mental illness has only gotten worse and I feel totally helpless. ATT as they’ve done before are sending threatening letters that I return to work despite my doctor’s recommendation. I’m in treatment 3 days a week for now & of course had to file a new claim which hasn’t been approved yet. When is the bullying gonna stop?!!!!!?

    VelisiaJun 4, 2016  #575

  • Hi Stephen, all this stuff I’m reading about Sedgwick and the way they do people. I was just wondering why all of is can’t get together and file a class action lawsuit on thim for the hardships they have caused. A lot of us have lost everything because of this company. I thought it was just me this was happening to until I found youre website and started reading everyones ttestimonials. What I’m reading it seems to me that Sedgwick is doing this toeeveryone. I think it’s there tactics to get people to give up and settle there claims for a little bit of nothing. Obviously this company and it’s employees have no souls and definitely not a conscience. My question is why can’t we put a class action lawsuit against Sedgwick for the hardships and mental anguish they obviously cause everyone.

    Steven W.May 21, 2016  #574

  • Wendy, please feel free to contact our office to discuss your claim. Also, as Sedgwick is a third party administrator of Starbuck’s plan, have you spoken to anyone at HR about the problems you are having with Sedgwick and your disability claim.

    Stephen JessupMay 12, 2016  #573

  • I work for Starbucks, and have been battling with Sedgwick for months. I have been diagnosed with Multiple Sclerosis and the pain and fatigue are so bad that I could not perform my duties as barista, on the bar in a high volume store, a job which I have held for almost 10 years. I filed for and was denied STD and my fmla was cut off. They lied constantly about their lack of communication with me, about my Physicians “not returning paperwork ” and lied when I presented proof that they did return the necessary forms. They ignored my emails, Audry Calhoun admittedly sent my confidential medical information repeatedly to the wrong email address, even after my contact information was verified by another Sedgwick employee at my request. She lied about sending my denials and other paperwork, stating that it must be a problem with the US Postal service, over and over again. I was denied my appeal, just today because they said I didn’t return the physician forms, when I never received any. I have emailed many many times requesting that all of my correspondence be mailed because my Hippa rights were violated via they’re shoddy email practices. I also called several times. I could go on and on. Bottom line: my household of 3 is being solely supported by my husband. I cannot work, my insurance with starbucks has been cancelled because, with being denied STD payments, we could not afford to pay it, I has MS and cannot afford to continue on with my neurologist, therefore, I am not being treated. They lie, they cover up those lies and they do not want to pay.

    WendyMay 10, 2016  #572

  • Sedgwick, in my opinion, is the most fraudulent and corrupt insurance company in this country.
    Amoung the many fraudulent things they do including hiring doctors to lie on their IME reports (in my opinion this is malpractice and insurance fraud) the worst thing they are doing to all their claiments is cheating them out of 28 days of payment a year by using what can be referred to as the 13 months a year method.
    Let me explain how they are doing this.
    Each check they send you should be a biweekly check having only 14 days listed on the check stub.
    But if you add up the date range on the check stub it will add to 15 to 17 days, not 14 days.
    Then after a year has past a total of 28 days has not been paid to the claimant.
    They have been getting away with this because most claimants don’t take the time to count the date range on each of their checks.

    LynMay 8, 2016  #571

  • I just recently had a baby at the end of January and was out on leave of course and I get a call on March 7th saying it was the last day they were covering me for leave and I hadn’t even had my postpartum check up yet. The lady then tells me I need to try and get on a “cancel appointment” list or have it moved to an earlier date otherwise I won’t get paid. I go to my check up and my OB tells me I’m suffering from postpartum depression and that she’s releasing me from her care but I need to speak with my primary physician first before going back to work and Sedgwick tells me they aren’t going to pay me and that I will need to submit an appeal! My doctor still has yet to release me to go back to work and I’m currently going to counseling with a psychiatrist. If I haven’t been released and my dr said no way no how why am I not getting my money?!! I’ve submitted all documents they asked for and this has been going on sinc March 8 no pay! 2 kids and a husband is hard to survive on 1 income!!!

    ChristianMay 5, 2016  #570

  • Have osteoarthritis so bad they won’t even perform surgery on me. In every joint. Was supposed to be able to get short term care then long term care. Had five doctors say I couldn’t work but Sedgwick was so bad that I was forced back to work. Last twenty days. I finally quit and filed for social security disability. I was so bad I got approved in less than sixty days. Would like to get my money lost from these people.

    Mike T.May 3, 2016  #569

  • Michael, they would have had to provide you with a denial letter explaining the basis for the denial. Please feel free to contact our office with a copy of the letter to discuss the steps available to you.

    Stephen JessupMay 3, 2016  #568

  • Joe, it may be a wise idea to speak to a worker’s compensation attorney.

    Stephen JessupMay 3, 2016  #567

  • Angelo, although common sense would dictate it shouldn’t take that long, approximately 2 weeks is not out of the realm of their timeframe. If you do have issues please feel free to contact our office to discuss your claim further. That being said, I am hoping you won’t have to go through with them what you did before.

    Stephen JessupMay 2, 2016  #566

  • I was denied my short term disability starting in January and was off tell the end of March when I tried to go back to work because I was denied my short term benefits. The day I went back I was there for four hrs and hurting so bad I couldn’t move my arm so I went home. The dr decided that since I was still having problems surgery was needed after they had done tried brasses and even a shot when surgery was done, I was approved but only from the end of March they said they couldn’t back date even thou I had new finding in my case and I would have to sue them and the pay I’m getting now doesn’t seen to be right. What can I do about this?

    Michael W.May 1, 2016  #565

  • I work for auto zone, fell off a ladder and hurt my back and everything your saying in the videos is right on point. They are giving me the run around and doctor is dose seem like he works for them. I’m in Texas.

    JoeApr 29, 2016  #564

  • We have been getting the run around from Sedgewick since January. They tell us they will send paper work that is never sent. Told us the doctors never filled out paperwork. Excuse after excuse. It has been a horrible experience and still ongoing. My mom has been out since January.

    DianeApr 28, 2016  #563

  • This is got to be the worst company in the world they are terrorists they put unreasonable demands confusing input for your doctor to answer is in the process of buying a house when I who’s injured Ed Edd has paid me and okay with my doctor and his explanations but yet Sedwick is consistently harassing me through their second party doctor evaluation process and is withholding funds that I paid into for my paycheck and said they can do so up to 48 days which is most likely going to cause me to lose my home purchase and leave me homeless thanks Sedwick on top of that I work for the Comcast Corporation and their HR department is absolutely useless as well if there is any type of class action lawsuit I would gladly be part of it and anyway would be helpful to anybody out there having the same issues thank you

    Ernest BakerApr 28, 2016  #562

  • We are about to lose our home we are in the middle of buying because of Sedgwick! They don’t care, they are unprofessional and horrible to deal with. Why does Comcast, one of the biggest corporations in the USA use this company. Even they complain it! We will sue them if our sale falls apart because of them.

    Ernest F.Apr 28, 2016  #561

  • Had to file a claim through Sedgwick last year for a back operation due a birth defect that started causing issues. Because my surgical date was planned out well ahead of time, I was able to get all the paperwork and information together to get approved for STD and not have a gap in pay. Near the end of my recovery time, every time I submitted the Attending Physicians statement, they (Sedgwick) said they needed more information. At one point I had sent them my entire medical file from the surgeon who performed the operation and stated on EVERY Physicians statement when I would be able to return to work and Sedgwick still denied the claim stating that the information provided did not support a disabled status. I appealed and won. Found out that a co-worker went through exactly the same problem, including to being refered to the claims managers supervisor, neither of which know how to return a phone call. Now I am facing another surgery due to healing complications of the last, and Sedgwick is dragging their feet. They have had all required paperwork on April 22nd, but say they “legally” have until May 9th to make a decision. I guess I’m just wondering if this is an acceptable amount of time to make a determination or are they screwing with me.

    AngeloApr 28, 2016  #560

  • Went out of work 1/20/16 due to main reason seizures not being controlled. Was approved till 3/4/16. On 3/1/16 went to dr and would not release me due to other issues. Called Sedgwick about extending STD was told all i need to do was have office notes faxed over so called dr office and that was done that day confermed it on website. Waited a few days didnt hear anything so called Sedgwick was told they needed more information they wanted all 4 dr that i was seeing but states thay my PCP was the one handling all thw paperwork becuase she knows everything that is going on. Few days went by requested a update via website got a voice mail saying that paperwork had been faxed to dr. Next day called my PCP nurse said they hadnt received anything. So back on the phone with sedgwick they said oh we sent it to the oncologist i asked them why and stated i told you all that my family dr is the one taking care of the paperwork. So thwy faxed it to the right dr and so by now its the 23 of march the day the paperwork is due. I receive a text message crom sedgwick saying you leave has been approved from 3/19/16 to 4/30/16 so i call they say we have no record of this and it is a mistake. So on the 25th my dr faxes paperwork which was a Friday i call and confirm that it was received and it was they told me takes 2 day to get approved should know by Wed which would be 3/30/16. So i call and they say that it was sent to the nurse board and should have an answer by monday which was another 5 days going passed the end of the pay period and i hadnt been paid at this point going on 4 weeks. So i said no i would like to speak with my examiner so i get a voice mail and then i ask to speak with a supervisor and was told should have an answer by friday. So call back Friday 4/1/16 and rold that they need more information i asked what information do you need my dr sent 15 pages of info on the 25th. So monday 4/4 i call back and told that my examiner will be calling on Tuesday. I wait till noon tuesday and call again was told that she will contact me and tell them that she hasnt and asked to speek to her. I was told that they cant transfer me cause i was told that she will contact me. Finally on wed i was given an answer that my claim wqs denied off of office notes feom the neurologist saying that my seizures had decreased some but not releasing me to go back to work. But sedgwick did extend the LOA till 4/4/16 so even they agreed that the dr wouldnt let me go back till then even though he had not released me as well as the other dr that i was seeing. On 4/10/16 i received my appeal paperwork and got a copy from my dr office that was faxed to sedgwick. Called and asked sedgwick about extending my leave of absence since my PCP had not released me and in fact put a returen tonwork date down on the last set of paperwork a 4/1/17. On 4/20/16 requested in writting from sedgwick a copy of all paperwork that they had faxed via email request because when i was telling them that my PCP had not released me and pointed out the date that she put on the paperwork they stated that it was left blank. On 4/27/16 received a call voicemail from sedgwick saying that they received more paperwork from my dr and they cant really review it because they hadnt got a formal request for an appeal even through i have stated every time i have spoken to them. The voice mail stated that i could do it over the phone mail or fax. It was only 10min later that i called them back. The rep i talked to acted lime they didnt know what i was talking about. Said to call back tomorrow. I am so tired of dealing with them. They claim that because i had a normal eeg that i dont habe seizuries even with both mu PCP and nero dr stated a normail eeg does not mean that i do not have seizures. Again this is the only 3 page report they took not the 15 pages my PCP sent. And listed the her, nerologest, oncologist, cardiologist and not ortho dr due to injuries from the number of seizures witch can be as many as 4 a week.

    ShannonApr 28, 2016  #559

  • Josie, does your short term policy indicate it covers for pregnancy-related conditions, as some employer funded policies do not contain such provisions. Please feel free to contact our office to discuss your claim further.

    Stephen JessupApr 27, 2016  #558

  • Was out due to pregnancy related 1st trimester severe symptoms -nausea , dizziness, bathroom issues. Was out of work as recommended by doctor for one month due to long commute to employer onsite location. As soon as I was out for first five days for sick , company Fannie Mae, told me to seek Sedgewick STD. I never heard of sedgewick until after the five days I missed of work. Well went through claim application and of course denied after all paperwork was due and signed and faxed by my doctors stating specific of time out they recommend for me to return to work.. The representative when I asked her reason for denial, not enough medical proof and that they had certain conditions of bad health that were not met?
    I guess my employer would prefer if I was falling and puking on every one around me at work or puking on the HR department? So now doing the appeal. However from my research on this site seems they will just deny me again where then I guess I will not have income for a whole month, since I am not protected on FMLA due to less than a year of employment with employer. Should they deny me again is pregnancy related issues considered disability even though on one of the forms they stated pregnancy itself is not a disability?

    JosieApr 26, 2016  #557

  • Joe, I think you need to speak to your doctor/doctor’s office to see if they really indicated they were not certifying you as disabled before the surgery- if they did say that it is not so much the Nurse overrode your doctor’s opinion so much as agreed with it.

    Stephen JessupApr 19, 2016  #556

  • Sherraine, did they deny because of credentials or because they did not believe the information was sufficient to support disability?

    Stephen JessupApr 19, 2016  #555

  • Been trying to get “Sedgewick” , they handle Time Warner Cable Short term disability. I emailed them thru thier portal to contact me as to what they needed to continue my STD. No response, that was on Monday. I have since asked to seek to my leave specialist and no response. I have spoken to agents but hey can only refer back to my leave specialist. I am currently not getting paid any longer as of 04/12-. I need to submit paperwork but no response. I have provided them with my Doctors fax but nothing yet. I need to submit the paperwork by the 04/19. They are stressing me out. The doctor as not released me yet, stated normal time off for a hip replacement is 90 days. It been only 6 weeks and wants me out for another 6 weeks. I have was also denied benefits for 60 hours was told I could have come to work even though certification was sent to them, I lost the appeal thinking that the Doctor who reviewed it would understand.. This part of my conversation with Sedgewick with appeals. I spoke to my doctor and they were certifying me not to return to work and they did tell who ever called I was not going back to work due to my inability to walk, due to ongoing hip pain, getting dressed issues with getting in and out of vehicle..

    On Apr 1, 2016 08:51, “Tonia” wrote:

    Your short term disability claim was denied as your medical submitted did not support total disability. Your doctor needs to submit more than a certification in order for disability to be approved under your employer’s policy. This was determined by a nurse within Sedgwick who called Dr. Katz’s office. It was advised by Dr. Kanz’ office that they were not certifying you out of work prior to your surgery.

    If you continue with the appeal process, we will do an Independent Physician Review on your claim and that doctor will make up to two call outs to your provider. This will be done on 04/07/2016, unless you request a tolling extension on your deadline of 04/07/2016. Please let me know if you have any questions.

    So a nurse can override the Doctor wow… I am so fed up with them I emailed them today, I did get response they faxed paperwork will be checking with My doctor Today 04/15/16. I have 4 days to submit paperwork.

    Joe N.Apr 15, 2016  #554

  • My employer, Apple Inc., uses Sedgwick. I was on leave due to stress, and I wasn’t sure of what type of doctor to use. I called sedgwick to verify my doctors credentials, they approved the credentials, then denied the claim because of her credentials. Is that even legal?

    SherraineApr 15, 2016  #553

  • Crystal, prior to filing any legal action you must undergo an administrative appeals process- have you already completed same?

    Stephen JessupApr 11, 2016  #552

  • Pam, please feel free to contact our office to discuss your rights.

    Stephen JessupApr 11, 2016  #551

  • Phyllis, if you have already appealed the denial of benefits then you will have to give them the allotted time to conduct its review. In the event the continue to deny your claim please feel free to contact our office to discuss how we may be able to assist you.

    Stephen JessupApr 11, 2016  #550

  • I am so frustrated and stressed out dealing with sedgwick these people do not care. Then I work for the worst Walmart. I hurt myself on the job i tore a muscle in my side. Painful! but the people at Walmart didn’t want me to do a workers comp claim. Make a long story short, I did a short term disability claim and a leave of absence on Feb 15,2016. So almost two months. I’ve been calling Walmart every other day and sedgwick getting the run around. Calling everyone. Even my doctor took her time to sign the paperwork. They aporoved my leave for two weeks and my std claim for two weeks. I just got the money this past Tuesday. Only $170 for two months!! Then they denied my leave from March 2 until March 20 due to my doctor not specifying dates. But she did. Then I get more letters stating they approved my leave the day after I get terminated from Walmart because I’ve missed so many hours. Now Walmart is saying I’m termed but they don’t know what’s going on since sedgwick sent the approval. They denied my st disability claim. Only two weeks were approved. I am going to take legal action. Walmart the doctors and sedgwick are all snakes. I’m ready for this to be over!!! I’ve filed for unemployment. I need my money now. Thank you for any responses. I’m so tired of this. Legal action requested

    CrystalApr 9, 2016  #549

  • I have worked for Comcast for over 20 years. I went out of work due to a back issue where my legs and butt were going numb. My doctor filled out every form we sent mri reports that stated 2 bulging disc and. A tear in a disc I then got shots in my back and my pain clinic did not fill out forms so I called my doctor the next day my doctor filled out all the forms but they waited until after the due date to inform me my doctor didn’t send any and written doctors notes so I was denied my short-term disability from the day I had The injections in my back I then called Sedgwick and filed a I filed an appeal and was again denied saying that there wasn’t enough information stating why I was disable I don’t know how to how much more they needed because all the forms were filled out and the MRI report stated why I was disabled because I had to bulging disc and a tear in one of my disks this is getting out rages the Sedgwick is been allowed to do this to many people I don’t know where to turn I have lost three weeks paid to do this and like many Americans I can’t afford to lose three weeks pay my name is Pam Hargan and I work for Comcast in Michigan I was also when I found out that my pain clinic wouldn’t fill out the paperwork I immediately same day called into Sedgwick this was on Friday, January 22 I called Cedric on Monday and they told me they sent the forms to my doctor I had a doctor appointment on the following that Thursday and the paperwork was due the next day I was given less than a week to get the proper paperwork my doctor fill that out immediately and send it in the same day but again because there were no him written doctors notes again was the reason it was denied.

    Pam H.Apr 8, 2016  #548

  • My doctors said I could not go back to work yet, but sedgewick denied my claim, so I appealed it sent them documents and reports showing the doctor had me off work for back issues and they still denied it again. They owe me almost 9000.00 in back pay is there anything I can do.

    PhyllisApr 8, 2016  #547

  • Codi, is your claim for disability insurance benefits or worker’s compensation? I only ask due to the indication of TWC benefits.

    Stephen JessupApr 5, 2016  #546

  • I am having a horrible experience with Sedgwick. I work for Time Warner Cable and had a knee surgery over a month ago due to extreme pain and limited mobility. The Dr. Micro-fractured my knee in 3 places and removed bone and loose cartilage from the inside of my knee (i have a booklet of pictures feom the whole thing from inside me from the Dr.) I was told i was not allowed to walk on it for 6 weeks. I was unable to work. I initiated 3 claim from Sedgwick. The 1st: an fmla for the time i was out before the surgery due to flare ups, which was denied because of my own ignorance. I didn’t know i had to bring paper work to the Dr. I thought it was sent automatically. So 10 days before my surgery I initiated another fmla AND the short term i was going to be out. I provided the fax and requested it be faxed directly to the Dr. Office and emailed to me as well. The Dr. Recieved both packets filled them out and assured they were faxed baxk to the fax number on ther form its self. Sedgwick claimed they never recieved it. This happened 3 more times. Until Sedgwick miraculously recieved the packets, which i believe well after my surgery had been preformed. They then were unhappy with 2 questions and sent was was called a “clarification document” that i had faxed directly and emailed as well to myself. Same problem. 3 or more times faxed before Sedgwick “recieved” the pages. This has now been over a month since the claim was filed. I had to ask for an extension because they had closed my case. TWC being my only income and a 2 year old to povide for ment nothing to them. When i cried over the phone (which I have never done in my life) they were extremely rude and uncaring. On the call were I finally confirm they had the “clarification document” they informed me that my short term had been denied as well due to never recieving the “medical document” and allowed me and extention on that as well. 14 days only . They emailed me the medical form only this time with the subject line “medical document” as i requested. Packet was filled out and faxed at which time 1 Sedgwick rep told me the received but it was for fmla not short term and another rep told me they recieved ‘nothing, that rep lied’ after which I admit to loosing my temper and using some choice words to express my frustration. Then right before she hung up on me she said claimed she knew they had actually recieved the packet today, informing me she had knowingly lied on a (supposedly recorded) line. I have gone over a month with no income and face eviction due to not being able to pay my rent, while my “case manager” if she exists fails to call me back every EVERY time a call has been made and a reqest has been place. I’ve even asked for her sup and i can only assume they dont exisit either. I’ve even broken down and called my HR to see if they can help and he flat out told me he hears non stop problems with Sedgwick but the most he could do is call for a status even though the 14 days is up. I very very much am in need of assistance. And at this point I strongly believe it needs to be legal….

    CodiApr 2, 2016  #545

  • Velisia, FMLA and Disability are two separate reviews and procedures. FMLA is federally mandated laws protecting your employment status while on medical leave whereas disability is an employer provided benefit that pays benefits while on leave. AT&T is correct in stating that you must apply for FMLA to protect your job.

    Stephen JessupApr 1, 2016  #544

  • Velisia, please feel free to contact our office if your appeal is denied to discuss your options.

    Stephen JessupApr 1, 2016  #543

  • I was approved for short term disability initially for stress, anxiety, and depression. I also suffered from insomnia, headaches & an inability to focus. My job requires me to think critically because I work in tech support. The representative from Sedgwick would call every 2 weeks asking questions that were answered by the correspondence received from the doctor which said I didn’t have the mental capacity to perform my job functions but could be treated. The Sedgwick rep called me again… Asking why I needed to be off… With my state of mind at that run I couldn’t answer her questions so they denied my short term disability despite the doctor saying I was unable to return to work. I’ve appealed the case but I don’t feel good about the outcome because they are still calling me about needing more information that they already have!
    After I appealed the denial, my job AT&T calls to say that the appeal won’t protect my job and I needed to file for FMLA. My FMLA was approved; don’t the 2 go together? Needless to say, I was forced back to work in order to support my family. Had a follow up doctors visit today & was told I wasn’t ready to be back at work. The lady handling my appeal says their internal medicine doctor needs info from my doctor which my doctor is willing to provide in writing but not over the phone. The lady handling my appeal says they won’t accept paperwork. Seems like just a convenient avenue not to approve my claim

    VelisiaMar 31, 2016  #542

  • I was approved for short term disability initially for stress, anxiety, and depression. I also suffered from insomnia, headaches & an inability to focus. My job requires me to think critically because I work in tech support. The representative from Sedgwick would call every 2 weeks asking questions that were answered by the correspondence received from the doctor which said I didn’t have the mental capacity to perform my job functions but could be treated. The Sedgwick rep called me again… Asking why I needed to be off… With my state of mind at that run I couldn’t answer her questions so they denied my short term disability despite the doctor saying I was unable to return to work. I’ve appealed the case but I don’t feel good about the outcome because they are still calling me about needing more information that they already have!

    VelisiaMar 30, 2016  #541

  • Sedgwick is the worst company I have ever dealt with. I am afraid to file a short term disabilty claim with them because they are so ruthless. My girlfriend was denied 2x. We then discovered that the 3rd party examiner LIED about the peer to peer review. IT WAS NEVER DONE! When confronted with this accusation Sedgwick reopens the claim and assigns the same 3rd party examiner that was just caught lying about peer to peer review. WOW! The examiner finally spoke with her doctor and was told that she needed the time off and was struggling with mental health ect. The doctors words were twisted and the claim was again DENIED. WTF?!? if you can, stay away! Far away from Sedgwick. They are the DEVIL!

    MileyMar 30, 2016  #540

  • General Motors employee of 18 yrs, back surgery with screws and rod denied medical claims for not being substianted even though Dr. Filled out paper work, Appealing Denialing Company says will fire me if appeal not over turned for time I was off.

    NiecyMar 29, 2016  #539

  • Lorraine, does your employer provide disability insurance coverage? If so you can look into applying for same if you are not able to return to work.

    Stephen JessupMar 25, 2016  #538

  • I’m currently on intermediate leave for manic depression, panic disorder, anxiety. Every time I turn in paper work there’s a problem to them, my doc said my condition is permanent yet they want an end date. The amount of attacks can not be said yet they want to know how many times it’s going to be if I’m late it’s counted as an absence. They give me such a hard time I end up with a panic attack. What can I do, just trying to stay working with out worry but losing my job because of my condition.

    lorraineMar 24, 2016  #537

  • Deeana, have you already appealed the denial of benefits?

    Stephen JessupMar 18, 2016  #536

  • Hello! I just found this website and had the same problems that they did not want to pay out. When the GYN doctor wanted me to stay out of work long and still never received pay my claim was denied. I work in the ER and had a total Hysterectomy and my appendix removed. They paid for 6 weeks and said I had a desk job by my job detail is bedside Registration and push and pulling a computer that is more the 5 pounds. My doctor said I could not push or pull more then 5 pound and rest. My doctor who done the surgery said not to return back to work for 4 and half more weeks because my surgery site inside was still bleeding. Please advise.

    DeenaMar 17, 2016  #535

  • I too am out on short term disability with an unknown illness and trying to be diagnosed. I have been denied once and then you have 10 days to correct and then denied again. I was told I am not elligible for disability without a diagnosis but have understood from others that it will probably be denied then also. I am house bound with very little activity since obviously I am Ill.

    I called today for detailed infomration of the denial because they said there were no limitations for work. My reply was that limitations will be set at the return to work stage and that we are still in the diagnosis stage of the claim. It seems to me that if a licensed physician is certifying that I am out of work due to illness and we have provided detailed information to them on the status of my complaint, testing and results and a plan going forward proceedures next week, that should be sufficient for payment from the insurance company. Being tough or dificult is not very good and is very stressful in this time of physical impair. Leave the medicine to the licensed medical people and Sedwick needs to start paying their claims as contracted to do so.

    I will probably file a complaint with the department of insurance for my state but I am curious what the process is for a lawyer to file against them and what is the success rate of these cases?..if I may inquire.

    Same Issue...Mar 14, 2016  #534

  • Cindy, I am sorry to hear of the difficulties your mother is facing. As Sedgwick is a third party administrator (not the insurance company) for your mother’s employer’s disability plan it may also be beneficial to try to contact her HR department to seek assistance.

    Stephen JessupMar 8, 2016  #533

  • Molly, most disability insurance carriers will never have an indication of “permanent disability” and most employer provided plans limit payment for mental health claims to 24 months.

    Stephen JessupMar 8, 2016  #532

  • Debbie, please feel free to contact our office to discuss the status of your claim. Your only option at this point may be to bring a lawsuit against your General Mill’s plan.

    Stephen JessupMar 8, 2016  #531

  • My mom had a stroke and all medical documentation was sent to Sedgwick who will not move her approved date out or pay her. They are receiving medical papers but not paying nor approving time for her. They only previously approved 2 weeks. They will not return emails or calls and I am trying to find out how to get ahold of a supervisor as the examiner is not doing her job. My mom has went without a paycheck A stroke should be pretty black and white and with them receiving all the paperwork from the doctors they are not doing as promised. And its very stressful to me who is trying to help my mom with her appts to call them daily

    CindyMar 7, 2016  #530

  • I am suffering from severe depression and anxiety. I am temporarily boarded off work for one n half year. Every six months need to go to my pychiatrist and pyschologist for reports and sent to my companys insurer which is Discovery. They pay me 75 perscent off my salary. How long will it take for them to permantely board me off work?

    MollyMar 7, 2016  #529

  • P.S.

    Forgot to mention I work for General Mills, and that after surgery my benefit miraculously reduced to 60%, that is, if I were to get approved. I do not think I can get unemployment for my time off for this in Michigan. Thank you for any comment you have.

    Debbie MMar 3, 2016  #528

  • Wedgsick is giving me stress also. Was informed that I needed surgery to replace breast implants that I had for over 25 years. They are meant to be replaced every 10. Safe to say I waited too long. Consult with Doctor and he said I should have removed/replaced immediately. I call Wedgsick and in great detail explain what I am having to have done and would I be covered, because I had heard horror stories! Gave them everything they said they needed and was told by caseworker I was all approved, and would get 90% of my pay. Great! Surgery went well, however, 2 weeks later, when I attempted to find out when my benefits would start to pay, was told by email I was denied benefits due to lack of information. Ok, fine I call and have to wait for them to call back. 6 phone calls later, I finally get a rep. and they said they needed a note from doc explaining why this was not cosmetic. Well, because they can tear and cause great harm when they are that old. That they break down in your body slowly over time. Sent in note same day and two days later after 3 phone calls was told denied again. Why oh why didn’t I get AFLAC instead of believing what these people told me!?! I am in tears wondering how after a month I am gonna pay bills. Can an attorney help me with this? And if so, can we make them pay your fee for making me hire you?

    Debbie MMar 3, 2016  #527

  • Horrific experience! It was already challenging to deal with having to take a medical leave from work but working with this third party source just caused me extra anxiety. They sent initial claim paperwork to the incorrect email on 4 occasions after I called and verified the correct email and they recognized they left a letter off. Yes…they still continued to send it to an invalid email by leaving off a letter. This delayed approval and payment for about 3 1/2 weeks. At the time of renewal, they denied request for continuation and waited the Monday of pay week to inform me that not enough supporting medical documentation was provided. Clearly I provided my note from visit with diagnosis and treatment protocol. I called my supervisor to inform her of what the return to work date would be as my FMLA exhausted and STD didn’t approve more time. She saw my diagnosis and said that was a no-brainer that I am not ready to work with my clients yet. Now I must wait for appeal review and I am suppose to return to work Monday and my boss and I are looking like what?!

    L. MitchellFeb 25, 2016  #526

  • I was disabled after a surgery, a Judge from the state of Florida ruled I’m permanently disabled, long story but I moved and because setting up new doctors and living in Florida Sedgwick denied my claim witch also canceled my retirement benefits MED, and prescription coverage, I have had to go with out meds, withdraw go to cheaper meds that do not help me it started a snow ball affect, witch left me so overdrawn in the whole I cant see a way out, Im getting aarp insurance and already being denied medication, to top it off now sedgwick is saying I was overpaid and want 17k I believed I was covered by at&t if something ever happened to me but the truth is I did not think I would ever be disabled at 45 now 50 lost my home, lost my car its depressing , Nira a Robot who, works at sedwick told me “if you can’t afford your house and lost it and foreclosed you can’t afford to sue us, many calls and letters to AT&T no response, I loved working for them, I recommend get disability insurance not thru your employer, aflac, mortgage insurance. Your employer does not care about you after you are no use to them. They pay company’s to denie your claim and give pays them extra for more denials. I wish I knew, I’m so hopeful I can go back to work some day but with prophera I was in the hospital 4 times last year, no one will hire such a risk.

    Anthony E.Feb 15, 2016  #525

  • Lynn, I understand that the LTD claim has reached a maximum benefit period, but what is the status of your Worker’s Compensation claim? You may wish to consult with an attorney as to same to determine what other remedies may be available to you.

    Stephen JessupFeb 15, 2016  #524

  • Jason, please feel free to contact our office to discuss your claim in greater detail.

    Stephen JessupFeb 12, 2016  #523

  • I was re-injured on my job on January 23, 2013. Due to that injury, I need a complete right-shoulder replacement. Sedgwick dragged their feet to start my disability pay for six months straight. I was almost homeless. When they finally did pay me, I owed more money that I received from them. Why? The reason I owed more than I was paid from Sedgwick because I was borrowing money from my friends and family to keep a roof over my head and pay my utility bills for six months. My doctor’ letters and reports did not convince Sedgwick to speed up the process of paying me.

    I want to go back to work as soon as possible (I have to). I went through pain management, prescribed pain medications, and physical therapy for a year — all to no good consequence. Since May 2015, my primary physician asked to surgery authorization. The surgery could have been done long ago; and I could have been back at work by now. Once again, Sedgwick dragged their feet. They finally had some company called Allied Managed Care Incorporated certify the shoulder replacement this past January 7, 2016 (keep in mind that I have been suffering unnecessarily for almost a year). Get this: I can have the shoulder replacement surgery; but I cannot have the shoulder sling. HOW STUPID!

    I received a letter (not until January 13, 2016) from Sedgwick dated December 22, 2015 that my LTD benefits will terminate on January 23, 2016 and my last check will be issued on February 28, 2016, because I attained the age of 65 years old. Even though I filed the claim after I was 62, along with waiting for almost a year for the certification of my surgery, I now have to face the same financial crises I did in 2015. This is not fair. In this day and time, many of us older people still have to work. And, I would have been back to work no later than this past October 2015 had Sedgwick along with Allied Managed Care Incorporated not dragged their feet regarding my surgery.

    I will advise everyone this: DO NOT PEFORM ANY TASK ON THE JOB THAT CAN HURT YOU! If the company you work with deals with Sedgwick (I work for the County of Los Angeles), I shout this advice to you very seriously as well as loudly. No job is worth going through a situation like this. Not only will they not care that you got hurt, they do not care for you to get what is necessary to get healed in a timely manner. I have recently been told by other unfortunate victims of Sedgwick that they drag their feet in order to force you to go back to work before you are ready (healed). Another reason Sedgwick does this to us is so the insurance won’t have to pay for the surgery. They also don’t care if you are put out on the street, or if you have food to eat. I don’t have enough time accumulated for an early retirement. I only started working for the County of Los Angeles in January 1994. All of this is my reward for a job well done. Mind you, I was getting very good employee evaluations.

    Lynn T.Feb 12, 2016  #522

  • I have a bad lower back and was approved for disability for a few months. I needed a 6 week extension and although the time from work was approved, the disability pay (70% of pay) was denied. The reasons they denied it were completely contestable and I had everything I needed in place. Still, they had me see one of their doctors an hour away…so I did. When I got to that doctors office, the doctor had nothing from Sedgwick nor the Network Medical Review team. So I filled in the doctor and gave him the paperwork I had with me. He supported the denial being reversed.

    Sedgwick now says that they need me to see another doctor as the 1st doctor “wasnt giving the statements to the insurance companies satisfaction”. I have been without pay for 2 months now and given Sedgwick 2 extensions to get this all done.

    I would LOVE to join a class action lawsuit against Sedgwick and the Network Medical group for how badly they have handled everything. I have contacted the California Insurance Commission (as the company I work for, Apple, is based in California) as well as the Dell & Scheafer Law firm. This really is inexcusable and I am hoping that the law firm and the California Insurance Commission office will be able to assist.

    JasonFeb 11, 2016  #521

  • I worked for baker Hughes for seven years. At the end in June 2015 I had arthritis so bad I could not walk a quarter of a mile. I filed for short term Disibility and for 4 weeks it went fine until five doctors all told them I could not do my job any more. No one would release me to go back to work and that is when Sedgwick decided that they didn’t have enough from the doctors to continue my Disibility. They told me they were asking doctors for information and time after time I reviewed the paperwork at the different doctors and of course they had done nothing in the way of asking the doctors for more information. When confronted with this information they of course denied it. After not getting paid and running out of time I decided to quit my job. I went to social security and gave them the same information that Sedgwick had. Sixty day’s s later they gave me social security disability and asked the question ” how did I work for the last couple of years “. Sedgwick cost me 1500 a month in disability moneys that we had paid in over the course of seven years so that if you become disabled you can at least live alright.
    I would love to find someone in a class action suit against them, or be the lead dog if some want to join in. If you know of any let me know.

    Michael T.Feb 9, 2016  #520

  • My husband was involved in a serious vehicle accident in April of 2015. He has been on long term disability since August of 2015. Sedwick has been a nightmare. They are the Long Term Disability provider for his employer and have stopped our check more than once because they claim they did not have copies of his medical records. I have personally went to the hospital, paid for and obtained the records myself and faxed them to his case manager. The last request was the day of his total hip replacement and they have cut off his check again for supposedly having no record. They have the hospital bill and records of his surgery which I don’t think anyone is released from a total hip replacement in a month but they still stopped our check. When I contacted medical records they stated that his case manager did not get the records because she failed to include a medical release which they stated she knew was required. Now due to her negligence she is stopping our check again for lack of records. He has long term issues with the injuries from the wreck to the point his employer has assigned a case worker to help him apply to total disability through Social Security. One would think that if they feel he is in need of Social Security then it is obvious his long term disability should still be eligible or he would be back at work. I am going to have to go to the expense of an attorney to get benefits that he and his employer have paid for. He is entitled to his check and some case worker that feels she is God is controlling our ability to live. The last time she cut off his check was Christmas!!! Who does that when they know he had total hip replacement on November 30th!!! How do we make these people accountable and do the job they are paid for. I am sure she is still getting her check regularly so we just don’t matter.

    Michelle S.Feb 2, 2016  #519

  • I had major abdominal surgery plus a hernia on December 17th 2015. My date of return is February 1st 2016.(yes this Monday). Sedgwick is denying my claim from January 16th through January 28th 2016 forcing me to take Fmla and to take a vacation days away from me is which is 2 weeks of the 4 weeks I have earned this year. Sedgwick does not care what the Dr. say even though info/paperwork was sent over repeating over and over again before the deadline and return date of February 1 2016. per Sedgwick request – but they make their own rules, they do not listen to what the doctor say or what the patient is saying either. They are absolutely horrible, they don’t care, have no empathy. I had 3 different representative they all refused to give me a call back the only way One call me back one day because I left a voice message with their supervisor and yes I got the email that same night and yes gotta call 8 o’clock in the morning telling me I was denied and I must do an appeal or have earn days taken. Wow how is that for quick response! be treated like this as an employee of Comcast for the last 11 years is appalling, mind blowing and I’m not the first one that is happened that work for my company that has Sedgwick something needs to be done! and something WILL be done.

    MaxiJan 28, 2016  #518

  • Ce, unfortunately, we would not be able to offer anything new as to what you might be able to do from a legal standpoint.

    Stephen JessupJan 28, 2016  #517

  • I came out of AT&T in 2013 and std. Sedgwick sent my reports from my Dr to one of my coworkers personal email. He was NOT authorized to view it. It was a violation of Hippa and on top of dealing with being sick and dealing with sedgwick hell and nonsense. Sedgwick never even apologized for this. I contacted a local lawyer after contacting the union official, was told by the lawyer that hippa was to help protect the dr. And wouldn’t help me unless I could prove an injury. The coworker no longer works for att, but he did save the email. I was mortified knowing this happened! I have called numerous lawyers who tell me the same things. Sedgwick was incompetent and caused mental anguish. What can I do?

    CeJan 27, 2016  #516

  • Melissa,

    Has Sedgwick formally denied the short term leave, or are they just holding it up? If the claim has been formally denied you will need to appeal Sedgwick’s decision. As Sedgwick is a third party administrator for your company I would also suggest you contact your HR to advise them of the issues you are having.

    Stephen JessupJan 21, 2016  #515

  • I had a miscarriage on Jan 8th.. I went to my obgyn on Jan 12th and he said that I needed an emergency d&c. My Dr said I can’t go back to work until Feb 6th and Sedgwick says there isn’t anything restricting me from going to work.

    MelissaJan 20, 2016  #514

  • Terri,

    Have you appealed the denial of benefits with Sedgwick?

    Stephen JessupJan 20, 2016  #513

  • Henricus,

    They would have 45 days to render a decision on the appeal, with the possibility of a 45 day extension. So if it was on December 14th, they would still be within their initial 45 day timeframe.

    Stephen JessupJan 20, 2016  #512

  • I have been on short term disability for 3 months. My primary dr sent me to an orthopedic dr, have to have shots put in back to help my leg and back. Sedgwick denied me my ck but approved my time off hoping shots will help me but don’t understand why I was denied my ck having the same problem as before hoping I will get better I work at walmart, been there for 5 years. What can I do to get payed…

    TerriJan 19, 2016  #511

  • I filed my appeal I think dec 14th as required before that they “reviewed” my claim, the lady of Sedgwick ” apologized” it took them so long, before making an decision on my STD…..

    HenricusJan 19, 2016  #510

  • Henricus,

    How long ago did you file your appeal?

    Stephen JessupJan 19, 2016  #509

  • I was taken off work due to severe osteoarthritis of the hip, chronic pain disorder, graves disease, hyperthyroid with high heart rate issues and the side effects of the medications. I could no longer preform my job. I have paid for short term disability fof years and never had to use it till now. I have been denied several times from sedgewick even though my dr clearly stated I could not return to work. I have went without pay since August 2015 and been threatened with termination. I am at my wits end. I had to go without insurance and medication because they canceled my insurance , luckily I was able to get on tenncare but not right away. I now have numerous medical bills. Now because I have restrictions walmart will not let me work and they still have not approved my short term pay. It is in appeals but they said that if I was able to work on the medicine last year then it is not approved. This was the only thing that they were seeing, the rest of it didn’t matter. I recieved a letter stating that if I didn’t work something out with my hr that they would consider me as voluntarily quit. I don’t know what to do anymore and neither do my Dr’s. I have to pay every time they request paperwork. One dr is 25.00 each time and the other is 10.00 per page. Without an income this is impossible. I have sold everything of value including my wedding rings just to keep my electric on.

    MaryJan 19, 2016  #508

  • Been off work since june 16, for back problems, after doctor treatments with painkillers and muscle relaxers, and x-ray, he adviced physical therapy. In the meantime I was on aproved STD, the physical therapist stopped treatment because it only made it worse, and I finally got aproved for an MRI, which showed several problems, and they send me to pain management treatment. On september 22 was my first appointment and part of treatment was tramadol and flexeril for one month and come back for test treatment with injections in my back, (oct 27), that morning they couldn’t do it because at that moment pain level wasn’t high enough, so they rescheduled, that is when all (sh”””t) with Sedgwick started, the stopped my STD, my doctor has been sending everything they requested even offered to talk directly on the phone to them, which the lady friendly denied.

    In the meantime I had 2 required test done, and had to appeal now because I have no income for almost 3 months, my insurance has been canceled, I can’t even get my final treatment done wich should helpe for atleast the next 6-12 months, am out of money, have lots of bills (doctor bills and other) my family uninsured, about to loose everything, need HELP. Work for Frito Lay.

    HenricusJan 19, 2016  #507

  • Brady,

    If you claim is denied your next step is to file an administrative appeal of the denial of benefits. Please feel free to contact our office to discuss your claim further.

    Stephen JessupDec 30, 2015  #506

  • I don’t know if Sedgwick’s staff is overwhelmed/unqualified or if they purposely deny claims to see if people bother to go further in the process. I have a dual diagnosis of bipolar/alcohol dependency and have a very stressful job which requires a stable mood and intense data review. I came out of a three week partial hospitalization/intensive outpatient treatment program with great follow up care planned in the middle of med changes. The treating MD indicated I would be disabled for six weeks on the claim form and my initial treatment plan with the therapist showed I have a very low functional level. Sedgwick’s clinical reviewer determined I was not disabled despite the complete lack of contrary information. When I asked the claims person if he had the ability to disregard the review and approve the claim (based on common sense) the answer was no, you need to appeal for further consideration. I am completely at a loss to understand the decision.

    BradyDec 28, 2015  #505

  • Jeremy,

    Unfortunately, you will need a doctor to certify disability in order to have a chance to be awarded benefits.

    Stephen JessupDec 16, 2015  #504

  • I work for a technology company and needed short term disability through Sedgwick. After paying doctors bills and faxing them over and over again- They often claimed they had not gotten it. It went back and forth for a month now. Now after calling them 3 to 4 times a week to tak with case examiner, they get back to me today December 15th, denying my claim. There was 36 pages faxed over to them on all of my disabilities. They denied it based on that I have no doctors note saying that I can return to work. No doctor will fill one out because I took the leave myself under boss’ suggestion. Now I may lose my job due to a formality.

    JeremyDec 15, 2015  #503

  • Dusty,

    You will need to consult with a Worker’s Compensation attorney, we only handle disability insurance plans. Please feel free to contact our office should you need assistance in contacting a Worker’s Compensation attorney.

    Stephen JessupDec 9, 2015  #502

  • I am a trucker for a big trucking firm. Never had back problems, been at a similar weight for several years. Woke up one day in massive lower back and hip pain. Docs says Can’t work. Sedgewick doesn’t pay me for 5 weeks. Then, after 2 checks, sends me a denial letter and demands what little money they have given me back. Says my weight is the issue. Thing is, the company paid for a physical about a month before the injury. My weight was not an issue, wasn’t given any restrictions. I have never filed a workers comp claim before. I feel I am being treated very unfairly, and am now a complete wreck over money.

    DustyDec 9, 2015  #501

  • Recently filed my second appeal on 12/4/2015. They denied me from day 1. I have had to beg and plead for what little money they have paid out so far. I am set up for another surgery on December 21 and the appeal doesn’t look good. I received a letter recently from Walmart saying that my insurance is going to be canceled and I have Short Term Disability Plus where they are supposed to pay my insurance as well. My STD ends December 29th because it started June 29th. They have every single doctor visit that I have been too and they always find a reason to deny me. The last set of doctor visit even states the upcoming surgery. I have followed through with Sedgwick all the way but the Neurosurgeon that I was seeing would delay paperwork. They played around and denied me time after time until they played out my 6 months for short term disability and now I am having to choose between my surgery and my job. I can’t perform full duties. I have informed them that it is wrong to push this much work off on someone that is sick.

    Misty C.Dec 7, 2015  #500

  • Tiffany,

    We would need to see copies of the denial letters to determine how we may be able to assist you.

    Stephen JessupNov 24, 2015  #499

  • My husband was injured on the job over a year ago. At first we thought it was a pre-existing injury until about six months ago. Because injury originally happened over a year ago no workers comp claim can happen. Finally got a doctors note with restrictions. Returned to work that night after receiving note and manager sent him home and told him to contact sedgwick since there was nothing he could do at store. Contacted sedgwick. Horror began! Paperwork after paperwork after paperwork. Doctor had filled out forms every week for over a month. Not filled out correctly or to their satisfaction. Just received email stating denial of claim. Three claims have been filed. First one approved. Second one just denied and have been doing paperwork non stop for over a month. Third claim approved for a total completely different matter. When asked about financial assistance or pay, was told wouldn’t receive any money due to medical not through company of employment. Now what do we do? He’s filed for unemployment and is being denied pay. How is it legal for this company and the company he works for say he’s unable to work due to restriction but can’t get paid when it was his manager that sent him home? Any advice or help would be greatly appreciated.

    Tiffany D.Nov 24, 2015  #498

  • I have a Blood Clotting Disorder and i also, have Hypertion and nerves Problems and I AM CURRENTLY Seeing a pain Doctor for the right leg that I have a Blood Cllot in and unable to walk and now the Doctor has Refered me to a Vascular Dcotor I am having Problems walking on my legs and they have DENIED MY CASE 2 TIMES AND i AM IN THE PROCESS OF appealing it. I feel that my employer gettiing them as a 3rd party was a mistake that they could do. I have been out of work for 2 months and All i AM ASKING FOR IS MY SHORT TERM DISABILTY THAT i HAVE PAID INTO IN. also, siince I have been out of work they canceled my health insurance for family for the blood Discorder Called factor 5 . also, it has been 45 days without a pay check. and my home caught on fire and lost everything.

    Jamie J.Nov 22, 2015  #497

  • Sedgwick totally pays off the doctor. I went in to their doctor he asked two questions. Told me to climb on the table and that was the extent of my exam!!!!! He said I needed no treatment for my work related injury but from my MRI he felt I wouldn’t be able to return to work….. uhmmm
    Do they ever approve Kohl’s employee’s claims??

    DynneaNov 21, 2015  #496

  • Heidi,

    Without seeing the denial letters we would not be able to comment as to your son’s rights. Please feel free to have him contact our office.

    Stephen JessupNov 16, 2015  #495

  • I have Hashimotos autoimmune disease and have dizzy and blackout incidents. My neurologist has taken me off work. Sedgewick fought it at first then approved the claim. Then they held my last check because they did not have update from Dr even though Dr update was not due for 2 more weeks. Today the are withholding the payments still because mt examiner Erika Ellis feels that the Dr (One of the top neurologist in Texas) has not properly diagnosed me and has turned it over to a nurse to review and decide if my Neurologist is competent is his diagnosis….. Really? A nurse reviewing a top neurologist? I was told that sedgewick would deny my claim after 2 pay periods and I would spend weeks or months fighting them for payment. Never mind that I have four children relying on the paltry 40% they pay until my SSI case is decided. I guess anything to save walmart a buck.

    RobbieNov 13, 2015  #494

  • PK,

    If Sedgwick denied your appeal please feel free to contact our office to discuss your claim and rights.

    Stephen JessupNov 11, 2015  #493

  • My son works for a cane co. He was scheduled for a major back fusion, he is only 26. he was on light duty until the surgery. Then the doctor put him out on temporary disability so he could have the surgery. 2 days before the surgery the insurance co denied the surgery because he could not continue on light duty he kept him out and had him do physical therapy. This was in August. He just returned to work last week because he had no income. His doctor would of kept him out longer. Sedgwick denied his claim and his appeal. I can not understand why. They told him your approved for the time off not the pay. People collect for paper cuts how does someone who needs surgery per the doctor not get paid.

    HeidiNov 11, 2015  #492

  • I have been dealing with Sedgwick, regarding short term disability. During this time I was mentally unable to function, due to extreme anxiety every day, major depression, and something that did not come to mind at that time, was my inability to process information and not being able to remember things, or communicate in an effective manner. I am rather new, a little over 2 yrs in San Diego County, I haven’t adjusted completely, financially, mentally, or emotionally. The event of ADHD has greatly been uncontrolled since working at Time Warner Cable, almost 1 year, this job has lead me to be on a 2nd medication in addition to the antidepressant I have been on for more than a year, and now I need more therapy. I struggle with ADHD, part of the symptoms are anxiety and panic disorder and major depression, irritability, inattentiveness, and impulses that can’t always be controlled, especially under stress; also bringing on bipolar reactions.

    These symptoms are not Time Warner’s best interest to have me interacting with customers if I can’t consistantly perform in a professional manner; furthermore to be a effective team member and to comply with the stringent metrics required to excel at the job of a Customer Service Agent in a high volume call center, also to be to work on time.

    In addition, I travel 70 freeway miles to and from work each day, which is an added anxiety and depression to get to work, and more wear and tear on my car which is costing me more to repair, which gives me panic that the car will break down. Furthermore, even if accomodations are made, which is probably to work part-time which; it would not pay off for the distance to travel.

    I have already been denied once by Sedgwick, in the mean time, the State of CA SDI has been paying out benefits. After reading the complaints against Sedgwick for Bad Faith Practices. I have jumped through the all the hoops and had my provider jump through the hoops. My appealed claim with Sedgwick is pending after being off work for only 34 days, they tell me that a determination would be on Dec 18.

    PKNov 10, 2015  #491

  • I filed a claim with Sedgwick for short term disability. I have Fibromyalgia, osteoarthritis, bursitis and stress anxiety disorder. My job as a housekeeping Supervisor was very demanding and stressful. My illnesses are triggered by stress. My feet would not stop swelling and I have problems walking and my bursitis is horrible. My doctor put me off of work until I was to see my Rheumatologist doctor. Sedgwick only approved me off of work for 3 weeks when my doctor wanted me off much longer. They denied the rest of my leave saying that my medical didn’t hold up while I was off. That was crazy because they have all my medical to support. I wound up appealing and they denied it again. The appeal specialist was rude, stuck up a d wasn’t trying to help my case at all. She was out for the company. She had the nerve to say that maybe I should just go back to work. I knew then she was out for the company and not for me. She made me wait forever for a decision on my appeal, knowing she had no intention of overturning it. Sedgwick is not what they say they are!

    Trakita C.Nov 9, 2015  #490

  • Dennis,

    You could attempt to send the records certified mail, or some other source requiring signature receipt- it makes it harder for Sedgwick to claim they didn’t receive it.

    Stephen JessupNov 6, 2015  #489

  • I am doing Sedgwick right now through Walmart. When i first filed with them it was nice, but my doctor said i cant work for another month so i contacted them to see what to do. they said that i have to have the doctor fax in a report stating that i cant work this month. i contacted the doctor and he did do that and i never heard a response back and then my employer called me to see what was going on and i told them the situation. so i called again and they said sorry still no fax came in and so we went in to the dr office and we witnessed the dr fax in the paper work. i waited for a bit no response so i called again and the lady i talked to was rude and said that my claim number had to be on the paper so all the previous time they did not mention that to me. so we called the doctor again and he put all the stuff on the paper and faxed it again. and its been a couple of days and nothing i am returning the end of the month but I’m in the dark i am hoping i do not get fired because of them doing this to me. i am over whelmed and stressed out at this point. Any ideas on what i can do?

    Dennis RNov 4, 2015  #488

  • Injured,

    It sounds that your claim is for worker’s compensation (please correct me if I am wrong) and as such you would need to consult with a worker’s compensation attorney as we only handle claims under short and long term disability insurance plans. That being said, Walmart also provides short and long term disability coverage that you can also explore benefits under if you are eligible.

    Stephen JessupOct 25, 2015  #487

  • I was a cashier at Walmart they are also paying Sedgwick to insure themselves I got hurt there in 2008 because they worked me to death sometimes causing the registers to “lock out” there were others who got hurt before me an older lady about 60 they have a Dr office up the street on rt 40 and he’s paid to lie.That lady worked in the bakery fell in the freezer hit her head and someone came from Sedgwick took her in the back office and threatened her with her job if she didn’t get back to work another younger girl worked in the deli and when she went to walk into the fridge a pallet fell on her leg two weeks later it looked like her leg was gonna fall off she still hadn’t seen a real dr a week after that and she was fired I heard.My problem is I’m starting or have been wondering if my own ATTORNEY isn’t taking money to screw me over! I’m in a terrible situation here I’ve had 3 attorney’s strangely enough I hire one they act all sincere like they’re gonna help,next thing you know a month or three goes by I’m not getting paid and the attorney has up and stopped working my case so I get another and balm the same thing! My case is legit I’ve had two cervical fashions and have been awarded ppd I’d like to finish it since they pd the emotional dr to lie and get me cheated out of continuing medicals but I don’t really want to get another attorney because so far they’ve collected 9000 dollars of my award for nothing at least this last one has done nothing but apparently work for the Sedgwick! Please give me some insight if you will as to what’s REAL going on here.thank you so much!

    injured personOct 24, 2015  #486

  • Harry,

    You will need to consult with a Worker’s Compensation attorney to determine if you have any additional rights. As we only handle claims under disability insurance policies we would not be able to advise.

    Stephen JessupOct 21, 2015  #485

  • Sedgwick is the worst! I work for one of the big chain pharmacies. On July 31st I had rotator cuff surgery. Since it was a planned surgery and to expedite the claim I reported it ahead of time to Sedgwick. For various reasons per Sedgwick ( ie not enough MD info, MD did not respond etc, no follow up visit was noted etc.. Every excuse and lie in the book! ) they took a month to approve the claim and get pay sent to me. throughout the claim period , they constantly harassed me for info or stated MD info was not enough, they would approve continuation of the claim in 3 weeks increments and harrass me and attempt to deny the claim because MD follow up was not in line with what they wanted. For example, at my last office visit the MD did not schedule a follow up until 2 months out and to contact office if an issue arised. I also had requested to return to work, but my physician wanted me out and agreed that if I felt ready to return to work in 4 weeks to contact his office. Well 3.5 weeks go by, I’m at week 10 of my leave and I feel that I’ve progressed enough to return to work. I contacted my MD, he agrees I can return to work on a part time basis with minimal accommodations ( mainly no lifting or repetitive use of my surgical arm , which is not part of my job description anyways) until my scheduled appointment. Well that’s all good , but Sedgwick has denied my claim for the last 2 weeks and also denies my return to work. Sedgwick stated that my employer needs to approve my return as well. Stated I didn’t see the MD so could not approve claim further. Again they only approve 3 week increments and would not approve 2 months out from last office visit. My employer won’t approve my return because Sedgwick won’t approve it .. so I’m stuck in the middle and meanwhile my employer will only hold/ guarantee my position for 12 weeks total for day one. I’m hunting down physical therapy notes and MD office visit notes and sendimg them to Sedwick ( which they claim MD never sent or replied to .. even though the MD copies me on their email transmissions to them .. So I know it’s all a lie.) very depressing and frustrating ! I think I need to seek out legal counsel. I don’t want to loose my position because of this.

    LBOct 20, 2015  #484

  • I was injured at work 2006. I filed a lawsuit 2006. I won the workers comp portion of the lawsuit, but my prior employer kept the medical open. The insurance company is Sedgwick. Getting treatment from Sedgwick has always been difficult. I had to switch to a new pain management doctor in February 2015, my prior pain management doctor was no longer in the network. Since I have been with my new pain management doctor, he has repeatedly requested services and procedures to help in my pain management. Sedgwick continues to deny the care my doctor is asking for me. My attorney has appealed multiple times with no success. Each denial letter from Sedgwick states study after study showing why what my doctor is requesting to help me, is not medically necessary. When I started with my new doctor in Feb 2015, he requested an MRI of my lower back so he would be able to see my issues. Sedgwick denied this pocedure. I am in constant pain, 24/7. All my doctor can do is give me Norco and Gabapentin to help with my pain. Sedgwick approved a S1 hip injection once with this doctor, but it had no positive results. My doctor needs an MRI to see the damage at the discs so he can help me properly. Sedgwick has been a nightmare since 2006. They do not care about me at all. They do not support what my doctor feels is a reasonable aid to my pain.

    Harry S.Oct 20, 2015  #483

  • Why do they continue to delivery disability payments at their leisure? Will they ever be consistent? Wish I knew how to Settle, without choosing me anything, to be done with them.

    Pissed Off Disabled WorkerOct 20, 2015  #482

  • Another Frito Lay employee denied! Said Medical Report did not support Disability. Guy had no Medical background that denied the claim. My supervisor even said I could not come back until I could drive. SO NO PAY FOR MONTH. Smh.

    BECKYOct 17, 2015  #481

  • SP,

    You will need to consult with a Worker’s Compensation attorney to determine what rights you may have. As we only handle claims with Sedgwick under disability insurance policies we would be unable to assist you. However, please feel free to contact our office and we can assist you in contacting a Worker’s Compensation attorney in your area.

    Stephen JessupOct 14, 2015  #480

  • Kate,

    ERISA does allow for one 45 day extension of the review of appeal. If Sedgwick has properly taken same then there is little that can be done but wait. As Sedgwick is only a third party administrator of Frito Lay’s disability insurance policy I would suggest contacting your HR to inquire/advise/complain about the delay. Ultimately Frito Lay is responsible for the payment of your disability benefit so if they are aware of what’s going out it may help in forcing Sedgwick to process the claim faster.

    Stephen JessupOct 14, 2015  #479

  • I was out on a workers comp injury for multiple injuries, after Sedgwick sent me to 3 different Doctors and did not get the answer they wanted, the doctor had to do multiple surgeries. After 2 1/2 years of physical therapy, I reached MMI and sent my permanent restrictions to my employer and the case manager with Sedgwick, I was terminated from my job, because I was not able to perform my duties to the fullest. No more TTD, no more nothing, just suicidal is all!

    SPOct 13, 2015  #478

  • Im currently 7 1/2 months pregnant, I am a pmo at frito lay. Ive been out on fmla since 4/26 due to the fact I cant do heavy lifting cause I am spotting during my pregnancy. My job requires me to lift 70 to 90 lbs frequently all day, 12 hour shifts. My feet swell by the 5th hour at work, I have a syst on my ovaries which cause me so much pain as the weeks go by. Some days I can barely walk. I tried to go back to work 1 month later and ended up in the hospital for dehydration and severe spotting, so I had to go out again and Sedgwick denied my claim. When I went back to the dr to get a release to try and return to work she did a sonogram to ensure everything was ok and found out that my placenta was to low so I was put on bedrest until further notice. I appealed the denial sent in all my notes and paperworkand the told me the appeal takes 45 days which ended Oct. 9. Ive lost y car, home, all my insurance at work and I cant take care of my other 3 kids. Ive expressed that to them several times they dnt care. I called in on last Friday to check on my appeal and they informed me that its gonna be Nov. 23rd before they have a decision they have other drs reviewing my claim now a peer to peer process. I thought my dr was the best to let them know about my situation since she sees me monthly, whos word is better than hers?? What can I do now?

    KateOct 13, 2015  #477

  • Pam,

    You will always have appeal and/or civil lawsuit rights under ERISA against AT&T. Please feel free to contact our office to discuss the denial of your claim in greater detail.

    Stephen JessupSep 28, 2015  #476

  • I work for AT&T for 8 1/2 years . I began recieving long term disability for 6 months when it was time to renew I was declined even thou my doctor sent them information they requested twice stating i was totally disable. I have severe arthritis in my shoulder and now they want to replace it. Before I had whipple procedure done in Dec 2013 which i have been on disabilty since. Segwick says under there guidelines I should beable to return to work. On some days I have either severe gas or Im in the bathroom all day with mutiple bowel moments which is a side affect from the whipple .Segwick has this information from my doctor. Is there anyway I can at least appeal this or fight Segwick on this.

    Thank you

    PamSep 27, 2015  #475

  • Joann,

    You will need to discuss your claim with a Worker’s Compensation attorney. Please feel free to contact our office if you need assistance in finding one.

    Stephen JessupSep 15, 2015  #474

  • I herniated a disc at Starbucks in 2012. I went out on leave and my Dr. Recommended I have surgery as I was starting to have nerve issues and lose feeling in my left leg. Sedgwick ignored my doctors request for surgery and only approved physical therapy and pain meds. Then my company switched to Gallagher Bassett who finally approved the surgery but it was a year and a half later and I have drop foot and loss of feeling in my left leg. I wear a brace and walk with a limp which I’m told is permanent. I’m a young woman with children who was once active and it’s hard to take. I have since had an adjustment disorder/depression added to my claim. Now the company has switched me back to Sedgwick and they are denying any further treatment. I hired a lawyer but they aren’t doing much. I’m just lost for words. If there is ever a class action suit against Sedgwick I NEED to be a part of it even if there’s no monetary incentive. They destroyed my leg and I live in constant pain.

    Joann PerkinsSep 14, 2015  #473

  • I work for Walmart and got a herniated at work 3 months ago. Was on light duty for about 6 weeks until they denied my workers comp claim. I was forced to take a leave of absence and tried to get std from Sedgwick and was denied and gave no good reason besides that I wasn’t disabled after I got the everything they said I needed to be approved. On there paperwork they had y dr fill out ask has the pt recovered sufficiently to return to work? My dr put NO… has the pt recovered sufficently enough to return to work with restrictions? My dr said NO… wtf does it take… I seriously feel as if I have to be paralized to get approved… these people r scu of the earth and something has to be done… theres no worse feeling than being disabled and broke dealing with these guys…

    KenSep 7, 2015  #472

  • I’ve worked for UHG for almost 4 years. I was recently diagnosed with Bipolar, ADHD, Anxiety Disorder, and Depression. I reached out to Sedgwick for short term disability, and they denied me easy. I admitted to them I attempted suicide, and continue to have thoughts of suicide. They had their doctor reach out to me, for a phone evaluation. Their doctor told them the same thing that my doctor told them and they still denied me in appeals. Sedgwick is a company full of rip offs. They can careless about the hard working Americans. I gave that company 4 years of my time, and the money that I’m trying to receive is the same money I put into the damn company. It’s my money!!! And I’m entitled to it. They won’t learn until someone seriously takes their life, or hurts themselves because of the way they treat us. I’m going to file the biggest suit that Sedgwick has ever seen!

    AnonymousSep 2, 2015  #471

  • RenoJim,

    As the claims history is very long and detailed- please feel free to contact our office to discuss how we may be able to assist your son.

    Stephen JessupAug 30, 2015  #470

  • I am dealing with Sedgwick CMS for my son who had STD and LTD as an employee of Apple Computer Stores, USA. His disability started when he had a collision with a car while riding a bicycle (not work related). He did receive a concussion from that and because he was covered by Apple’s Health Plan he went to doctors available through that plan and he was aware that some of the money that he eventually receive as settlement would go to offset those medical expenses when and if he ever got them. As it turned out the Psychiatrist that was on Apple’s list of providers turned out to be only a Nurse Practitioner and not a doctor at all. She Prescribed an anti-anxiety medication that should not be prescribed to anyone with an addiction and my son was a recovering alcoholic for two years prior to the accident, so that the drug that the Nurse Practitioner/Psychiatrist prescribed was in itself contra-indicated. These facts were discovered by the attorney who handled the car/bicycle accident case. The outcome of this error resulted in manic episodes and he has now been diagnosed as Bi-polar Type 1. During the first manic period he returned to work at Apple at the insistence of the CMS (Matrix) and he started back working, but he suffered a manic episode that landed him in a mental hospital for a few weeks and his Bi-polar condition was officially diagnosed and only at that point he was taken off the mis-prescribed medication. At this point Sedgwick took over as CMS. After six months he returned to work starting at just 4 hours per day 1 day per week and he was phased back into full time work after 3 months. A month later he had his second Bi-polar manic episode and his second stay at a Mental Hospital for another two weeks. This second manic episode occurred while he was at work. Following this second incident he began the application for SSDI benefits , but 90 days after release from the hospital Sedgwick insisted that he once again come back to work on a 4 hour per day schedule this time limited to 2 Days per week. He sat at a desk by himself for the first 4 hour day and then on the second day he was brought to HR and forced to sign a confession and a restitution agreement for his behavior for the manic episode that had happened while he was working. They made him sign a confession and agree to pay restitution of $150 per month, but he never was given a copy of that agreement and he was not ever given an exit termination package . A few weeks later they may have sent out a Cobra package but that was sent to a shelter for homeless people where he was sent upon release from the hospital, but he never received it. He did continue to receive his STD monthly checks for three additional months, and even received his pay for those two 4 hour days, but then the checks stopped. He called Sedgwick and he was told he would receive no more benefits because he had been fired. So at that moment he had no more income, he had to pay $150/month restitution or go to jail, he had no more medical benefits and he had no idea what to do and he was completely unable to defend himself. It is now a little over two years and two month after he received his last STD check. and it is also now 2 years and 2 months that he has received his SSDI and he has had to live in my house for the last two months because his wife has thrown him out without a penny in his pocket and she filed for divorce. But During these two months I have been working with him to get his life back in order and I had been communicating with Sedgwick CMS to find out what happened to his Long-Term Disability income checks, and after 2 months of being jerked around I have been put in contact with CIGMA and they have issued a claim # and they said they will back-date the case to the original bicycle accident because at no time did he ever go back to work for 6 months or more, which I believe means this is all one claim stemming from the concussion. I have read your site quite a bit and I now realize that I am no match for this bunch and I would like to turn this over to a proper law firm. I am very impressed with you and I have called the consultation hotline that you have on your site and I am looking forward to speaking with y0u as soon as possible. Thanks, RenoJim

    RenoJimAug 29, 2015  #469

  • Gloria,

    Unfortunately, Sedgwick is not an insurance company, rather a third party administrator for your company’s plan.

    Stephen JessupAug 24, 2015  #468

  • In 2004 was in a major accident.
    Rollover. Fx ribs, chest tube , many contusions. Now I have acute pain neck and back. Had a finder bender accident a few weeks ago. Went to PCP. He gave me off 4 weeks due to my injury. MD and I filled paper work to Sedgewek. And have been denied.
    What kind of a Co. Is this ?
    I am in acute pain now.

    Gloria GysbertsenAug 23, 2015  #467

  • In reference to the above referenced notation my partner also works for optimum rx which is a subsidiary of United Healthcare. Sedgwick keeps using the excuse that they’re only following the guidelines required by the employer. However his employer and immediate supervisor are the ones who elected that he take the short term disability to begin with he did not elect to take that on his own. His immediate supervisor arranged everything. Sedgwick CMS, having to ask for an extension themselves after waiting for months, is absolutely insidious. I have already written a letter to the Attorney General in Florida explaining the situation. Hopefully that might get someone’s attention. However it’s heartbreaking to see that this process causes more stress and more physical and mental challenges and excessive the underlying problems at hand. These are benefits that are supposed to help employees, and it seems to be a process that is challenging even for the ones who deserve it the most.

    chrisAug 22, 2015  #466

  • I have POA of my partner. He has filed a claim in April 2015 and they denied the claim stating he hadn’t missed enough work, when he in fact had missed almost 2 weeks. They sent a new claim that both his physician and him had to refill out yet again. They stated after a month denied not enough medical docs. He has 3 dr.’s all agreeing that he is not to return to work. He appeals, he gets a call stating that he put the wrong 1st claim nu mm bet on appeal and to send in the right one after no calls for a month. It’s been 4 months now and when they were supposed to have a decision yesterday the 20th of august they call and say that they require a extension on their part that could take another 45 days. This is reduculous. His physician has told theme he has been diagnosed with a life threatening illness and he’s a mess and cannot return and is attending IOP 2 times a week and they need an extension?

    chrisAug 21, 2015  #465

  • Torre,

    One can only hope that companies will realize how horrible Sedgwick is and stop using them as a third party administrator for the benefit plans they (the employer) created to protect its employees.

    Stephen JessupAug 20, 2015  #464

  • Sedgwick is gonna kill me with stress and denial and incompetence and rudeness. I was hospitalized on 07/31/2015 at St vincent hospital jacksonville florida. I had very high blood sugar level and very high white blood cell count of 17,000 because I had a really bad infection. I have type 2 diabetes and hidradenitis suppurativa in which I develop large cyst through out my body all over and this case I had a large cyst right under my groin and one on back of my neck and my blood sugar was very high so I was very dizzy and was suffering from weakness and blurred vision and major pain in groin and back of neck to point I had to take pain meds while in hospital but they seen me in the emergency room on 07/31/15. I left work at 10:00 p.m. that night, I was held in hospital until they ran test on blood. Found I had a staff infection and white blood cell count of 17,000 and AC1 of 10 …… I was released from hospital on 08/04/15 as soon as I got home as soon as I laid on couch because I could no longer walk because I was exhausted from very high blood sugar and being pumped full of antibiotics for 5 days and not being able to eat really and diarrhea and in pain from cyst in groin and back of neck. I tried to lay down but as soon as I laid down the claims representative for Sedgwick called me and wanting to discuss the claim. I explained to her that I just laid down and was exhausted, she immediately got an attitude with me and was rude through out the conversation. I advised her I was exhausted and very weak, she didn’t care and tried to get an attitude so I just wanted to get it over with so I could rest. She asked me all my Doctors names, phone numbers, and what type of doctors I explained them all I had three, one for my diabetes and one for my primary physician and one for my surgeon that handles my cyst if I need them cut open and drained or they will proscribe me antibiotics to give time for the cyst to subside / the infection to go down ………. so I asked the rep specifically who do I need to fill out for the STD forms. She advised me the primary physician so I had my physician fill it out. When I went to see him on 08/07/15 he took me out of work until 08/17/15 to give time for my cyst in groin and infection to get under control and my blood sugar to be manageable again and to give me time to see my surgeon on 08/10/15 so I advised Sedgwick of this and advised them of my condition letting them know I was extremely exhausted and in pain and my Doctor sent all paperwork required to Sedgwick that the claims representative sent me for him to fill out. They faxed it to them so I went on 08/10/15 to see the surgeon to see if he wanted to proceed with surgery for my cyst I had …… I could not see my surgeon on 08/10/15 due to not receiving the paper work they needed me to fill out so they rescheduled my appointment and gave me paper work to fill out for 08/12/15 in which I went to see him again. He advised he did not want to do surgery if not needed so he advised me to take antibiotics for an additional 10 days to see if cyst / infection subside so on thursday 08/13/15 at 5:00 p.m. I received a call from the Sedgwick claims representative stating she was only able to approve my claim up to 08/10/15 she needed further information detailed information from my Doctor why i would be out to 08/17/15 i explained it to her that i was extremely exhausted and in pain in groin from cyst to point i could barley move and my blood sugar still high in 200’s which feeds off infection and vise versa they work on each other i needed time for cyst to subside and was extremely exhausted could barely move at times she said she would send up for review to a RN of theirs as well that will contact the doctors office and she wanted information from Doctor fully detailed that I would be out to 08/17/15 for those reasons i asked her several times what he needed exactly for this paper work so no mistakes are made and she told me what was needed… so I went back to Doctor office on 08/14/15 gave them paper work and every time I have to go back to Dr. I have to pay copay of $15-$25 so this would be second time now …. I went to Doctor office and he was frustrated with Sedgwick stating what don’t they understand so he refilled out paperwork and stated they do not give enough space on the forms to give detailed information as they are asking for so with him being frustrated he refilled out same paper work again then the claims representative sent me email with more paper work for a Short Term Disability extension form just one sheet of paper with hardly anywhere to right anything so on friday 08/14/15 evening I got really sick really bad. I was laid up in bed all weekend. I was really weak and could barley get out of bed to get water, I was terribly thirsty and having diarrhea and could not eat. Was getting sick so afraid I was getting sick again I called my Doctors office that day 08/17/15 the day I was to return to work and had an emergency appointment made that morning at 9 a.m. to see the doctor or i was going back to hospital so they took me in as emergency appointment and come to find out per my doctors diagnosis. I had a ( gastro intestinal virus ) or basically stomach flu so that is why I was not able to eat and was so weak. I needed to get some electrolytes and potassium was low as well so the doctor took me out of work for an additional 3 days until 08/20/15 he advised should be out my system by then, so I called Sedgwick immediately to advise my claims rep that the doctor wanted me out of work for additional 3 days because of new issue with virus / stomach flu …. so I did not get a call from them until 08/18/15 from the RN reviewing my case for approval from 08/10/15-08/17/15 in which I had my doctors office fax those updated papers that the claims rep emailed me so I had doctor office fax those on 08/14/15 already …. but did not receive a call about them until 08/18/15 the RN stated she just received them and it would take her 24-48 hours for reveiw so then she called me next day 08/19/15 the day before I return on 08/20/15 to tell me that the paper work for STD that rep emailed me was not sufficient enough from doctor to support. I was out for STD claim and the last paper work she had was from 08/07/15 the very first paperwork that was filled out. I tried several times to explain to this RN that I had two other forms sent in after that and obviously the claims rep never gave them to her. She kept interrupting me being very rude and would not allow me to speak. I tried to explain to her why I was out from 08/10/15 because of my high blood sugar plus my cyst / infection in groin and back of neck and advised I was very weak, I could not eat, I was having diarrhea and could not get out of bed since friday.

    She kept interrupting me and advised me that does not matter and does not mean I was disabled and could not work and proceeded to scold me on there is a difference between FMLA and STD and she has a bachelor degree in medical science and all these certifications and she just needs to speak with doctor directly to support reason for me being out of work. I tried to explain again that I did everything the representative advised me to do, that I was only following my doctors orders and what the claims rep told me to do for the paper work. She got very rude with me and kept telling me that does not matter and basically she didn’t care what I was telling her so I advised her I don’t care if I was getting paid for 3 days for the stomach flu. I was only concerned about my STD claim that was totally different illness / medical issue than what I filed the STD claim for she stated to tell me that because I did not return to work on 08/17/15 that did not matter that it all would be on same claim. I advised I would do FMLA for days of 08/17/15 – 08/20/15. She told me I could not do that, it had to be on same claim because I didn’t return to work on 08/17/15 so I advised her that they are killing me here. I did everything they asked of me and they were stressing me out and raising my blood pressure from all the misinformation and confusion and that the rep did not give her the updated paperwork obviously because she only had paperwork from 08/07/15 so I advised to just call my doctor to speak with him. I was to stressed out and frustrated at that point and my concern is my health so then I called Sedgwick and requested to speak with the claims reps supervisor and the RN’s supervisor to report the rudeness and misinformation given and the non communication between them but of course they could not reach a supervisor. Then attempted to get a regular rep on phone claiming to be a senior lead then admitted they were just a regular representative so I advised rep to email both supervisors and have them call me ASAP so I am still waiting on that call and I return to work tomorrow 08/20/15 so I will be speaking to head of my HR about Sedgwick! Now this is several times I have had to deal with Sedgwick for my condition which is incurable for hidradenitis and they know about my condition and I have had to have paperwork redone several times. Every time I file a claim because of the incompetence of the reps there… so thank you for allowing me to share my horrible experience with Sedgwick!

    Sounds like it is an ongoing fight for hardworking people to get their benefits. I hope you guys can make a change because it feels like the stress and high blood pressure will kill you quicker than anything dealing with them! SEDGWICK IS GONNA KILL ME !!!!

    TORRE940Aug 19, 2015  #463

  • Timothy,

    Please feel free to contact our office to discuss your STD claim.

    Stephen JessupAug 13, 2015  #462

  • I work at one of the big 3 uaw plants i have crohns diagnosis in 2008, reconstruction bowl surgery in 2010. I’ve was in remission until now had to start meds again. I filed my claim with these same folks n they denied my claim wtf. Theirs no cure for my illness. Yet ive had 16in of my intestine removed and they tell me my claim needs more medical info he[[ i paid for my copys of medical records and they say they need more info i dont have anything else to give them. Whenever i go to the doc i get my own copy of office files n fax them as well. Ive been off for a month now with no pay. Can you send me in the rite direction?

    TIMOTHY LAMMARRAug 13, 2015  #461

  • I had a serious infection and was admitted to the hospital for a week. I contacted Sedgwick from the hospital to get my claim started. That was now a month ago and I haven’t been paid for my short term disability yet. Every time I call I get a different answer as to what they need. I have left a number of messages for my case manager and she does not return my calls. Except for today when she called to say they did not receive enough information from my doctors office earlier in the week and it’s due today. My doctors office is not open on Friday so they are going to deny my claim. They have just been awful to work with and don’t seem to care at all about someone who is sick or injured.

    ShawnAug 7, 2015  #460

  • My current employer has sedgwick short term and long term supplying our disability needs, it recently changed employees now must pay weekly for this insurance. I pay weekly for my short term disability coverage I had a claim submitted in May since then I have 5 medical opinions as well as my surgeon saying I am unable to work until after therapy currently in first week since surgery, i have denied short term disability due to the fact sedgwick feels my time is too much for my injury, which has 5 doctors and 1 surgeon providing statements and two certifications that I could lift 3 pounds without the possibility of losing full use of my right arm, I am right handed as well.

    Throughout process I have been told they did not receive information needed or fax did not come through even though I have confirmation codes, and dates sent, for each process.

    My FMLA was not approved until last Tuesday. Whenever I speak to reps, everyone has different opinion I was told I was denied in July, when I called complaining about this I was told no I was not denied, I only needed to send extra info, which they are sending, I received this certification form, faxed it back to sedgwick, now they say I did not include my appeal letter although I was told I was not denied they say I needed to send appeal letter, so here I am broke, rent late, just had decompression scope surgery on the 30th, and still not receiving short term disability and no payment of FMLA either, which I pay weekly for this short term coverage but cannot get claim approved for payment.

    MichaelAug 6, 2015  #459

  • Ina,

    We hope that Sedgwick acknowledges the severity of your condition and does not wrongfully deny your benefit. Please feel free to contact us in the future should you experience any difficulty.

    Stephen JessupJul 30, 2015  #458

  • I have multiple sclerosis. I am on permanent SSID and supplemental Long term disability through my job which comes through Sedgewick. I get a letter back in February stating I am up for a 24 month review to determine if I can perform any job which is reasonably qualified taking into consideration the my training, education, experience and past earnings.

    They have requested all medical records from all my physicians. They then tell me from my medical records it only proves that I am physcially disabled and doesn’t show that my cognitive condition prevents me from performing any job duties. So they are making me go through a 2 day IME Neurophyscology testing.

    I tell them that from the state disability determination due to my cognitive issues they I had to designate someone over my finances. So they asked me if I could get a copy of my records from the state determination that would help. My husband goes through alot to get these. The people from the state said what they are doing is a HIPPAA violation but we are trying to do what we can so that I don’t have to go through this horrendus test. I have done this test before and I did the 1 day testing back in 2013. The records show my diagnosis codes but now they tell us this still doesn’t work. The need to see the actually exam records. Well the state gave us everything.

    Now I think they are being knick picky because they have all records, letters, and diagnosis codes. They are saying this still isn’t enough and they are making me go through this testing. Utterly Ridiculous!

    InaJul 29, 2015  #457

  • Ashley,

    Same thing happened to me. I worked for SunTrust Bank and Sedwick handles their claims. I am in such bad shape from pain and hurt so bad that I only sleep about 3 hours a night. I am on heavy narcotics and have been told I will be for the rest of my life. I believe that Sedwick doesn’t give a rip about us and what’s worse is that our employers must not either because they allow this to happen to us.

    I have lost my home and 2 cars. I had to have a yard sale to survive and sold all my furniture and such. I am also very depressed and feel like life is not worth living most of the time.

    I am pursuring my Social Security disabilty and hope that will come through soon but as far as Sedwick and Suntrust is concer ned, I really think they are EVIL. IT IS AN INSURANCE POLICY THAT IS A FAKE.

    Connie MansonJul 29, 2015  #456

  • Ashley,

    Do you have any additional appeals or is your only option to file a lawsuit? Please feel free to contact our office to discuss your claim.

    Stephen JessupJul 27, 2015  #455

  • I have been out of work at Walmart because I got injured in service and it has created bone infarcts in my leg… osteocrosis… my bone in my leg is dying. I’m in so much pain… but Sedgwick said there’s not enough evidence. I appealed… and still denied it. I’m also dealing with the Va to treat me which hasn’t been a success either. So I don’t know what to do now? Sedgwick should give me my short term disability which is around $1,000! I’m in a financial struggle thanks to them and I’m only 26 and been very suicidal because of all this.

    AshleyJul 23, 2015  #454

  • Dealing with Sedgwick is a nightmare, about ready to go to news about this company. Something needs to be done about them denying claims and messing with people lifes.

    Barbara PhilippiJul 21, 2015  #453

  • Barbarajo,

    I am assuming you are not working based on your inquiry. If that is the case then unless you have a privately purchased disability policy then we would not be able to assist you in securing a disability benefit.

    Stephen JessupJul 21, 2015  #452

  • This is crazy, I’m approved for the loa part with Sedgwick but they say I don’t qualify for my disability benefits. How do qualify for one an not the other, they say I’m not disabled enough to work even though doctor says no I can’t, but if work can follow restrictions he has I can an work will not follow the restriction which they have told this to Sedgewick, so which means I can not work. Does that not make me disabled, here’s a little bit whats going on: was supposed to have surgery on the 22nd of june, 2015, was canceled cause I am diabetic an my ac1 was too high, the surgery is for ankle I have a torn paroneal tendon in my ankle the only it can be fixed is with surgery, we are gonna to look an see if surgery can be preformed on august 4th, 2015 will be discussed what the plan will be, I pay for short term disability plus therefor nothing is getting paid for now not even my insurance. Tired an stressed an sick of crying how do I fill out these appeal forms, so confused in what to do.

    Barbarajo PhilippiJul 20, 2015  #451

  • Scared,

    Please feel free to contact our office to discuss the denial of your benefits when you receive the letter.

    Stephen JessupJul 18, 2015  #450

  • My first few weeks on short term disability went smooth. It was short-lived. I got a message on my phone that I was being denied from a date a week before. It told me that I would receive a letter with instructions to appeal the decision. I wrote a letter on my own and faxed it to them discussing why I was appealing. That was 1 1/2 weeks ago and I still haven’t received a denial letter. I’ve been to the doctor several times and she gave more information as to why I was unable to do my job. Today was payday, and I didn’t get paid. I called Sedgwick and was told that my case was being reviewed. I would have a decision no later than August 25! I feel confident that my employer will terminate me, if they already haven’t started the process. I can’t believe that they can get away with this but as I read all the comments on this site, I am terrified that I have been shafted by Sedgwick. My disability has taken this long to determine a diagnosis, I’ve had blood work, xrays and numerous prescription changes trying to get rid of my pain. They are a shameful group, for sure.

    ScaredJul 17, 2015  #449

  • Reggie,

    Please feel free to contact our office to discuss your wife’s claim and what options are available to her at this time.

    Stephen JessupJul 17, 2015  #448

  • Hi, my wife recently had a newborn baby and went out on leave while on leave she develop postpartum depression she began to talk to psychologist and psychiatrist and was told that she could not return to work because of her mental state they first deny her claim because they said that a psychologist could not speak on her behalf as far as her mental state so then she appealed their decision and was referred to psychiatric doctor and that doctor also came up with the same diagnosis and did not release her to go to work. Sedwick denied our claim stating that the letter was signed by a psychiatric nurse practitioner not a doctor so she went back to get the doctor to sign and try to contact sedwick and they have not responded at all. The psychiatrists are all trying to help, they are also not getting a response, my wife is getting worser and worser and finances are really tight now, we need help.

    ReggieJul 16, 2015  #447

  • Michelle,

    Please feel free to contact our office to discuss your claim. Many mental health claims that result on account of work conditions/environment, especially those without a prior history of mental health problems are quite often challenged strongly. You may also have a potential Worker’s Compensation claim.

    Stephen JessupJun 27, 2015  #446

  • My employer ESURANCE uses Sedgwick cms. I went on short term disability in February due to a nervous breakdown because of work while at work. I’ve done everything that I’ve been asked to do ran around town getting letters from doctors. Then finding out its not EXACTLY what they wanted. The first time I received the notice that my claim was denied I cried I felt like my job was doing it again . But I decided to appeal and just received notice that my claim has been denied again. Even with letters from the doctor stating why I’m out and a time line to return. To make matters worse my employer just told me I’ve been terminated too.

    MichelleJun 26, 2015  #445

  • Linda,

    Is your claim being administered through Sedgwick under your employer’s disability insurance plan? What is the status of your claim?

    Stephen JessupJun 23, 2015  #444

  • I went out on a arota by pass, my doctor was later putting in papers which since have been received and they denied my claim figured out weekly wages wrong below what they are. I was told to have doctor fax thing in and when I was to his office they gave me another two weeks off. I filed my dispute. It is impossible to speak to someone who figures the claims and weekly wages. I am guess only thing to do is call a lawyer and bbb claim against them.These people are joke. I work hard and this operation is necessary to live.

    LindaJun 22, 2015  #443

  • Darlene,

    If you are not represented by a worker’s compensation attorney I would strongly suggest you speak to one. Please feel free to contact our office and we can assist you with same.

    Stephen JessupJun 18, 2015  #442

  • Pamela,

    Please feel free to contact our office. We would need to see any correspondence from AT&T as to the nature of the overpayment as it relates to your prior disability claim in order to determine what assistance we may be able to provide.

    Stephen JessupJun 17, 2015  #441

  • “It’s a crime”,

    Sedgwick acts only in a capacity as a third party administrator to determine eligibility for disability under your employer’s disability plan. Ultimately, your legal rights would be against your employer’s disability insurance plan (whatever the designated name of same is). Please feel free to contact our office to discuss your options and how we may be able to assist you.

    Stephen JessupJun 17, 2015  #440

  • I am a truck driver for General Motors, I was hit by a truck and I was driving a gm truck. I did not take time off work but simply asked for rehab to be paid for by the company. Sedgwick denied wc claim for rehab. The truck that hit me was totaled and an ambulance was called…his truck was put on a flatbed. I was at work in a gm truck and sedgwick denied the claim; I was injured in a slip and fall at gm on january 8 2009 and this was a re-injury of the same area. Susan Horvath at Sedgwick tried refusing to give me her last name because she did not want my Union calling her…I have pictures of the vehicles and the seat belt abrasion on my clavicle and neck. They are sedgthugs.

    Darlene SawickiJun 17, 2015  #439

  • Even though I was already collecting my SS benefits, Sedgwick still denied my LTD & Appeal decision! They said I was deemed NOT disabeled, according to their records! Even though the state of Ca. declared “I was permanently disabled! How do you figure? Sedgwick DID NOT take responsibility or LIABILITY for my injuries & DISABILITY! And put the responsibility & LIABILITY of ALL MY MEDICAL CARE & injuries in the hands of FEDERAL govt! & REFUSED to take ANY liability! leaving me depressed, DISABELED, BROKE & HOMELESS! THIS IS AN OUTRAGE! I PAID into this DISABILITY INSURANCE CO. to PROTECT ME in a time like this, and NOW SEDGWICK REFUSED TO KEEP TO THEIR OBLIGATIONS! And instead MADE THE FEDERAL GOVT & MEDICARE PICK UP THE MEDICAL COSTS, I LOST MY ENTILEMENTS & now I’m having to FIGHT AGAINT THE INSURANCE CO. that I PAID, “TO PROTECT ME!” THIS IS AN OUTRAGE!

    "It's a Crime!!?"Jun 16, 2015  #438

  • I’m writing because Att Risk Management and Sedgwick said I was overpaid. So far thru my pay checks 4526.67 was paid taken out of my check from 11/24/2014 to 3/6/15 then they said I owed they 999.99 because the total amount was 5526.50. I just received a letter from sedgwick saying I owed them another 305.74. I paid 999.99 to Att risk management. Is there any way I can stop them? I don’t think I’m responsible for anymore money to them. I think I need an attorney.
    Pamela J Lyon

    Pamela LyonJun 16, 2015  #437

  • Rosie,

    Please feel free to contact our office to see what steps are available to you as it relates to potential litigation.

    Stephen JessupJun 10, 2015  #436

  • Sedgwick denied my LTD benefits from LA County, Peace” Officer Status!” And left me on SS Welfare income, THIS IS AN OUTRAGE!” They denied my appeal, and federal court application! Never going to a judge, stating they did not need to give me a reason of denial! This is an OUTRAGE! And because I was denied my LTD, I was also denied my La Cera Retirement benefits! I am now only receiving SS Income welfare, with no benefits as if I Never worked before! This is an OUTRAGE!

    RosieJun 9, 2015  #435

  • Christopher,

    You will need to consult with a worker’s compensation attorney. Please feel free to contact our office and we can assist you in finding one.

    Stephen JessupJun 4, 2015  #434

  • Tired,

    Is your claim currently formally denied? Feel free to contact our office if you would like to discuss your claim further.

    Stephen JessupJun 3, 2015  #433

  • Mike,

    Please feel free to have your brother contact our office to discuss his case. After the short term period, the claim will transition to long term disability with Liberty Mutual. Please note that regardless of the claim being approved, claims for mental health conditions are limited to a set period of time under the LTD plan.

    Stephen JessupJun 3, 2015  #432

  • My experience with sedgewick has been mixed. It was undeniable that I was injured at work after four surgeries. My problem was that the agent shared private communications with my employer. I was amazed that the agent was sharing phone messages left for her from my doctor and me to my employer. I believe that is highly unethical and I think illegal. My employer used those messages to termimate me. In one message the doctor told her that I was off work, but she told me that she wouldn’t agree and told me to go to work. I worked for two weeks on my leg and later was told I had violated company policy and with her sharing of my private conversations was terminated. I should have realized that sedgewick wanted me off WC when she started saying that I have been on WC to long. I still have trouble walking, but she wanted me off the claim and she broke the law to do it. If anyone knows the law I would love to hear from you.

    ChristopherJun 3, 2015  #431

  • I have worked for a large healthcare company for nearly 10 years and recently became ill with Bells Palsy which affects the facial nerves on the left side of my face. I have loss use of the left side of my face. I can’t close the eye, I drool, and the mouth is twisted so I talk out of the right side of my mouth. My job requires me to work on a computer all day pretty much and my eye is bandaged due to the dryness. I see with the right eye but it is blurry. My 2 doctors decided I needed to be off and submitted the information requested to Sedgwick and they stated their 2 RNs that reviewed don’t feel my illness and doctors warrant me not being able to do my job. Well, I asked them if I can’t see clearly to drive how can I get to work and how can I do the work on the computer? I have to talk all day and I drool due to the numbness on the left side of the face. This is so frustrating to have to deal with on top of dealing with health issues. I also emailed my company to let them know how horrible this process has been. Sedgwick is not concerned about the health of the employees or trying to help get documents processed. They have no compassion and I am wondering why we even pay for insurance and any benefits when you have problems getting access to the benefits when you need the services.!!! I have prepaid legal maybe I should seek legal help!

    TIRED OF THISJun 2, 2015  #430

  • My brother has been a Walmart associate for over a decade. He has recently been diagnosed with severe depression, was recently admitted for suicide watch, and has a host of physical impairments from years of strenuous labor. He was approved for pay and benifits through sedgwick then without provocation he was dropped and Noone could tell him why. One person said they didn’t receive paperwork (lie), one associate said it was 1 word in the doctors summary that was not even there (lie). His claim has since been in appeals but im not hopeful after seeing all I’ve read here. My brother is a single father of 3 he’s a great father. I’m afraid because he has told me on several occasions that he understands why people kill themselves. Someone please help us we are desperate.

    MikeJun 2, 2015  #429

  • Brenda,

    Please have your sister contact our office so we can discuss her claim in detail to determine how we may be able to assist her.

    Stephen JessupMay 28, 2015  #428

  • Anthony,

    With respect to your questions as to tax implications, you will have to contact a tax professional/accountant for proper advice.

    Stephen JessupMay 27, 2015  #427

  • My sister has worked for Walmart for over 25 years has been paying for both Short and Long Term Disability for the entire time. She had invasive back surgery on 12/29 where they placed rods and pins in her lower back along with a “bracket” to hold the lower back in place. The bones have not fused with the metal and although she could return on “light” duty, Walmart says they have a policy that says she cannot return to work unless she is 100% healed. In the meantime, she received short-term disability from 12/29 – 4/19 from Sedgwick. Now they are refusing to pay her the short-term (or long-term) disability and Walmart won’t allow her to return to work. If she cannot receive short-term disability or long-term disability and Walmart won’t allow her to return to work, what are her options? She, like so many Walmart employees, are stuck between the insurance company denying her claims and not being able to return to work. What should she do? I just sent her $$$ so she could pay her insurance premiums through Walmart otherwise she would have lost her ability to get prescriptions and medical coverage! Any help you could offer will be greatly appreciated. We have written Sedgwich supervisor Chad Mirich and sent all the doctors documentation confirming her prognosis but have heard nothing. Is it time to call an attorney? My sister could easily lose her home during this.

    BrendaMay 27, 2015  #426

  • Been dealing with att sedwick for past 5 years they claim I owe them money and have not received a payment after payment ssdi I have reqused another claims rep due to the rude manner of my rep my Doctors offices has also gotten into with her in the past I moved to Gainesville Fl for UF health I sent in all the paper work from them and again she has denied my claim I have fax Sedgwick request for balance info request for a manager I also sent Colts to att att tells me I get 40% Ltd Sedgwick tells me it’s 30 i have asked for w2 so I can get my taxes in order if I had to pay back money I paid tax on should I get the tax benefits but No none of my request have been address I only get calls to let me know my claim has been denied I would love to sue them and att for not addressing my issues is the anything I can do ?

    Anthony ElliottMay 26, 2015  #425

  • Readers: Harvard University’s Digital Media Law Project has the federal court documents in Sedgwick v. Delsman. It’s a good read, for those interested.

    Injured worker Robert Delsman, who has posted on this website, started blogging about Sedgwick’s unethical practices and doing mailings, was sued by Sedgwick in federal court in Northern California. Sedgwick sued Mr. Delsman for: Copyright Infringement (Delsman used two of their executive’s photos in his blogging and mailing), Defamation, Tortious Interference, Trade Libel, Unfair Competition and other causes of action.

    The federal court judge in Northern California kicked Sedgwick out of court on it all and said Mr. Delsman had a constitutional right to criticize Sedgwick, his use of their photos was “fair use” under federal Copyright Law, and the federal court judge said that California’s Anti-SLAPP law protected Mr. Delsman’s criticisms of Sedgwick which were a matter of public interest. Kudos to that federal court judge for kicking Sedgwick out of federal court!

    Sedgwick appealed to the Ninth Circuit Court of Appeals in San Francisco which agreed with the federal court judge’s decision. Kudos to the Ninth Circuit Court of Appeals!

    Silicon ValleyMay 23, 2015  #424

  • Rosie,

    When was the denial of benefits, and have you filed your appeal?

    Stephen JessupMay 22, 2015  #423

  • Sedgwick DENIED my disability, even though I was receiving Social Security! “Declared permanently disabled by state of California” They left me and my family on federal govt. Aide! Even though I was paying into their disability insurance! This is an OUTRAGE!” A CRIMINAL OFFENCE!” TO DENY WORKING CLASS PEOPLE THEIR BENEFITS & MAKE THEM HOMELESS!”

    RosieMay 21, 2015  #422

  • Jed,

    If you are not protected by FMLA your employer could terminate you for failure to show. You can also be potentially terminated by your employer- even if you are receiving benefits. Sedgwick is a third party administrator for Walmart- Walmart would ultimately make the decision to terminate.

    Stephen JessupMay 21, 2015  #421

  • Sadly, the famed Stanford Hospitals & Clinics (Northern California) is using Sedgwick for workers’ compensation, short-term, and long-term disability. The results? Tragic for those in need of medical care and benefits, like all of the other posts here. What is a world class hospital doing in choosing a third-party claims administrator (Sedgwick) that doesn’t uphold its medical and ethical values? This puts injured employees and their families at risk.

    Silicon ValleyMay 14, 2015  #420

  • Jed,

    If you are not protected by FMLA your employer could terminate you for failure to show. You can also be potentially terminated by your employer- even if you are receiving benefits. Sedgwick is a third party administrator for Walmart- Walmart would ultimately make the decision to terminate.

    Stephen JessupMay 12, 2015  #419

  • I appreciate your website and your explanations about the egregious conduct of Sedgwick. I am in California. When trying to figure out what goes on at Sedgwick, I uncovered the federal court case here in Northern California in which Sedgwick executives sued Robert Delsman for his complaints about Sedgwick’s practices and their treatment of him and others. The federal court judge tossed Sedgwick out of federal court and ruled for Mr. Delsman!!!

    Mr. Delsman, I just noticed your comment on this webpage. Sir: You rock! I have told everyone about you and I can’t thank you enough for standing up to these bullies!

    Silicon Valley, CaliforniaMay 11, 2015  #418

  • I have been out for six months and now Sedgwick says I will lose my job. This is the same thing over and over both them and my employer (Walmart) knew it would be awhile because I had to see a back surgeon, the wait was three months. Can fire me for following my doctors orders? Sedgwick has said at least four other time I was fired. Can Sedgwick fire me?

    jedMay 11, 2015  #417

  • Silicon Valley,

    We are glad to hear our information could be of assistance to you. If you need assistance in finding a Worker’s Compensation attorney please feel free to contact our office and we can assist you in locating one.

    Stephen JessupMay 10, 2015  #416

  • I appreciated your law firm’s youtube videos and information about Sedgwick’s hard ball tactics. My family also found a Facebook page devoted to Sedgwick’s hardball tactics.

    I was injured on the job recently and found that Sedgwick denied me medical care for my injuries, prescriptions, etc. Disappointingly, this occurred at Stanford University (California) and I was shocked they would do business with a company with such a poor track record as Sedgwick’s. I have had to file complaints against Sedgwick with the State of California’s regulators and the California Attorney General’s Office. I am also having to get a Workers’ Compensation attorney.

    Silicon ValleyMay 9, 2015  #415

  • john doe,
    You need to speak with a Worker’s Compensation attorney to determine what your legal recourse is. If you need assistance in finding one in your area please feel free to contact our office and we can assist with same.

    Stephen JessupMay 5, 2015  #414

  • 1. Yup I feel like a ” john doe ” a nobody!!!! I was injured on the job last summer 2014. I went to the hospital. After seeing nurse, told from hos. dr. that I would need major surgery. I Did not recieve any pain medication for 48 hr.s because insurance took there sweet time, missed my first surgery because of paoer work. Did not get any pain medication for 3 days after surgery…. NEEDED 2ND SUERGERY and again did not recieve any pain medication for 3 days because i was waiting on sedwick to authorize medication, the record so far to wait on authorization is 8 days! Worst pain ever felt like i was alone, grown adult crying out loud and screaming in pain…
    2. Payroll is a joke never get paid on regular schedual, longest was almost a month, gotten eviction notices, almost car repos, shutoff notices etc. and to top it off dr. says i think ur depressed and anxieties im refering you to a head dr.?!
    3. My physical therapy hasn’t been consistant, I’ve missed visits because dr. , physical therapy not paid, claim shut off temporary, no gas or transportation there because no steady income!
    4. This has been the worst experience ever, I’ve called, emailed and just burnt outtalking to the wall, leaving messages with no response… have phone bill record of all calls made to Sedgwick, phn not on anymore as of 2 weeks ago, no money sent yet in mail to pay bill!

    john doeMay 4, 2015  #413

  • Covered through Segdwick Short Term Plan . A pre-X investigation was to be performed. Every thing stated on YouTube I believe true. With 20 yrs experience as claim examiner, which required producing high level correspondence, I felt confident standing up to any challenge. Realizing they were stalling , I had tricks as well. In the end, a remit was received by the long term insurer. A benefit draft was never, over the course of 6 months, issued by Sedgwick. The approval letter stated, there rationale to pay was based on the fact they could not make up there mind.

    Thank you for the hard work gathering this important information on Sedgwick.

    Nancy (Nantuckette) Jean OmdahlMay 3, 2015  #412

  • Kathy,

    I am so very sorry to hear about all that you have been through. Please feel free to contact our office to discuss your short term disability claim, and any potential claim you may have under the long term disability policy.

    Stephen JessupApr 29, 2015  #411

  • My complaint with Sedgwick started in Aug 2014. I had been at Walmart for 7 years, and during that time, paid into a short term plus and long term disability benefit program. which Sedgwich is the third party for Walmart. I lost my only daughter suddenly and tragically on February 1, 2014. I’m now raising her little girl, who was only 2 when my daughter passed. I took a month off just to try to get my life together and returned to work on March 2014. The next few months my health was really going downhill, and in August my assistant manager told me I needed to take some time off to deal with my medical issues.

    My last day of work was on August 22, 2014. I went to my family doctor and she wanted to run some test, and took me off work for a couple of months, while running those tests. I filed a claim with Sedgwick and I got approved for the time off, but then I contacted them and ask when I would get a check. At that point they told me that I had only applied for time off and that I had to file for medical disability. So I did. My family doctor filled out the paperwork and immediately faxed it back to them. One of the medical reasons for my leave was because I was having trouble breathing, but Sedgwick put it down as a “heart problem” and then denied my claim, saying I had no medical problems with my heart. I fought that with them and they “appealed my claim”. But as soon as the second week of me being off, Walmart stopped my insurance and as soon as my family doctor found out I had no insurance, she stopped seeing me.

    My short term disability benefits was a “plus” program and it would have paid my insurance premiums for me while I was off. But since they denied my claim, I didn’t have any insurance. Since my family doctor would not file out anymore forms, because I was no longer her patient, I could not go see the specialist that she had wanted me to see. It took a couple months to be able to get a medical card and go see the doctors I needed to see. I got a call on December 8, 2014 from my HR manager, saying that since I had no medical to prove I was not able to work, they fired me from Walmart. Then they sent me my last check with my paid vacation days left on it, but had taken my “insurance premium” out of that check, because they said i owed it to them. But none of my medical bills got paid, Walmart just got their money but didn’t pay any of my bills, so now I have all these late payments letters coming.

    I am barely hanging on financially, and was waiting for the appeal to be done, so I could get my benefits. It took Segdwich from October until April 22, 2015 to send me a letter denying my appeal, and was told the next step was to get a lawyer. They knew I had been off work for 8 months, and had no income coming it, so a lawyer was not an option. So now I’m sitting here trying to figure out what I can do, I’m raising my granddaughter for my daughter. I have not only lost my only daughter but also my job. Now my car is in trouble to be repoed, and eviction is going to be coming also, all because Sedgwick denied my claim that I had pain into for 7 years.

    KathyApr 28, 2015  #410

  • Matt,

    Please feel free to contact our office.

    Stephen JessupApr 24, 2015  #409

  • I have a claim with Sedgwick and need an Attorney. Please help. They say my claim is too complex, what’s up with that? I need someone to look into this.

    MattApr 23, 2015  #408

  • Larry,

    Is this a worker’s compensation claim? If so you will need to consult with an attorney that specializes in same. If you need assistance in contacting one please feel free to contact our office to see if we can assist.

    Stephen JessupApr 21, 2015  #407

  • My claim was approved by Sedgwick in early 2013 and I been on and off work do to this injury [back]. Long story but have had surgery in the last year but now Sedgwick nurse has been showing up for my appointments with me. Should I stop her or let her attend my appointments? I may need help settling this claim as well.

    LarryApr 20, 2015  #406

  • So why isn’t this company shut down by now? Do they ever play a claim?

    What a complete sham.

    CarrieApr 16, 2015  #405

  • Sedgwick denied my LTD benefits, even when I was deemed a disabled worker by Social Security! Sedgwick, refused to pay my Long term disability benefits and put me on Federal Aide Assistance for life! And because I was denied my LTD benefits, I was also denied my Retirement Benefits from La Cera, even though I was declared permanently disabled & receiving benefits by Social Security! This is preposterous & an outrage!

    Mrs MijaresApr 15, 2015  #404

  • Valley,

    Do you have a worker’s compensation attorney to assist you? If not, I suggest you speak with one.

    Stephen JessupApr 8, 2015  #403

  • I was out of work due to a beam from the ceiling that fell on my head at work. I was out of work due to a head concussion, severe lumbar muscle strain, neck strain, back pain and cervical radiculitis. The first month She we compassionate and acted like she cared. They paid me every two weeks and was approved for PT. My doctor referred me to a neurologist, nerve doctor and chiropractor which all got denied by Sedgwick. Sedgwick had me see there individual doctor, I was in shock when he said I was able to wok and all further treatments was not necessary. Mind him, I can’t walk straight, by body is still off alignment, due to the fact that they denied my chiropractor and my neck is is pain 24/7. I couldn’t even carry a new born baby because it hurt so much. My suggestion to anyone who gets hurts and you have Sedgwick to deal with, go see an attorney! Sedgwick does not care about you or the pain and agony that you are experiencing. They just want you back to work.

    Valley IsleApr 7, 2015  #402

  • Tammy,

    Thank you for sharing your experience and advice.

    Stephen JessupMar 24, 2015  #401

  • I have not dealt with Sedgwick directly but I work as a nurse at United Health Care. I know of several nurses that have had to be on short term disability due to circumstances beyond their control. The nurses I have known are dedicated beautiful loving nurses that are out to serve. One nurse was in the hospital with gastric bleeding… Sedgwick called her at the hospital and harassed her. Hello… hospitals no longer keep you in the hospital if you are not very very sick. Another nurse had to have rotary cuff surgery. She was on pain medication and could barely lift her arms yet Sedgwick harassed her to get back to work. Another nurse told me that her dr stated he would no longer see her because Sedgwick was unreasonable and too hard to deal with. They are notorious for losing faxed documents. The fax machine is off at times. I think it is an absolute shame that hard working people.

    As a nurse i advise that you request a peer to peer meeting between the Sedgwick medical Dr and your own. you have the right to call Sedgwick and request that.

    Tammy GMar 23, 2015  #400

  • I work for Comcast and they use Sedgwick. In March 2014 I was out of work due to severe pain, nausea and vomiting and my primary said you can not work until these symptoms are under control. And he wrote books for them and I gave them all my chart notes. They said I could “drink water and go to work”… umm I pointed out to them 2 days later I was in the ER for severe dehydration from nausea and vomiting. They “never received” that ER report. I faxed it to them 6 times and mailed it to them. So I am out of pay from March 10 2014 until April 12 2014 (I had no choice to go back). And when I did an appeal with them, these incompetent people stated they never spoke with my primary, and primary said he spoke with them for 2 hours straight. They claimed that I made up who my gynecologist was because they could not find him at the practice they called (they called the wrong office). Fast forward to July 2014 and I had surgery which surprising they paid but when I had a nasty post op infection from it “they had no proof it was there.” Really cause my doctor showed them labs and gave them the list meds I was prescribed. So my last half of my claim was denied.

    Rae McDermottMar 16, 2015  #399

  • Alfred,

    You need to contact a Worker’s Compensation attorney. We can assist you in contacting one- please feel free to contact our office.

    Stephen JessupMar 13, 2015  #398

  • I was injured at work in March 2014, and received my 1st check from Sedgwick Claims on 4/15/2014. I was off work for about 3-4 weeks. I was put on light duty for about 4-5 weeks. Not much light duty work for a delivery driver. Then I was made to drive my vehicle, making deliveries with a helper. Not helping my injury at all but the employee has no say so. It took until July to get approved for therapy, 3X a week. Getting paid weekly from my job didn’t filter to Sedgwick. For months, checks came whenever. Since being released from work, in August 2014, because there was no longer a position for me (driver with help), I now only due therapy 3X a week and hope there’s something in the mail from Sedgwick Claims. It’s now March 2015 and I have not had a check since 2/20/2015 and it was short of my usual payment. I have a few numbers to call, no one answers or returns calls. I need to know what is going on. Which direction should i be going?

    To date, i’m not allowed to return to work unless i’m 100%. The injury is still with me.

    Alfred JohnsonMar 12, 2015  #397

  • Anna,

    Please feel free to contact our office to discuss. If Sedgwick continues to deny your only option may soon become to file a lawsuit against your employer’s named disability plan.

    Stephen JessupMar 7, 2015  #396

  • I work for HCA NPAS out of Louisville KY. I am currently off work on a meantal health issue. I applied for my shot term and with in a week a case reviewer / RN. called me and basically called me a liar as this is not the only time I have been off for this reason. My PCP sent Sedgwick his chart notes Sedgwick requested, my claim denied. A superior I requested to speak with advised they needed more info from my therapist, fine. She advised I had until 2 24 ’15. My doctor sent in the therapist notes, a new diagnosis including new meds, 10 pages total. I spoke with the supervisor on 2 24 and she advised they where received but not yet reviewed and advised I would have to appeal and send in documents? How do they deny a claim without reviewing the records they requested? I put in a call to the main HR for HCA as my HR rep was not returning my calls. He advised he would look into it. That was 3 days ago. No response. I called him back today 3 6 ’15, left a message and still waiting on a call back. HCA is the largest owner of hospitals in the U.S. and a self funded company. Sedgwick and it’s employees have made a bad situation worse. I’m not sure if I need a attorney? Or, go at it alone. Short term disibliy is a benefit provided by my company. Any advice, suggestions? Thank you.

    Anna JaggersMar 6, 2015  #395

  • I work for the County of Los Angeles and have been dealing with Sedgwick for the past five years. I thought the County had good disability insurance and I even paid extra to have additional coverage – i.e. a shorter waiting period to receive your first check.

    Little did I know that was a waste of money and that it would be literally hell to get – and keep – disability payments.

    In all my 55 years on this planet, I have never been treated so badly as I was by Sedgwick. It is shocking to know they are allowed to operate in such an unscrupulous manner. It has made me bitter and I have lost faith in the system.

    Their agents talk down to you and question you non-stop about why you are not working. They act like sending you a check is coming right out of their pocket – which it very well may be. One agent even claimed I had not called him to renew my disability for that month, when in fact I had called and faxed him the doctor’s note. I am sure the agents are pressured like hell to make sure claims are denied, and I saw how they will take any step necessary even if they have to lie about it. No doubt, they get bonuses for this.

    Sedgwick is by far the most unscrupulous organization I have come across. They make the IRS look like patron saints of virtue.

    It was so hard getting short term disability payments that I was forced to return to work – when it was unsafe for me to do so. Forget about getting LTD – when you cannot even pass Sedgwick’s STD hurdle. After a year back at work I got even sicker, and found myself having to fight them for STD all over again. The payments would start – then stop for no reason. It was like a game to them and when they stopped it was hell getting them started again.

    When it came time for LTD they played their little tricks again, and I was so sick of their behavior I filed a Government Tort Claim notifying the County what they were doing to me. The payments resumed and continued after that.

    My health insurance was paid out of the LTD and it kept getting cancelled, when they would stop paying. With no health insurance, it was hard to go to the doctor. This is the vicious cycle they put you in and I spent two and a half years dealing with this downright nonsense.

    I was eventually granted a disability retirement by the County, and am soon going to be receiving back pay. Sedgwick has now reared their ugly heads and are claiming I owe them a majority of that money as ‘overpayments.’ Because they cancelled my disability payments, I was forced to use my County time on the books. Had they been honest and paid me, this would not have been used up and my health insurance would not have been compromised. I told them I would reimburse the overpayments, but subtract the months that I never got paid and for the sick/vacation that got used up by their shenanigans.

    If they are unagreeable to that, let them sue me to get a penny back. I am going to treat them with the disrespect and disdain they treated me. I will file bankruptcy if I have to, but I will not co-operate with them one bit.

    Their reign of terror needs to be stopped and I am saddened to know this is allowed to exist in America. What a damn shame.

    Marie T.Feb 25, 2015  #394

  • If you’re dealing with Sedgwick, hire a lawyer ASAP. They are not professional and will not be helpful willingly. It is my opinion that Sedgwick thinks they are above the law and not liable for their actions.

    DavidFeb 11, 2015  #393

  • DL,

    Have you already filed your appeal? Please feel free to contact our office to discuss further.

    Stephen JessupFeb 6, 2015  #392

  • Sedgewick denied my disability claim although NY State was already paying my claim.

    DL Flight AttendantFeb 5, 2015  #391

  • Silicon,

    Unfortunately, I cannot think of any grounds by which your employer would be liable for negligence for hiring Sedgwick to administer claims.

    Stephen JessupFeb 1, 2015  #390

  • Can an employer be found negligent for using Sedgwick when Sedgwick can’t identify a doctor within its MSN with skill set to treat RSI? Forget about a disability claim. I’m talking about Sedgwick assigned case nurses encouraging me to leave WC and return to private healthcare because WC doctors are unable to make diagnosis or provide pain relief. So I started return to private healthcare, but learned private healthcare cost for this condition will have to be paid 100% by patient because private insurance must deny coverage. Private insurance, which i fund, will not cover me seeking a diagnosis. I feel my Silicon Valley employer is negligent for retaining an third-party administrator with no means of delivering care for a common condition in Silicon Valley. I feel my employer harmed me by taking my right to take care of my body with health insurance for which I pay.

    Silicon Valley RSIJan 31, 2015  #389

  • Amber,

    You will need to speak with an attorney that handles employment matters to determine what your rights are. Please feel free to contact our office and we can assist you in contacting one.

    Stephen JessupJan 30, 2015  #388

  • So I did a disability claim for kidney stones that was approved just fine. We thought I passed them all, but I didn’t, I did an accommodation for 3 days in August at the very end. I got my papers on 10/28/14 from our FMLA person at work; my doctor approved those days and signed and faxed them on 10/30/14. I was terminated from work on 01/17/15 for points; all days show as points. How is this even possible? I have a copy of the doctor’s paperwork and I am told it can be 1 year or more before I could possibly get my job back?

    AmberJan 29, 2015  #387

  • I am 28 years old with scoliosis, degenerative disc disease, osteoarthritis, sciatic nerve pain,constant chronic pain and depression and anxiety. I had 2 back surgeries when I was younger but as I got older and after having my son my condition got worse overtime. I have been getting the run around from doctors trying to get another surgery hoping that would make me better. All doctors have told me that they can’t do the surgery because it is to dangerous now because of my age. I am on strong medication for it and that helps a little but not enough. My doctors decided to take me out of work back in November because of my situation of not being able to work anymore. So sedgwick approved that claim which was set for me to be reevaluated later in December after seeing multiple doctors trying to get help. I had to file another extension because of there not being any treatment methods available to fix my disability other than taking medication which I said before only helps a little. They denied that extension. I didn’t find out until I received the denial letter in the mail. No one called me or anything. It said they didn’t receive my last exam notes from the doctor in time. When I filed the first time they called me a few days before the deadline saying the doctor hadn’t sent medical records in yet so I was able to call the doctor and get them to get this done on time which they did and I was approved. Now this time I don’t understand why they didn’t call me to say they need the exam notes and they had been trying to get them but the doctor wouldn’t return calls? I think that was a lie and they just didn’t want to pay me anymore. They just denied me without communicating anything to me first. This is an awful company. They should know I am still unable to work if nothing has been able to be done for me so I obviously am in no better shape than I was when they approved the first claim. It makes no sense to me why this happened. Now I have had to submit an appeal letter and wait however long for them to look at it. I just saw another doctor today who as deemed me total disabled but I can’t even submit that until I hear if this appeal is approved. It is rediculous this was all over not getting a piece of paper in time and could have been avoided if they would have informed me before just going on ahead and denying it. I now have no income coming in and don’t know how I am going to support my family. I guess that one piece of paper missing “if that is even true” says I can return to work.

    JenniferJan 13, 2015  #386

  • Adrian,

    If you do not already have a Worker’s Compensation attorney I would suggest you speak with one. If you have any issues under the AT&T disability plan in the future, please do not hesitate to contact our office.

    Stephen JessupJan 6, 2015  #385

  • 3 year with AT&T, got hurt on job and struggling to pay mortgage and bills. It took 3 months and they barely aproved my claim and now on light duty and dealing with pain and lower income then I use to make. Was picked up by ambulance from place of incident and managers report I got hurt next day. AT&T and Sedgwick are not a family oriented worst to work for and deal with, they don’t care if your kids don’t have food on the table.

    AdrianJan 5, 2015  #384

  • Rubyruiz,

    If your Worker’s Compensation claim was denied you will need to consult a Worker’s Compensation attorney to discuss your rights. If you do not have disability insurance coverage your only other option may be to file for Social Security Disability.

    Stephen JessupJan 2, 2015  #383

  • Brenda,

    If your claim has been denied, please feel free to contact our office to review the denial letter and to discuss what your options are.

    Stephen JessupJan 2, 2015  #382

  • I have been out of work due to an injury, after that I was in a car accident. I have not received any pay since July 2014. Sedgwick owes me 12 weeks diability pay. If I retire from the co., do they still have to pay me?

    Brenda BurkeJan 1, 2015  #381

  • I work for Frito Lay, have for 30 years. I had a combination of things going on, stress over a pension issue that I had to file formal complaints on, high blood pressure, and some back problems. It got to the point I self reported (commercial driver), and took some time to get things fixed. My BP was beyond allowed limits for drivers, and the 12-14 hour days were killing my back. Filed a STD claim with Sedgwick and they denied it saying my back problems were the result of my military injuries from 6 years ago (totally unrelated), and the BP was a result of the back, and the stress had not been documented well enough. Sorry I didn’t document talking to stress counselors. No wonder some VETS get depressed with treatment like that. I have been punished enough for my ongoing military service from Frito Lay by having my vacations taken away, my 401K loan forclosed on, my pension docked, and a host of other things. Now, after 30 years I cannot even get sick without being punished. Sedgwick has it all locked up so you have no recourse, can’t take them to small claims, can’t afford to fight them in Federal court, and not worth an attorneys time. Thanks politicians, for allowing a system like this. It’s criminal.

    Steve JohnsonJan 1, 2015  #380

  • Rubyruiz,

    If your Worker’s Compensation claim was denied you will need to consult a Worker’s Compensation attorney to discuss your rights. If you do not have disability insurance coverage your only other option may be to file for Social Security Disability.

    Stephen JessupDec 31, 2014  #379

  • I have been injured at work and had an amputation. Lost my job, no longer receiving workman’s comp check. I got evaluated by a doctor that judged me in five minutes and said I no longer needed checks, I was recovered. I disagree with all on it. I’m going through pain in suffering, got no income. Got 3 kids and now they have me seeing a specialist pain surgeon. They’re referring me to injection through my neck, say I can’t get signed back to work. If I was in good terms do I still have all this going on? What can I do if I disagree and want to get reevaluated, if my conditions worsen?

    RubyruizDec 30, 2014  #378

  • Robert,

    I would strongly suggest that you and your wife contact an attorney who specializes in Worker’s Compensation claims. Please feel free to contact our office should you need assistance in finding one.

    Stephen JessupDec 20, 2014  #377

  • My wife has been dealing with Sedgwick since a workmen’s compensation was filed back on January 2014 due to a large cyst on her hand. Her Sedgwick’s case worker Mario Castro has been little to no help and refuses to return phone calls. They paid my wife less than what her employer said she would and did nothing but give us a run around. The doctor released her to go back to work with restrictions on October 20, 2014 which her employer has since been having her perform different duties due to the restrictions and has been paying her full benefit rate. She works straight commission and her benefit rate is bases off her sales for a certain period of time. The benefit rate is what she’s paid for vacations, sick time and when she is required to be off the sales floor for a certain period of time. On December 12, 2014, her check was extremely short and her employer is now telling her that they are suppose to pay her a base rate of $9.00 an hour and Sedgwick is to pay her the full difference of her benefit rate. Since the 12th my wife has left a number of voice mails for her case worker Mario Castro at Sedgwick who has failed to return any of her calls. She is also being told by her employer that Sedgwick isn’t returning their calls as well. We have already used up our savings and are looking at not making rent for the first time in our lives. Her store manage continues to tell her that they will make things right, but it doesn’t seem to be happening. Not too sure what to do…

    RobertDec 19, 2014  #376

  • Pam,

    Your benefit can be reduced by any enumerated source of Other Income contained in the policy – SSDI being the most common.

    Stephen JessupDec 17, 2014  #375

  • Nicole,

    It appears that your claim is for Worker’s Compensation. If that is the case you will need to consult with an attorney that handles those cases. Please feel free to contact our office and we may be able to assist you in contacting one.

    Stephen JessupDec 16, 2014  #374

  • My appeal was approved by the appeals team. They said I could get long term disability. They also told me to call my HR dept to see if I would be still with At&t as far as being employed. My question is: they know I am recieving disability with Social Security, do they have the right to reduce my pay again?

    Pam LyonDec 16, 2014  #373

  • I have been dealing with Sedgwick CM for over a year now and my case examiner stated that they have forwarded my case to the state of Arizona for further review. My most recent visit to an IME stated that my case is now Permanent Partial. She stated that it could take up to several months for a loss of earnings capacity and award from the industrial commission. Does this normally takes this long? She also said that I have the opportunity to place a settlement demand. I don’t know what to do at this point.

    Nicole MooreDec 15, 2014  #372

  • I work for Daimler Trucks North America in Portland. I had an accident at home that damaged my neck and was out of work for 2 1/2 weeks. Sedgwick gave me 20 days (including weekends and Thanksgiving) to return paperwork. Kaiser Permanente lost the paperwork. I called and left mess. for my worker on 3 different occasions giving her an update. She closed my claim on Monday even though I called her that day and left a message saying Kaiser was going to give me paperwork on the next day and I would fax it to her (and I did). Now my work has refused to allow me to collect my vacation pay and has written me 2 disciplinary letters for being absent.

    MikeDec 14, 2014  #371

  • Nicole,

    I am sorry to hear about the recent decision. Is your husband’s claim under a disability insurance policy or a worker’s compensation claim?

    Stephen JessupDec 9, 2014  #370

  • My husband and I have been dealing with Sedgwick for over a year and just out of the blue his payments stopped. I decided to call Sedgwick myself to see what the problem is. Well come to find out that during his last visit with IME Dr. Patel the doctor agreed that his condition was considered permanent stationary. With a 3% disability. My husband has a serious spine injury and has had many injections as well as radio frequency ablasion but there was no relief. Here’s the kicker, we were told that this most recent visit with the IME was just to check his condition and see if there was any other types of care that they could provide him and it was not an impairment rating. We have two documents stating that it wasn’t an impairment rating but were told just the other day that it was. I know that by Law they are allowed to stop his payments but shouldn’t they notify us if that is what is going to happen? We were told that they have 30 days to file with the state of arizona so that we can finish the end processing. I have talked to many lawyers but none of them seem like they want to help. My husband and I depend on this check to help support our family of 3 kids and this especially hurts during the holidays. I don’t know what to do. I just need some help.

    Nicole MooreDec 8, 2014  #369

  • Bernadette,

    I am equally confused myself as it relates to your fact pattern. Please note that Sedgwick is not an insurance company, but rather a third party administrator. It may be that ADT self-funds its own STD policy and hires Sedgwick to handle the claims process, and that Cigna is the LTD carrier. However, without seeing the policies/correspondence there would be no real way of knowing. Please feel free to contact our office to discuss your claim further.

    Stephen JessupDec 6, 2014  #368

  • I am an ADT Outside sales rep. since 1990. I am now 56 years old. I work in NYC. So I recently had problems with my right hip and bad arthritis, I cannot walk, climb, I cannot lay down for a long time, I cannot raise my leg without intense pain. The doctor said I need to rest and put me out on temp disability. I do all my work on foot throughout the city and cannot walk at all. If I was able to drive I still count do it, I am in pain when I drive also. I cannot sit at a desk either so that is why I was put out by my Orthopedist. Sedgwick has denied my claim and I have recently appealed. I also have a person from Cigna (who is my insurance co.) contact me. I don’t understand if this is 2 different people handling the same claim? Today I received a small check from Cigna but I was put out on disability as of Nov 3, 2014. I have an advocate from my HR helping to get my appeal. After all I am reading I am assuming it won’t matter and I won’t get my disability? Please help me understand the different companies.

    BernadetteDec 5, 2014  #367

  • Sedgwick has been causing me problems for months. Now, they keep telling you that they have all the documents that they need and they just need a physician to look over it and then later they say I got denied because the doctor did not send in enough documents. They then told me that my doctor needs to call them personally and they gave him some numbers to call. He repeatedly tried to call for 3 days and no one answers.

    They tell me that they will call me on a specific date, like Monday, and tell me what’s going on with my claim and they never do. I have to call the call center to find out what is going on with my claim. They just tell me that I need to wait for my claim representative to call but they can try transferring me. I never can get my case worker so I repeatily leave messages. When she does finally call me back I get told that another department is looking at my claim and she will call me next Monday to tell me the status. She doesn’t call me again and I have to call the call center. I told the lady to just transfer me to a supervisor and of course no answer so I left a message. I try to contact them to ask questions to talk to the supervisor and figure out what’s going on with my claim and I leave my claim repressive multiple messages and I still hear nothing back.

    It’s gotten to the point where I am now going a month without a paycheck and my boss is telling me I need to fix this and get back on short term disability or go back to work. I am starting to think I’m going to bring an attorney into this because right now I’m getting nowhere.

    Ashley SeggertyDec 5, 2014  #366

  • I work for WalMart Distribution Center and have been there over 6 years. On October 7, 2014 I had to have total knee replacement surgery. I received 1 check from Sedgwick and 10 days was back pay. I was emailed a letter from Sedgwick stating how much I would receive. OK good, now I know for certain how much my checks will be. Well the check I received this week was only for $122.00 when the letter stated I would get $778.00 every 2 weeks. So I call them yet again and am told they only considered me disabled for 2 weeks. Um hello, I just had my knee cut out and a new one put in and YOU (Sedgwick) consider me disabled for 2 weeks when the original paperwork says I’m not to return to work till January 2015. The person (AKA asshole) I talked with said just because I want something doesn’t mean I will get it. Meaning just because I said I would not return to work in January means that’s what I will get. The doctor wanted me off of work for 3 months which would make me return to work in January 2015.

    Sedgwick emailed me on Monday, December 1, 2014 and said they needed more information yet again. Ok I call the doctor, the doctor faxes them more information. Fast forward to today, December 3, 2014 Sedgwick calls me and says they received the fax from the doctor but they still need more information. The doctor said I had a return visit of 8 weeks from November 5, 2014. OK, does Sedgwick not have a calendar and know how to use it? Sedgwick knows I had knee replacement surgery but if my doctor doesn’t put a restriction on me then I will no longer receive short term disability. And since I’m done with physical therapy they have to fax Sedgwick and tell them I am done, how I done, and what I’m supposed to do between now and my visit in January.

    So for anyone who uses Sedgwick in the future, write down everything. Where you go, who you talk to, what you talked out, what color underwear you wore that day. Keep all emails, all faxes, anything you mail, make copies and keep names of the people you talk with at Sedgwick.

    Sedgwick is a joke and expect too much!!! They want you to return to work before you are able and your doctor completely releases you. I have bills to pay and getting short term disability just barely covers my bills. But I’m not able to return to work just yet.

    CindyDec 3, 2014  #365

  • Pam,

    Since you have already filed your administrative Appeal you will have to unfortunately wait until they render their decision before additional legal rights will become available to you.

    Stephen JessupDec 2, 2014  #364

  • AT&T has denied me disability benefits from oct 1 to Nov 3. I have been on disability with them since Dec 20, 2013. They said since I was on social security for disability beginning in June till Nov they overpaid me. I have not recieved any compensation from them since Sept 30. They knew I was on social security benefits around June. I told my case manager with Sedgwick AT&T benefits Kora Hamilton about them. They have also recieved faxes from my doctors saying I am disabled and unable to work. Is there anything I can do? I already set up an appeal with Sedgwick AT&T Disability.

    Pam LyonDec 1, 2014  #363

  • Jayden,

    If your claim for worker’s compensation benefits? If so you will need to speak with an attorney that handles said cases. Please feel free to contact our office and we can assist you in finding one.

    Stephen JessupNov 23, 2014  #362

  • I was injured on 10-16-2014. Lifting a 160 pound shelving unit. I was sent to doctor experiencing low back pain and right but cheek pain with shooting electrical pain down to both feet. MRI confirmed l3-4-5 s1 hernias with nerve impingement on left and right with compression of the cal sac (spine). Had IME the doctor who performed exam said he can not give advice. By the end of exam he was so concered he told me it would either be surgery or series of epedurals and lots and lots of physical therapy as he also discovered something wrong with my pelvic ring. It has been 6 weeks almost and Sedgwick will not allow me to see a specialist or neuro surgeon. It almost feels like the doc I am seeing is doing what Sedgwick is telling her to do, because I am still working with restrictions but I can hardly stand or walk for minutes, let alone a 8 hour day.

    JaydenNov 22, 2014  #361

  • Stacie,

    Please feel free to contact our office to discuss your claim.

    Stephen JessupNov 22, 2014  #360

  • Does anyone handle Sears Sedgwick claims. I want to talk to an attorney. Getting the runaround on a claim I filed in September 2014.

    StacieNov 21, 2014  #359

  • Mary,

    Is your claim with Sedgwick for disability or worker’s compensation?

    Stephen JessupNov 18, 2014  #358

  • Edica,

    Are they advising you that you are not allowed to return to work until on/or after November 13, 2014?

    Stephen JessupNov 15, 2014  #357

  • As of Nov 13th Sedgwick with Wal-Mart DC has denied my claim because they opened three different claims while I was on Medical leave they originally said I was approved through Nov 13th, 2014. Told me to get the medical forms in to clear up that I my Dr wanted me out of work from Oct 15th through Nov 3rd when I did return to work from my Doctor and it will get approved because they tried to open an STD claim when that was not was I was asking for. I did what I was told and they walked me out of my job last night. I was out on medical from Oct 15th to Nov 3rd and was hospitalized twice due to my health condition.

    EdicaNov 14, 2014  #356

  • Mary,

    Is your claim with Sedgwick for disability or worker’s compensation?

    Stephen JessupNov 10, 2014  #355

  • I have been dealing with Sedgwick for almost 2 years now and they have recently stopped my benefits as well and their doctor referred me to a Neurosurgery Doctor and he recommended a percedure that their Doctor refuses to do and now he is trying to put me back working with a clasped disc and bulging disc to cover his own ass, also referring me to a pain clinic versus solving the problem. Can someone tell me what I should do?

    MaryNov 9, 2014  #354

  • Jewel,

    If I am not mistaken Comcast’s long term disability plan is insured through Liberty Life Assurance Company of Boston (Liberty Mutual). Have you had any communication with them as to the LTD claim? I believe that you are correct in your synopsis that Sedgwick is denying the remaining amount of STD benefits in an effort to see LTD benefits denied. One word of caution with respect to the severance – most severance agreements include a waiver of all rights under various insurance plans- which means you could waive rights to your LTD benefits. Please feel free to contact our office to discuss your claim in greater detail.

    Stephen JessupNov 7, 2014  #353

  • I was working for Comcast and on 5/16/14 on my way home from work I was a passenger in a car accident. The other driver was at fault as he was by his own admission looking at the wrong light so he was accelerating and ran right into the passenger’s side of the vehicle totaling my friend’s car and as a result I suffered herniated discs in my back and neck. I have been receiving payments while out but every two weeks I had to fight with them as they kept saying they weren’t receiving the documentation. For the first few months, I would inform the doctor’s office of the information I was getting from Sedgwick. The doctor would resubmit and I would receive my payment. Now I am at the end of the 26 weeks of Sedgwick’s involvement and moving toward the long term portion of my benefits. On the 30th of October 2014 my doctor submitted the documentation as usual and once again Sedgwick is saying I am denied because they didn’t receive the documentation. This time what is different is that they are telling me I need to make an appeal. After viewing the videos on this page, I have come to the conclusion that they are trying to deny my long term benefits. My doctor declares he submitted the information on time as requested. There is another thing, on Nov 1, 2014 my department was closed and our jobs were outsourced. Since I am not in physical condition to go back to work, I was unable to apply for any of the 16 positions they were offering to 16 members of my department. This leaves me out in the cold. I can not only not apply for any of the positions for Comcast, but I cannot apply for work with anyone. I opened my claim on 5/19/14 and technically my 6 months are up on 11/19. Comcast has agreed that the separation date from them would be 11/26 so I am within the time frame to collect my long term benefits. And they have offered severance pay up to 11/26/14. I feel like my back is against the wall and I don’t know where to turn. If i take the severance and the unemployment, will that bar me from long term benefits? And is it legal what they are doing?

    Jewel WitherspoonNov 6, 2014  #352

  • Josie,

    Sedgwick is a third party administrator for your company and not the insurance company. In light of same, I would suggest you contact your HR department to vocalize your concerns and get a better understanding of why you are only being paid the $84, as this does not seem to make sense. Please also note that since Sedgwick is not an insurance company they funds to be paid do not come from their assets but rather those of your company and/or company’s established disability plan.

    Stephen JessupNov 6, 2014  #351

  • Dean,

    It is highly unusual that you would not have received a response from our office if you called, I am sorry if that is the case. If your claim is under Walgreen’s Worker’s Compensation insurance (which it appears to be) please note that we handle claims under disability insurance policies and not worker’s compensation. If you do not trust the attorney you hired to handle your claim I would highly suggest you consult with another Worker’s Compensation attorney.

    Stephen JessupNov 6, 2014  #350

  • I put my claim in on September 1st 2014 it is now November 5th 2014. I am about to lose my house in which I have 4 kids one with a newborn. Sedwrick approved my leave from 8/1/14 through 2/1/15 but my short term disability was not approved. They only want to pay $84 form October 16 – November. That’s it. What the hell, I can’t live off of this with a family. I’ve worked 14 1/2 years with the company and Sedgwick keeps giving me the run-around. I call daily in which they’ve only called me 3 times since September 1st. Every time I call they keep giving me excuses. Example today the excuse was “They just got your paper work today an will review it tomorrow”. A class action lawsuit needs to be filed against the company. They just sit on their asses and collect OUR money! They are sick! The other comments I’ve seen on here and the people didn’t get approved is sad, people who need this and they are getting turned down for ridiculous reason. It’s pathetic.

    Josie BrownNov 5, 2014  #349

  • I haven’t worked since 4/26 after slipping off ladder at work for Walgreens and compound fracture of L2. Had surgery to inject cement into spine to correct the situation. Had over 20 PT visits and my doctor requested ESI – epidural steroid injections on 8/27. Denied on 9/16 by Sedgwick pending IME. IME on 10/1 – their Dr. agreed I need ESI’s after MRI. Had MRI 10/15 – agreed ESI’s needed but needed a follow up with the pain management specialist. My condition is worsens as it has been over 2 months since the initial request and they are taking their good old time hoping I will just give in and go back to work. In the interim, I have developed severe depression and anxiety which is causing many other problems. I want to go back to work but can’t sleep at night, toss and turn because of pain, can’t stand for longer than an hour with out pain, have limited range of motion, degenerative disc disease and arthritis in lumbar region. No one cares about us a human beings, only the amount of money they think they can save by denying things. They’ve paid my Dr. for several more visits, paid for an MRI that my Dr. doesn’t think is necessary and also paid me 2 extra months of TTD. I feel if I were able to get ESI’s I could have been back to work. This company and I’m sure others like it is just part of all the red tape and bs they put people through that really need the help because of others that have tried to milk the system. I have always worked and never looked for hand outs. I’m at the end of my rope because it has been 6 months since I’ve not worked and my employer, Walgreens has the right to terminate me after 1 year and if this happens, I will lose everything and become homeless and destitute. I’ve called your office twice without a response and I don’t even trust my current attorney. Where does one go to get the help they need?

    DeanNov 5, 2014  #348

  • Ruby,

    I am sorry to hear about your health and troubles with Sedgwick. Please feel free to contact our office to discuss how we may be able to assist you with your claim.

    Stephen JessupNov 5, 2014  #347

  • Ruby,

    I am sorry to hear about your health and troubles with Sedgwick. Please feel free to contact our office to discuss how we may be able to assist you with your claim.

    Stephen JessupOct 28, 2014  #346

  • My is Ruby Flanagan. I have worked for Walmart for 24 years. I have STD, STD plus, LTD. I had a heart attack in March 28, 2014 and they stopped two heart attacks. I tried to go on leave of absences but they told me I didn’t work enough hours to get a leave. I have a heart disease, coronary artery disease, small vessel disease, 6 disc messed up. I have been fighting for my STD since 7/7/2014 – 08/31/2014. I went back to work September 1st and went back out September5th through September 23, 2014, then I went back to work, went back out on September 25, 2014. And I’m still off. I have not received any money from them and I have paid into this insurance 24 years. I have given them everything they ask for. I just spoke with Betsy Hines she took me if I had the heart attack they would be paying, but because the hospital stopped it, she said I wasn’t disabled. They denied my claim. I spoke with a Brian he told me most likely they would denied me again. I was welcome to get a lawyer but I was wasting my time. I don’t only want paid while I have been off. But I want to sue them for pain and suffering. I have a lot more to tell you. I feel like I have been treated unfairly. I want to sue for more.

    Ruby FlanaganOct 27, 2014  #345

  • Michelle,

    Clinical evidence of Anxiety (or any other mental health disorder) is usually noted in the records submitted by your treatment provider. It is not uncommon that a provider does not documenting the records sufficiently. Please feel free to contact our office to discuss your claim further.

    Stephen JessupOct 24, 2014  #344

  • I am in a similar situation as Matt. Was put out of work in November due to anxiety. Sedgwick is constantly denying my claim. They’re asking for test results/clinical evidence. Can you represent me against them? Do you know what would be considered clinical evidence for anxiety? Is there any commission that we can report Sedgwick to?

    MichelleOct 23, 2014  #343

  • Spontaneous,

    Please feel free to contact our office to discuss the denial of benefits in detail.

    Stephen JessupOct 19, 2014  #342

  • Wow, this is the most shocking thing I have heard and am very surprised. Literally as we speak an incident occured at my place of employment (below is an example of the time frame).

    Incident occurred May, 2000. Sedgwick has paid and accepted incident. While seeing doctors for almost a year pertaining the case, Sedgwick has denied the claim which now ends up being SDI.

    If I am able to go over the issues over this site I would but for confidentiality I would like to be contacted.

    SpontaneousOct 18, 2014  #341

  • Matt,

    Without an understanding of your medical conditions and their effect on your ability to work in your designated profession it would be impossible to say what information would be required to secure benefits. With respect to AT&T terminating your employment I would strongly suggest you speak with an employment attorney to see if you have any rights as they relate to the termination.

    Stephen JessupOct 17, 2014  #340

  • Izora,

    Unfortunately, as the appeal is due in three days we would not be able to assist in the drafting of same. What I can suggest is that you make sure to provide Sedgwick with all pertinent medical records supporting your husband’s disabling condition.

    Stephen JessupOct 17, 2014  #339

  • Was put out of work January 1, 2014 due to severe anxiety and severe chronic asthma by my doctor. Sedgwick kept claiming I never sent any medical info. As of September 1, 2014 with no warning AT&T terminated me. I contacted the CEO of Sedgwick letting him know I have 70 pages of medical information with fax receipts. He told me to fax them to him and he will review them under the appeals process. What else do I need to do to get this approved? Can I sue? AT&T definitely violated my civil rights as I was unable to work?

    MattOct 16, 2014  #338

  • My husband has been on short term disabilty since July. He was diagnosed with congestive heart failure, acute on chronic systolic and diastolic heart failure, Nyah class 4, ischemic cardiomyopathy, coronary artery disease, prostate cancer, type 2 diabetes. In July went to the hospital because he was having breathing problems, they transported him to another hospital and the next day they put in a s/p defibrillator, AICD because of severe ischemic cardiomyopathy. His heart was only working at 20 percent. He still gets short of breath and falls asleep frequently, tired all the time. Sedgwick has stopped his short term disabilty and has denied his claim. He has until Oct. 23 to repeal his claim and cannot find a lawyer that has any knowledge of Sedgwick and how they work. We don’t know how to start with the appeal process can you help?

    Izora ArmstrongOct 16, 2014  #337

  • Kathy,

    I am truly sorry to hear about your loss and struggles. If you have not already appealed the denial of benefits please feel free to contact our office to discuss your options in detail.

    Stephen JessupOct 15, 2014  #336

  • I have been paying for short term disability plus benefits as a payroll deduction for over 7 years. In Feb. I lost my only daughter and I am raising her two year old daughter. I went to my family doctor in early September for several reasons. I was told I had fibromylgia, arthritis, copd, anxiety and depression. She took me off work and ordered several test to be done. I filed for my benefits through Sedgwick and was approved for the medical time off, but denied for the pay benefits. Said the disability didnt match the medical. Now I have to appeal it. I’m one of those people who live paycheck to paycheck but always paid my bills. But since this denial which i feel was not properly considered all my bills are late, my car is ready to be repo’d, I have disconnect notices of electric and gas, I’m losing my car insurance.. .all because they denied my claim. I have had no money at all come in, in two months, I am losing everything, because of a policy that I have paid for. They also did not pay my medical premium which is the plus part of my benefits, so they cancelled my insurance and now have a bill for $9980. If or when I can go back to work, if I have a car to get to work, I will be cancelling that benefits, because it is all corrupted.

    KathyOct 14, 2014  #335

  • Somia,

    In Washington State the Department of Labor and Indrustries is supposed to enforce the law. It appears though, that they have been manipulated to the point they refuse to sanction Sedgwick for anything at all, even blatent violations of the written law of which yours is in writing. If you go to the State website for L&I, you can access everytihing about your claim, read up on the laws that they are supposed to abide by, and find out who to contact in that department. I worked for Boeing and they have paid so many people off that it is impossible to get the State to follow the law. Anyway check out that website and see if you can find the answers you are in need of. You want to look for the Third Party Administrator within the States L&I department.

    Tim HaightOct 10, 2014  #334

  • Sedgwick is horrible. They care only about the employer. I do have lawyers (I hired a lawyer 5 months into this), but it’s like Sedgwick doesnt care, they are going to do what ever they want.

    At first Sedgwick helped me than they denied medical treatment and recently delayed temporary disability. I was injuried in a multi-vehicle accident over 2 years ago at work. Staples were put in my head, plus I had a back injury and groin injury. MRI ordered 1 month later showed 4 mm disc bulge. Workers comp. clinic did spinal manipulation for 2 months after the accident. They used cycling to deney the groin injury which I ending up using my own insurance to pay for surgery for the groin injury. I have been to around 40 rounds of physical therapy, which they tried to deney around 12 of them. I made it back to work about 10 months after the accident. But I had pain from waist down, tremors, and hypertension, which all got worse since coming back to work. A MRI and CT were denied twice, even with 2 different doctors wanting them done. Back injections were denied at first than they were approved a month or 2 later. Then I was able to get a MRI and CT done with some help a couple weeks ago and the CT found that my pelvis was fractured in 2 spots. One healed and the other didn’t, midway down the SI joint on the sacrum.

    If they would just take care of hurt people like they are suppose to, people could get back to work after the proper treatment and it would cost them a fraction of the price!

    GordyOct 9, 2014  #333

  • Sonia,

    Sedgwick is a third party administrator for your company’s disability plan, they are not the entity legally liable for violating terms of the plan. It would technically be your employer, or more specifically, your employer’s disability plan that would be held accountable.

    Stephen JessupOct 9, 2014  #332

  • I live in WA state. Who holds Sedgwick accountable for not paying me every 14 days, which I was told by my employer was required by law?

    SoniaOct 8, 2014  #331

  • Nikki,

    Do you have any additional appeals or is your only option to file a lawsuit at this point? Unfortunately, if you do not have FMLA and your claim for disability is denied, many employers will sever employment on grounds of job abandonment. Please feel free to contact our office to discuss further.

    Stephen JessupSep 23, 2014  #330

  • Tim,

    It would appear that your claim is for Worker’s Compensation. If you do not already have a Worker’s Comp attorney I would highly recommend you get in touch with one as soon as possible.

    Stephen JessupSep 23, 2014  #329

  • I have worked at AT&T call center for 7 years. Very stressful job. In May we changed to a retention office and my performance level went down, began feeling anxious and had just been coping with racing mind, no sleep etc. I took several vacation days because I got to the point where I felt like getting hit by a car walking across the street to work was a better option than dealing with the stress of that environment and the day. Got to where I didn’t want to leave house. In July I had a severe panic attack at work / breakdown and my director was very helpful told me to have my husband pick me up and get myself better. I immediately saw an AT&T Eap therapist and medical doctor. Diagnosed with severe depression, anxiety / panic attacks and placed on meds: an anti-depressant, Xanax and sleeping pills. Therapy once a week. Both doctors submitted proper paperwork to support my need for short term however Sedgwick denied my claim stating I can still sit, type and talk, which are my job duties. Forward 8 weeks, I’m on new meds because the first ones were not working. Still no energy, no sleep and add to the mix worsened anxiety causing me to pick / self mutilate as my doctor calls it. New documentation was sent in to Sedgwick to support social anxiety disorder, depression and self mutilation. Again denied. I’m out of options and getting worse and can’t deal with this. Help please!

    To add to it I received a letter advising I need to be back at work next week or they are removing me from payroll.

    NikkiSep 22, 2014  #328

  • I worked for Boeing in Everett Washington, they like others use Sedgwick for their injury claims. Four years ago now I exploded a disk in my back while working on their 7LATE7. I have endured 2 major back surgeries, have spent countless hours at 13 different doctors, have perminante nerve damage down my left leg from botched treatment, it has now grown to include my right leg as well. In February 1014, I traveled to another doctor in Salt Lake who diagnosed me with CRPS directly related to this injury. The claims manager at Sedgwick, Heidi Coleman, has done everything in her power to keep me from getting treatment, from not paying my doctor for over three years now, dispite State orders to pay, has refused to pay legitimate bills for medications, travel, tests and many other things. The Boeing company has the State of Washington department of Labor in their pocket, refusing to sanction them for blatant violations of the law, from closing my claim without sending any of their so called IME doctors that they sent me to, to my attending prior to claim closure for review as the law states and many, many other outright illegal violations. They tell you what is done is done and it can’t be changed, this is totally a bunch of garbage. If you are sent to prison and it’s later found that the prosecution broke the law during your trial, they over turn the conviction. Not when it comes to Boeing or Sedgwick. I live my life on heavy amounts of narcotics, fentanyl, tisazidine, gabapenton, cymbal tea and others. These drugs make it beyond dangerous to even operate a washing machine let alone work, they make you fall asleep at any time, vision issues, depression,sever memory impairment, and a list a mile long of other nasty side effects. I can not even get out of bed because the pain is so bad I am in tears most the time just trying to cope.

    Don’t ever ever ever accept payment from a workers comp or Labor and Industries claim, they don’t tell you that once you accept money from these firms you loose all your rights to sue your employer for negligance or anything else. This is the law, and they go out of their way to make sure you don’t know it. I have been fired, one month short of being vested in the company because I refused to return to work as they ordered me to, while I have written instructions from my attending doctor that I can not work, do you think the State did anything about it? Not a chance. Their so called IME Doctors are anything but independant, they are paid by your employer and issue the exact report they ask for. Folks, 13 doctors from both sides of the world have said the same thing, I will never be fixed, there is no cure for the nerve damage I received, and I will never be able to work again. Yet they send you to their IME, you see them for like the man from Fritos said for a very short amount of time, they do no tests other than minimal exam items, no scans, nothing, and issue a report that Sedgwick uses to cut off your benefits. I have lost my home, my car, everything I had worked my entire life for due to their lies and deceit, yet no one will take a stand against them because the Boeing company employes so many people in the state and pays so much in pay offs to keep the system in their favor. Did you know that because Sedgwick is a quote “Third Party Adminnistrator” that the insurance commission has no authority over them to as the law states make them treat you in good faith. These companies know this and use it to deny you what you rightly are intitled to by law. I’m to a point that I can’t even feed myself, or my family who has stood beside me through this nightmare, that I am about to be forced to go to work, which through no fault of my own, put anyone, be it employee, customer, person on the road if I end up having to drive in grave danger of injury or even death due to what these drugs I am forced to live on due to you. It won’t be intinentual but an accident will happen and someone will either be severely hurt or even killed because these companies are allowed to force people to be in situations no one should ever be in to survive.

    I’m am forced to either live my life in dibilitating pain, letting these meds kill me slowly, or choose to end my own life to get relief from this Pain caused by their neglect. I am not smart enough to figure out how to beat them at this well rehoused game they are allowed to play with people’s life’s, but I would love to hear from anyone, in great detail, about your experiences with these monsters. Please feel free to email me at tha1672338@aol.com. Maybe if we band together, we can stop companies such as Boeing from using people until they become a liability to their company, from being left with they desperate choices I have to make, I have nothing as I stated, and I am now having to sell this trying to keep a roof over my head and food on my family’s table. Please help if you can, I beg you, I am more than desperate and my time is up. Please send me your support and your stories and maybe we can find a way to beat these assassins at their own game.

    My apologies for autocorrection on the computer, I think you can figure out what I was trying to say. Again I hope this can help someone before they are put in a position such as mine.

    TimSep 22, 2014  #327

  • I am scheduled for surgery I’m the next couple of weeks and have been out of work for over a month. Sedgwick has 6 years of medical problems sitting on a desk somewhere. I have to pay rent and for my medicine but they still have not made a decision about “my claim”. I guess I won’t be getting my necessary medicine or paying bills. To top it off they want me to pay my health insurance premium. With what? Are they going to cancel my insurance now too? All I want to do is get healthy and back to work. I get the impression they don’t care if I ever go back to work or even able to get my medicine. Reaching anyone is impossible. I can’t work but they don’t care.

    KayeSep 19, 2014  #326

  • I am suffering from severe depression, anxiety and memory loss for eight years, now it’s gone worse. I am alway in hospital and absent from work. I have being admitted in hospital for three weeks in August for treatment and evaluation was done to see if I can continue working. After all the specialists did the evaluation it was said I should be medically boarded off. All my documents for disablity was compelted by me and my pychitrist and the medical reports were given to my company to be sent to their insurer. Can I work while I am waiting for my disablity claim to be proved?

    Gonsagrie ReddySep 18, 2014  #325

  • Sharon,

    You will need to consult with an attorney who specializes in Worker’s Compensation to discuss your rights.

    Stephen JessupSep 18, 2014  #324

  • Katherine,

    We handle claims for short and long term disability insurance benefits, and do not handle Worker’s Compensation claims. I would suggest you consult with your attorney in greater detail as to your concerns and questions.

    Stephen JessupSep 18, 2014  #323

  • Katherine,

    We handle claims for short and long term disability insurance benefits, and do not handle Worker’s Compensation claims. I would suggest you consult with your attorney in greater detail as to your concerns and questions.

    Stephen JessupSep 18, 2014  #322

  • I got carpal tunnel and filed workmans comp through employer Cardinal Health. For awhile I was getting paid then and going to the doctors then all of a sudden they stopped paying me just like that, no explaination and then I called sedgwick and they said I should of returned to work 2 months ago, I told them I have dr statment telling me I was released, they stated they have release to work no restrictions but I did not receive anything nor told otherwise. I called the dr which stated I was released to work no restrictions I stated then why didn’t I get a note releasing me, they stated nothing just kept telling me I am under care but no restrictions but, nothing was told to me which I find very funny, I am the patient and I was told nothing. So, needless to say, I am very upset and will not return to work to make this injury worse, also the same dr referred me to a neosurgeon, ok if I can go back to work then why was I referred further.

    SharonSep 17, 2014  #321

  • I’ve been dealing with Sedgwick since 2012. I got injured working for Target. When I reported my injury, they told me to finish working, go home and rest but instead I went to ER. When I started receiving medical bills I approached Target’s store manager and HR. They told me they weren’t going to pay me to sit at home and watch TV. I went and hired a lawyer. Sedgwick kept giving me nasty phone calls and demanding me to return to work. Soon after, Target’s HR recommended me to get Medicaid and have them pay for my bills. My lawyer at the time told me that’s illegal. 2 years go by and they offered a settlement. We discussed it and agreed upon signing the section 32. The judge said that my medical coverage was continued until the next section 32 hearing. Well, it’s been 6 months, I come to find out I haven’t received the hearing due to Sedgwick – they have decline all my medical payments to my doctors and they’re saying I should cover it from my settlement, which my lawyer said the agreement was they are supposed to pay until my section 32 hearing. So now I don’t know what to do, since I’m in college, single mom and my new job it’s only 26 hours a week. These people are monsters; they have stopped paying for my medications and my lawyer hasn’t given me a time frame.

    KatherineSep 17, 2014  #320

  • Laconn4,

    You will definitely need to consult with a Worker’s Compensation attorney to determine your rights. Additionally, contact your employer to determine if they provide any disability insurance coverage that you might be covered under.

    Stephen JessupSep 13, 2014  #319

  • I’ve been injured now for a year, sustained a concussion which led to memory loss, seizure disorder and MMD. They stopped my benefits 3 weeks ago without notice or reason. I went to their IME appointment over 2 months ago and still haven’t heard anything.

    They don’t return calls or emails. This is crazy, what they do to people, and they don’t care. Bills are being shut off, I’m beyond stressed, my medication has been raised due to stress and anxiety. I was hospitalized for an extreme panic attack and stopped breathing, I woke up in ICU with a breathing tube down my throat.

    I’m ready to just end it, I can’t mentally handle the stress.

    A.D.Sep 12, 2014  #318

  • I was injured, while driving a transit bus for the C.T.A. Which required me to have a A.C.D.F with a titanium plate, screws on March 11, 2012. I was in a lot of pain before, after surgery. Well, Sedgwick only gave me benefits 10/12/11-09/15/2012.

    When my surgeon said I was MMI, my workman comp benefits was discontinued. I tried returning to work three times, but I was having excruciating pain. It’s September 11, 2014, I’m having chronic pain. I was also told my surgical site is infected. That’s why, I’m having chronic pain. I haven’t received a workmans comp check since 2012. To my knowledge Sedgwick employers are working against us, the employees.

    Laconn4Sep 12, 2014  #317

  • Disgruntled,

    Approval of FMLA does not guarantee that Disability Benefits will be awarded. Although each claim operates under the same set of facts, the requirement to receive each is different, and therefore receipt of one does not guarantee the other. Similar situations arise when someone is awarded SSDI benefits but a private insurance carrier determines the person to not be disabled under the terms and conditions of the insurance policy.

    Stephen JessupSep 12, 2014  #316

  • Like so many others, Sedgwick is taking it’s sweet precious time. I currently just received FMLA approval from Sedgwick – my guy for that is amazing, possibly the only competent employee they have. I also have a short term disability appeal from July 2014, which was denied because I did not follow their “instructions” properly. They said that my doctor needed to contact them every thirty days for an update on my treatment/progress, even if I am under the same treatment plan, still unable to work, while waiting to see a specialist in September.

    My question is this… If they have approved me for FMLA leave which precludes that I have a serious health condition – the same health condition from the appeal, are they required to also approve the short term disability for that same health condition?

    DisgruntledSep 11, 2014  #315

  • Denied,

    It appears that Sedgwick is continuing its usual tactics and the denials have prompted the need to file an administrative appeal. Please feel free to contact our office to discuss how we may be able to assist you.

    Stephen JessupSep 8, 2014  #314

  • I am a health care provider currently employed (I think) by an HCA facility. I have been off on std since the end of April. I am suffering from major depression, severe anxiety, panic attacks and PTSD. All was going well until I was hospitalized for my condition due to worsening symptoms and the need for a medication change. The psychiatrist at the hospital failed to “completely” fill out the paperwork/or to Sedgwick’s satisfaction. Instead of my “disability advocate” faxing back to the Dr. and asking him to complete the paperwork, she denied my benefits effective 8/4/14 based on the lack of supporting medical information. I have been trying to fix this situation since the 22nd of July, trying to get the paperwork completed and re-faxed… it was again denied. So I had to appeal the decision or the “denial” would stand. Here I was ready to slide into home base and return to work until this denial letter, stress, increased anxiety and depression was so bad this went on and on, until I ended up back in the hospital the 18th of August. It is now the 7th of September, I still do not have completed paperwork, return to work release and no pay. I am widowed and have no other source of income. I am now being told that even though three physicians, two of which specialize in mental health have stated I can not go back to work, that I have to write a letter in my own words explaining “why I feel I can not perform my duties”. I wonder if I was a cardiac patient if they would ask me to write such an appeal letter? I will be back up tomorrow trying to fight the system, get the paperwork I need and appeal this decision. I am currently searching for the right attorney to help me fight Sedgwick. Any referrals to a fabulous attorney would be awesome. Also, I am going to make a formal complaint to the State of Missouri Insurance Commissioner. I hope I can hang in there without having to return to the hospital once again.

    Denied and HopelessSep 7, 2014  #313

  • N. Tunstall,

    If you still have an Appeal of the disability denial please feel free to contact our office to discuss how we may be able to assist you in securing benefits.

    Stephen JessupSep 7, 2014  #312

  • On June 3rd, 2014 I was sent home from work extremely ill. I have been ill on and off since we returned from back east in April 2014. I submitted a claim to Sedgwick due to my illness being constant. I’ve had high fevers, flu-like body aches, severe headaches, “fainting/blackout” issues & being found unresponsive and taken to ER via ambulance (my job requires me to carry a 9mm & M16, also climb several flights of stairs!), yet Sedgwick has denied my claim due to “the tests show no illness”. Hence, seeing different specialists, now seeing an Infectious Disease Specialist. I now have my denial under an appeal.

    I have seen doctor after doctor and specialist after specialist, my doctors have sent Sedgwick paperwork & more paperwork with recommendations of not returning to work until they can “find the source of my illness”.

    I have exhausted my 12 weeks of FMLA, I’ve not been paid since June, & now our company has informed me that I have till Sept. 11, 2014 to return to work or face termination! Had Sedgwick approved my claim in the beginning (under doctor recommendation) I would not have used up my FMLA, I would not be enduring this additional stress & my body would have one less issue to deal with. How can individuals that are not seeing the patients first hand go against a licensed medical professional? Where can I go for help? Who can help? I feel trapped & at a complete loss! Please give me some direction!

    N. TunstallSep 6, 2014  #311

  • Betrayed,

    Do you have any additional appeals left or is your only option at this point to file a lawsuit? Please feel free to contact our office to discuss what rights are available to you and how we may be able to potentially assist you.

    Stephen JessupSep 4, 2014  #310

  • Paul,

    I am sorry to hear of your difficulties. Please feel free to contact our office to discuss your claim in greater detail to determine what can potentially be done at this point.

    Stephen JessupSep 4, 2014  #309

  • I recently have gone on short term disability due to severe symptoms from a hormonal imbalance. I currently just started therapy less than a week ago. Sedgwick denied me for MY benefit, the one I earned through the company I work for. The reason for the denial was medical information did not support short term disability. I argued with this jerk telling him it takes time to see specialists, nevertheless, I escalated the call to a supervisor whom approved the leave, (my doctor told them 2 months, she approved it for one) but told me they would need more doctors notes to extend it. I had my doctor as well as the specialist send them the notes, Sedgwick got back to me telling me it was denied again! I asked why, they said they needed the specialists to put in writing that I could not work. I asked why didn’t you say that initially? Their response was sorry that should have been messages to you. So, I had the specialist send them a letter stating that I would need one or two months to allow therapy to work. They called and denied it again. This company is no doubt committing fraud, and the companies that hire them are also committing fraud. The unfortunate part is they are costing not only the company more money by causing much stress and aggravation to the employee in result making it more difficult to heal because as we all know stress makes us sick. They are also costing the economy more money, by having more people rely heavily on their state disability benefits, as in the state of California where no taxes get taken out. I just want to get back to work feeling good again being the Dad and husband I was prior to becoming ill, and it doesn’t help that the soulless people at sedgwick don’t care to understand. I will be the biggest advocate from my company as well as others to stop using this company and drive them out of business along with any companies that behave like them. It can’t be that hard. Let’s do this!

    BetrayedSep 3, 2014  #308

  • I have been on my job for over 15 years. In that time, I have had to use Sedgwick 3 times. Once for a bone disease (avascular necrosis) in which I had to have a hip replacement, once for a hernia, and most recently for a bacterial pneumonia. Each time I have had to contact and ask these people for short term disability help, I have gotten a horrible experience. They give you the run-around shuffling your claim and demand deadlines that are hard or almost impossible to meet. I had to wait 6 weeks for my first check, causing my bills to go behind and forcing me to drain savings to feed my family. Once they get the huge packet of forms they want filled out by my physician (he had a good laugh at the size, amount and type of questions they wanted answered), they then inform you they have a certain amount of time to “review” your claim. Then my doctor still found on my follow up x-ray and examination that my lungs still were not completely clear and I had quite a bit of wheezing, so the claim needed to be extended. Instead of just letting my doctor fax them over a simple form or letter in his office, they decided they have to start the whole process over again! They assign the claim to a certain person they call the “examiner” and every single time I have tried to contact this person they switch me to her voice mail, and she has never once has returned any of my calls. Now here I sit, with no check coming in again next week, and in the same situation. They make recovering from your illness worse then the illness itself as it has caused me much grief and worry, and unnecessary trips to the doctors office to try and get the matter they caused solved. This company is terrible and their practices shady to say the least. They need to be stopped or reigned in, this is totally ridiculous over a claim for bacterial pneumonia in which I spent 2 days in the hospital. They make it hard on people on purpose, and it needs to stop.

    PaulSep 3, 2014  #307

  • Very Worried,

    Do you have a concurrent Disability insurance claim with your employer? Our office handles Disability Insurance claims, as such you will need to discuss your situation with a Worker’s Compensation attorney. Please feel free to contact our office and we can assist you in contacting a qualified attorney.

    Stephen JessupSep 2, 2014  #306

  • I work for an auto maker and I have been off if work for a year now because of carpal tunnel in both hands. I also was complaining of my right arm hurting me so bad that the simplest task was difficult to do. I had carpal tunnel surgery in February of this year on my left hand with plans to have surgery on my right hand after the left hand healed. They also gave me a cortisone shot in my right hand when I had the surgery on my left hand to try to alleviate the pain that I had in my arm. So my doctor sent in a amended claim to add the problems that I was having in my arm and they sent me to one of their doctors. Well this doctor did not do anything except ask me a lot of questions & asked me to do things like put my fingers together, lift my arms and a couple of other things. So I went back to my doctor on several other occasions because of the complications that I had with my first surgery and the ongoing pain with the carpal tunnel & my arm. My surgery was scheduled for the surgery for my right hand and a couple days before the surgery the doctor cancelled because he said that he was referring me to the Cleveland Clinic because he thought I needed to see a specialist. But in the meantime they cut my workers compensation because the doctor they sent me to said that I reached the MMI. So needless to say I’ve been without any money for about 2 months. When I went to Cleveland Clinic the doctor found out that I had carpal tunnel in my right hand, the pain in my right arm was determined to be tennis elbow & I also have trigger thumb in my left hand which I already had surgery on. Now where do I go from here because I’m waiting on approval for the carpal tunnel surgery and how do I get them to add the tennis elbow & trigger thumb to my claim and will they owe me back pay? Please help cause I don’t know what to do!,

    Very WorriedSep 1, 2014  #305

  • Ann,

    It appears that your claim is for Worker’s Compensation benefits. I suggest you contact an employer specializing in same to discuss your rights. Please feel free to contact our office and we can assist you in finding a Worker’s Compensation attorney to speak to.

    Stephen JessupAug 30, 2014  #304

  • Paula,

    Have you made a claim for disability benefits under Apple’s disability insurance plan? If not I would highly suggest you investigate same. Please feel free to contact our office to discuss your options further.

    Stephen JessupAug 29, 2014  #303

  • I have been off work 4 months now, all Sedgwick has allowed is one shot. I have 4 disks out, had my MRI, in able to get shots to go back to work, instead I’m sent to the IME doc. In turn it’s been 5 weeks, no one has returned my calls. I went above my adjusters head and called her supervisor and he did not return my calls?! I called my state rep, who is checking into this? I find it negligent on Sedgwick’s part, all I figure is the IME report did not go their way, so now I feel like I’m in limbo and all they had to do was allow me to recieve 3 series of shots, 2 doctors recommended it! And I’d be back to work. Funny they waste paying you but not fixing you? What more does this backward insurence company want? I followed the rules, yet they break em. This should be against the law, to allow people to sit in limbo. I see why Massachusetts stopped lawsuits, this company should be out of business. So I will now seek an attorney, seeing they like wasting money and my time, they now can pay the high attorney costs seeing money is nothing to them LOL.

    Ann WhiteAug 29, 2014  #302

  • I was approved for FMLA in April 2014. I have severe pain and am going to be operated on in Sept. I became ill with my sugar levels being elevated and have missed a lot of work and was having my Dr. refile FMLA paperwork to increase my allowed days off from 2 to 3 a month to 3 days a week.

    Suddenly my FMLA claim is closed; Sedgwick claims I didn’t accrue enough hours and my job at Apple for last 8 years is in jeopardy.

    I need help.

    Paula GardnerAug 28, 2014  #301

  • I applied for short term disability through my employer and it was denied because my employer failed to submit my EOI and health approval during open enrollment. My employer will pay my STD but I have to sign a waiver for long term disabillity.

    Nelsie Marie AntiqueAug 27, 2014  #300

  • PM,

    Sedgwick can certainly be a nightmare to deal with. Please feel free to contact our office should you need any assistance with your claim for disability benefits.

    Stephen JessupAug 14, 2014  #299

  • My ongoing STD claim was just denied because of a clerical error by my surgeon which was corrected before the required 7 period in which to get Sedgwick my updated records and have my claim period extended. My last visit to my doctor was on 7/31 and as of today, 8/13, I have still not received a denial letter and the information on how to start the appeal process. but I was just told verbally and of course much of my check was not there. I spoke with my claim handler’s supervisor who informed me that once I am denied, it is too late, I just have to start with an appeal and they will get it looked at and inform me regarding approval within 45 days. They even admitted to me that they have the information required to extend my leave, but refuse to fix the problem with me without appealing it. I am the main income in my home and pay 95 percent of the bills. Now, almost halfway into the month I am told that I will not receive any form of payment starting back at the first of this month. I will likely be forced back to work, in a very labor intensive job with a double hernia repair that is not healing in what Sedgwick considers a “reasonable amount of time” – even though my doctor doesn’t want me back at work – I am still having severe muscle spasms and pain. These people absolutely do not care about you as a human being. They do not care that you have bills to pay. They do not care if you have done everything within your power to jump through their hoops and do what you ask and have done it right. Their supervisors will not return your phone calls – you have to demand to speak to them and endlessly wait on hold.

    If you are a company that is looking to find a self insurance administrator for your company I highly suggest that when you get to their name in the list, keep looking, they will only add aggravation and frustration to the life of your employee that is trying to get back on their feet and come back to work.

    Sedgwick Co. employees should be ashamed of themselves and I hope they have trouble sleeping at night knowing that they are screwing over hard working people who have paid for their harassment and mistreatment through years of hard work for “benefits” that are hardly what the name implies.

    For the record, you have no recourse through your state insurance commission or the US Department of Labor because a company that is self insured (your employer) is not under their jurisdiction and the Dept. of Labor will only help you if you are denied and appeal at all.

    I will be looking into the services of these attorneys should be first attempt at appeal not be handle quickly. I will do it knowing that some of the money will be lost to the attorneys, but I will do it because if enough of us do, just maybe they will treat us more like human beings.

    PMAug 13, 2014  #298

  • V,

    Please feel free to contact our office to determine if we may be able to assist you.

    Stephen JessupAug 12, 2014  #297

  • I have been dealing with Sedgwick for almost 2 years now. They paid me for the first 24 months and denied it after that even though medical reports side with me on my ability to hold a job that meets their own requirements of their definition of being able bodied. I have a lawyer and he feels we have a reasonably strong case. The problem is now that a suit has been filed he called to say that they were able to have the venue moved to St. Louis Missouri federal court. I worked and live in Alabama. He has until Friday to respond but he said that if they are successful we would not be able to represent me in Missouri. Is there anyone that you might know who could pick up the baton on a contingency?

    Any help would be appreciated.

    V. TurnerAug 11, 2014  #296

  • Lyh,

    Is your claim with Sedgwick a disability insurance claim? If so, please feel free to contact our office to discuss how we may be able to assist you.

    Stephen JessupAug 1, 2014  #295

  • Darlene,

    As we handle disability insurance claims I would not be able to properly advise you of your rights under worker’s compensation laws. I would highly suggest you contact a Worker’s Compensation attorney to discuss your rights.

    Stephen JessupAug 1, 2014  #294

  • I just had a surgery for a cervical neck injury. Not only was my surgery delayed for almost a year (causing more damage and suffering) post surgery I have not been paid by Sedgwick in over a month. No return calls not responses at all. My HR dept is useless and bills are pilling up…

    LyhJul 31, 2014  #293

  • I was injured at work in January of 2009. I fell as a result of my employer removing floor mats from entrances, January ice and snow. I expected a mat to be in front of the door. 3 year battle ensued and I ended up never being fully reimbursed and now, same employer, I fall in the back of the truck after I had repeatedly asked for new cargo straps and bars for my truck. Sedgwick is denying claim and I am getting bills from the emergency room. Company security took me to hospital. And as an added bonus, I am being financially harmed. this company operates as though it is an illegal immigrant and above the law. Do we have any laws to protect workers or has this become a right to work state and right to be injured and lose everything by expecting to be protected by workers comp? I am a single mom who is trying to pay for her youngest son’s college education. I spent the boys college fund the last time I was injured and I am still dealing with issues with IRS over that injury.

    Darlene SawickiJul 31, 2014  #292

  • Dean,

    Please feel free to contact our office to discuss how we may be able to assist you with your claim under the disability insurance policy.

    Stephen JessupJul 25, 2014  #291

  • I was injured by slipping off a ladder and slamming into a 5 inch steel beam causing a compound fracture of my L2 on 4/26/14. I had surgery to repair it within 2 days and was sent home from the hospital with instructions to return to surgeon within 3 weeks. That’s when the nightmare of dealing with Sedgwick began. They did not file a claim with OHIO BWC until 5/15/14 and I did not receive any money from them for 6 weeks and it was for the minimum allowable because they said they had not received any information about my average weekly pay from the disability side of Sedgwick. This is where the problem is… they have a workers comp side and a disability side and they do not communicate at all. I had to do all the leg work to get the information required so they could figure out what they were supposed to be paying me and all it took was 1 phone call to my company’s records department. They would rather send faxes or email instead of picking up the phone and calling who they are supposed to in order to get the job done. I did not hire an attorney in the beginning even though friends and family kept telling me I should. In the middle of June 2014, I had left a message 5 days in a row for my “rep” and she has still not returned my call. The managers and/or supervisors are argumentative and defensive and do not listen to what you are asking and don’t even let you finish a question because they are to impulsive to shout out what “the rules” are. I’ve since hired an attorney to handle this claim for me as I am still trying to recover from my injury and have fallen into a deep depression because they are still not paying me what I am entitled to. After reading a lot of information online about Sedgwick I find it laughable that they are able to do this to people and for all of us to hire attorneys to get the job done.

    DeanJul 24, 2014  #290

  • Breanna,

    As your situation is a Worker’s Compensation issue and not a disability insurance issue I would suggest that you contact a Worker’s Compensation attorney to address your concerns.

    Stephen JessupJul 20, 2014  #289

  • I work for Walmart, and they go through Sedgwick. I got hurt on the job while stripping the floors to wax them. The machines are old and work correctly only when they want to, malfunctioned and slid pinning my knee between the machine and a blood pressure machine. I filled out the accident report that night but did not seek medical attention until 2 days later due to the on shift manager guilt tripping me about the company loosing money. I went to urgent care on the morning of June 15th after working a full shift because my manager didn’t think I needed to go (I threatened to sue if they did not allow me). The doctor thought I tore my MCL and took me out of work until I got an MRI of my knee. Sedgwick took a month to approve the MRI, they are STILL saying they didn’t get paperwork faxed by my family doctor, right along with the “not filled out correctly” – all the excuses they can find! After saying I was going to contact an attorney they forced me back to work before the MRI even happened, stating they could fire me if I did not return. After I returned (before the MRI) they retaliated. My store manager, and shift managers began treating me terrible. My store manager yelled at me on the floor in front of customers at the end of a shift to the point that I had a breakdown. The retaliation was so bad I quit on July 5th. Sedgwick says my leave is still pending (bullcrap) and I’m now receiving all the medical bills that they’re supposed to cover. What am I supposed to do?

    BreannaJul 19, 2014  #288

  • Jill,

    That is not necessarily true if Sedgwick is asserting policy provisions that require treatment and care under a doctor appropriate for the disabling condition.

    Stephen JessupJul 16, 2014  #287

  • If Sedgwick is stating you must see a psychiatrist then Sedgwick has to provide you with one to see. Also they should have sent you a letter as to the time, day and name of the Dr you are being sent to. It’s usually called an IME Dr. They can’t without documentation just tell you over the phone, they must respond with a letter.

    JillJul 15, 2014  #286

  • I am on STD and Sedgwick has approved my claim for 30 days. My 30 days is up today. They advised me that in order to continue to be paid for the time I’m out of work that I have to see a psychiatrist (apparently a requirement through my job) which is fine with me. The problem is, however, my insurance, EAP and Accolade has done a search for me and there are NO psychiatrists within 50 miles taking new patients for anytime in the forseeable future.

    Accolade is checking with their nurse aids to see if we can find anyone outside of my insurance plan that will take me. So we’re trying absolutely everything we can. Sedgwick has advised me that the psychiatrist is specifically for medication – ummm… my doctor gives me medication and she makes sure that it’s working for me… so if that’s the issue why can’t they just continue to follow up with her?

    When I brought this information up to my HR department he basically told me he would send it to corporate. He emailed me back today and said corporate requires the psychiatrist – even if one is not available to continue to get paid or keep my job – this is NOT possible so far, not just that I don’t want to do it, but nobody is available! Aside from creating a psychiatrist out of thin air I don’t know what else I can do here.

    Please help me! Can I file for unemployment since they aren’t paying me?

    P.S. I contacted the Labor Board – who referred me to the civil rights board – who referred to me the EEOC – I have been on hold for them for well over an hour and a half – but we will see what they say.

    BrittanyJul 11, 2014  #285

  • You must go over your forms and any information you send with a fine tooth comb. They will look for any loophole they can find to deny your benefits. And YES, they can and will lie to you. You must have ALL copies of documents your physicians faxes to them and the “fax confirmations” (dates and time). You will need these when they tell you “they did not receive anything from your physician”. They will then miraculously see that the files have been sent and further delay the process while they review them. You must get copies of your doctors notes pertaining to when they talked to Sedgwicks doctors and what was discussed (without this proof they will say your doctor never returned their calls). Any typo on the files your physicians send will be used as a loophole. Unfortunately, doctors are not attorneys and do not fill out papers with a legal mindset.

    We are currently trying to correct our doctors conflicting dates regarding “return to work date” and “limitations date”.

    I’m not sure if it will do any good, but there is a complaint form for “Employee Benefit Security Administration” (ERISA/EBSA) at the “Department of Labor” website – http://www.dol.gov/ebsa/contactEBSA/consumerassistance.html

    Good luck to all.

    DougJul 11, 2014  #284

  • Brittany,

    If the policy does in fact have a requirement that you be seen specifically by a psychiatrist then there may be little that we can do to assist you. With respect to unemployment – if you are still employed, you wouldn’t be eligible for unemployment benefits. Please obtain a copy of your policy and feel free to contact our office to discuss how we may be able to assist you, as a specific requirement to see a particular type of doctor is highly unusual.

    Stephen JessupJul 11, 2014  #283

  • I am recently experiencing extreme frustrations with Sedgwick our company recently switch from Liberty Mutal at least they didn’t make you jump through hoops. I have found Sedgwick to be very picky and the LOA are worthless. I am writing an appeal letter as we speak. My claim was closed be cause Dr. office didn’t send medical and the LOA calls me several days after the fact. I am also experiencing a bigger issue with DR. Office not wanting to comply with releasing medical records.

    Which led to my case being closed. Is there anyway is there any way to launch formal complaint. I thought maybe they would have people spying on claimants. Since I’ve been out I’ve had instances were there has be a random car with someone sitting there. I’ve seen it 3x since I’ve been on STD who knows if there watching me or the house getting a new roof. I have never been so stressed I have reached out to accolade for assistance and they are going to further help me. This hasn’t been my only bad experience with Sedgwick I have had several since my company switched. When you do call they are very robotic and they never show empathy and each and every time you call you have to go through a call enter makes it very un personally and you have to repeat your situation every time you call. I have complaint to my human resources they could careless. Sedgwick also makes you report within 48 hrs or they will deny it for reason not fmla related is wht the letter says.

    EvaAnnJul 11, 2014  #282

  • Brittany,

    Sedgwick’s actions are common, but it is unfortunate to hear what your employer is doing with respect to assisting you in getting the problem solved. Please feel free to contact our office to discuss how we may be able to assist you.

    Stephen JessupJul 11, 2014  #281

  • I work for Time Warner Cable. I have been with them for 5 years. They just decided to switch over to Sedgwick for our disability management. So far this has been a huge headache. Sedgwick told me I am approved through 7/11/14 (even though my doctor gave them an estimated date of return for 8/23/14) and I haven’t been paid! They said they sent over this “voucher” to my payroll and it is up to them to approve it… I call my payroll department and they haven’t gotten ANYTHING from Sedgwick. So I haven’t been paid for 4 weeks so far and as far as I can tell they’re telling me that I have to start working again tomorrow, against my doctors wishes, without my doctors approval!

    I am also being told now that my company requires that I see a Phychiatrist if I’m out more than 30 days. The problem is when my insurance and accolade do a search for me they can’t find anyone available within the next 30 days.

    What am I supposed to do here? I am so confused and scared about what’s going to happen. I surely can’t focus on getting better!

    P.S. I have contacted my human resources. I contacted them via email on Monday and they have yet to respond (it’s Thursday).

    BrittanyJul 10, 2014  #280

  • Dee,

    You will need to consult with an Worker’s Compensation attorney as it appears your claim is under your company’s worker’s compensation policy.

    Stephen JessupJul 9, 2014  #279

  • I injured my foot at work, have had surgery which has not resolved the problem. Sedgwick denied my claim, sent me to an IME, who at that time niticed there was a mix up of my medical records with another client, that was last August, the problem has not been fixed to date. As a matter of fact the other person showed up for my court date. I am getting ready to go to trial to get my claim accepted. Any advice?

    Dee NelsenJul 8, 2014  #278

  • My employer has Sedgwick. My co-workers and I felt WE were the only ones getting the shaft. I’m letting people know at work tomorrow. My doctor on 3 occasions was out of office for 1 to 2 weeks. Sedgwick needing MORE information would not extent my due date resulting in denial. My paper work is due by July 13 (yes, Sunday) and my doctor returns Monday the 14. They will not extend. My doctor forgot to put in his notes for medical secretaries that this was a renewal of FMLA so Secretaries cannot submit paperwork requesting it. This is a scam. I went without pay before but occurrences are adding up and it may be my job on the line.

    Ann ArmstrongJul 7, 2014  #277

  • Sedwick is giving me the same thing to, denial, appeal, etc… I wonder why this isn’t heard of much, because it’s only a small percentage of employees who actually fight AT&T in the southeast. I have been diagnosed with extreme depression and anxiety very bad anxiety, axis1.

    Yay UnionJul 2, 2014  #276

  • Kristi,

    What you are experiencing is not uncommon. A majority of disability policies contain language allowing an insurance company to collect an overpayment based on their own mistake. It should be noted that Sedgwick is a third party administrator and not an insurance company. The benefit is probably being paid by your former employer. As such you could contact your employer to vocalize your position.

    Stephen JessupJun 28, 2014  #275

  • I have a LTD and Sedgewick is the ins. co.. After not receiving payments for over 3 weeks they claim they calculated my weekly check wrong. So after two years they say they are not paying me until the overage is satisfied. This could be months. Can they do this after two years? And leave me with no income now?

    This is IL. If this is true it’s their problem they had all the correct paperwork for their calculations?

    KristiJun 27, 2014  #274

  • Jeffrey,

    You are certainly not alone. Attorney Rachel Alters in our office has extensive experience and dealings with the Walgreens disability policy. She has litigated under the policy and was successful in getting the judge to remand the claim back to Sedgwick for further review. To date they are still being contentious as ever.

    Stephen JessupJun 19, 2014  #273

  • Joyce,

    If AT&T properly exercised their right to an extension beyond the initial 45 days to make a decision on the appeal, then all you can do at this point is wait. That being said, you would be wise to provide them any potential new supportive information that may arise while they continue their review.

    Stephen JessupJun 19, 2014  #272

  • I have been receiving short and long term disability from AT&T and in March I was informed that I was being denied permanent disability because the definition of disability changes in their system when you reach permanent disabled. I appealed and was told that on May 17, 2014 they would have an answer for me. Then I received a notice that said they were extending it until June 27, 2014. I sent in all information to them including a letter from my Doctor. I never was denied disability from AT&T and even was approved for total disability from Social Security. I don’t know what to do from here. The only response I got from AT&T was the language changed when it came for permanent disability from ATT. Is there anything I can do?

    JoyceJun 18, 2014  #271

  • I have been on short term disability from Walgreens for over a month now. Sedgwick sent my paperwork to the wrong address and denied my claim because I didn’t fill it out and send it back to them. I finally got it sent to the correct address but they are putting me through a long process before they will approve it. I have very little time before I get evicted from my apartment because I don’t have the money to pay the rent. Sedgwick says the first address they sent my paperwork to was the only one they have on file, and that I gave them that address, yet they somehow managed to send it to the correct address the second time. If they had sent it to the correct address the first time I would have my rent paid and wouldn’t be in this mess but they refuse to take responsibility for the mistake and they refuse to let me speak to someone above my case manager to make a complaint.

    Jeffrey CopelandJun 18, 2014  #270

  • Melinda,

    Have you appealed the denial of continued benefits?

    Stephen JessupJun 15, 2014  #269

  • I have had multi level depression and anxiety and was diagnosed with ptsd which causes me to lose my short term memory and causes confusion, I cry and can’t function when a customer yells and screams at me, I had bells palsy from the stress, I was awarded STD from dec 27 to march 31, had the same issues from Sedgwick as the others, required to see a psychiatrist but couldn’t get an appointment before the deadline except to someone who doesn’t take insurance… 600 dollars later I get initially approved, but then extension past march 31 was denied even though my doctor put down June 20 as return to work because Sedgwick requires a return to work date even if doctor can’t say when you are able to return. Anyway I was approved for social security disability. So 2 psychiatrists, a clinical therapist, and the government says I can’t return to work, but according to Sedgwick the information doesn’t warrant the approval of the extension. My psychiatrist says they are evil, and would only correspond with them in writing and the other psychiatrist played phone tag with their consulting doctor and so part of the reason I was denied was that they couldn’t talk to my doctors. What a crock of crap! This whole process with Sedgwick has caused my anxiety and depression to worsen.

    MelindaJun 14, 2014  #268

  • I worked at Walmart until about a week ago, and Sedgwick handles their LOA claims. I filed for LOA due to an injury, my LOA was denied before they even sent out the paperwork they said I had to fill out before they could continue with the LOA application and they didn’t even inform me that it was denied, until I called my employer who also had never contacted me and found out that I had been fired because it had been denied without me even knowing about the denial.

    MaryJun 4, 2014  #267

  • Beverly,

    Attorney Rachel Alters in our Office has a great deal of experience in dealing with Sedgwick under your very policy. As a matter of course I would agree 100% with your summation as it relates to Sedgwick. Please feel free to contact our office to discuss how we may be able to assist you appealing the denial of benefits.

    Stephen JessupMay 24, 2014  #266

  • I currently have worked for Walgreens for 8 years and never taken leave. I am 32 weeks pregnant with twins which makes me high risk and I also have pregnancy related high blood pressure which makes it even more dangerous. My doctor has taken me off work but Sedgwick is denying my claim saying there is no reason why I cannot still work. It makes no sense being that my CA state disability has already been approved. Sedgwick only knows the words deny!

    Beverly DuncanMay 23, 2014  #265

  • Trevor,

    You will need to speak with a Worker’s Compensation attorney as to your rights under applicable laws.

    Stephen JessupMay 15, 2014  #264

  • I had been out on comp. with Sedgwick for 30 days and my doctor tried to return me to work “light duty” to see if I could handle it. My employer said that they could not accommodate my restrictions and that I would have to stay out of work until I could return without restrictions. Sedgwick cut my comp payments to less than half when they caught wind of my doctor releasing me to return to work light duty, even though work wouldn’t let me return. Is that legal? Shouldn’t I still be compensated at the full rate until my employer allows me to return?

    Trevor J.May 14, 2014  #263

  • I have sciatic nerve damage. I have been out of work from February 18th until now. Sedgwick’s deadline for their paperwork was March 27th and I did not receive the paperwork until after the deadline. I took this paperwork to my doctor to get this filled out as soon as possible. Sedgwick immediately denied me because it was late (their fault) and I had to file an appeal. I’ve been trying to call Sedwick for 3 weeks and left numerous voicemails for them to contact me immediately!!!! I finally got a call back from the Disability Specialist Christine Okreglak…and she had the nerve to act like I was bugging her. Her excuse for not calling me was because she never got my messages! It’s Sedgwick’s job to help me! She basically told me with extreme attitude that I’m screwed and I don’t have enough medical proof for my claim to be approved. So I’m wondering, why do I bother paying medical insurance every month if I will be denied my benefits??? I have been paying out of my own pocket for chiropractic care and physical therapy because I did not want to go through the Worker’s Comp route so they can fill me up on pain meds and force me to get surgery. I have been struggling because I’ve been out of work, and Sedgwick just doesn’t care!

    I’m not trying to get long term disability. I’m trying to get well enough to go back to work. I am frustrated, stressed out, and on the verge of going crazy because of their lack of support. I have no choice but to go back to work hurt because I can’t afford this.

    MichaelMay 6, 2014  #262

  • To unknown SunTrust employee who just posted:

    I too used to work for SunTrust. They had a different disability company when I went on LTD. Then they switched to Sedgwick (cheaper and denies more requests). SunTrust caused my disability because of the terrible work conditions and goals pushed on us. It was a minute by minute what have you done for us lately. You were lucky that Sedgwick denied, even though it didn’t seem like it at the time. I wasn’t denied by Sedgwick and received LTD until my 2yrs were up because of the 2yr limit on mental disability claims. The 3rd party company that helped get my govt disability got me approved. Out of the $23K I received in back payments, I got to keep $1700. Yes, I signed a paper stating that I would owe Sedgwick (in turn, SunTrust) the difference between my LTD disability minus my SS disability. I still don’t see how I only received $1700. That’s just 1 month difference. But I didn’t fight it. Didn’t seem worth the damage it would have done to add to my mental illness problems. I’m not sure I can complain about Sedgwick or not. I was approved but also had to give up a lot of my back disability that would have helped me tremendously. After reading all of the statements about Sedgwick, I guess I must consider myself lucky. But it sure does make you wonder why you pay extra for LTD when denial is almost a given. Thank God for my Psychiatrist. She took good notes and was behind me 100%.

    Karen B.Apr 30, 2014  #261

  • So I was put on bed rest by my doctor bring that I miscarried one child their trying everything to save this one, I was told that isn’t a reason to be off work. It’s going on my third week and I must say this is the worst company in the world, rude people all around. They’ve contacted me to tell me my claim for short term disability was denied because I don’t have a real reason to be out of work so I guess their doctors too.

    Pissed OffApr 22, 2014  #260

  • I worked for a bank forc17 years. In between that time I had 3 major back surgeries. I never filed for disability after any of these procedures. I took vacation time, personal time or whatever time I had to get myself back to work. However, the last surgery was a triple fusion. My Neurosurgeon warned me this wa an extremely complicated, painful and long recovery of at least a year. Keep in mind I was working with extreme nerve damage, numbness and indescribable pain. I explained to my manager at the time of what I was up against if I were to have this surgery on my back. He was very understanding knowing I was a dedicated employee with nothing but stellar reviews. I went to work one day, stood up and fell down. I had lost the feeling in my left leg. I actually had to be walked out of the office to my car. I went straight to my Dr. Who immediately put me on FMLA. I tried physical therapy for 2 months doing everything I could to avoid this surgery. My physical therapist wrote a note to my Dr. That my legs were so weak he could no longer work with me and advised surgery. Within the next 2 weeks I had a triple fusion. I left work thinking I’d be back before my FMLA ran out. Unfortunately, I was still bedridden for 6 months. My FMLA turned in to STD, which Sedgwick did approve. My STD turned in to LTD which again Sedgwick did approve. The final result of all these surgeries, added major nerve damage where I could no longer sit, stand, walk, kneel or do anything any working environment required anyone to do. My pain was extreme and my great quality of life that I once had no longer existed. I was I heavy doses of pain medications of multiple types, I should not have been driving nor could I since I am unable to sit for 15 minutes without my back and leg throbbing. However, Sedgewick continued to pay my benefits for a year and a half. In between that time I was trying to get approved for SSD, knowing my LTD only paid out for 2 years. However, once SSD kicked in, Sedgwick would have to pay me the difference that SSD did not pay to equal my 70% income along with the continuation of our medical benefits until I was 65 as long as I “fell under the Sedgwick laws of being disabled”. Now, keep in mind I have been paid for a year and a half. My condition has worsened and has been documented as so, my Dr always sent the paperwork on time, and stated in his final paperwork to Sedgewick that my condition was “lifetime” and I was unable to work in any working environment for any amount of time. Still completing the paperwork in full as required by Sedgwick’s so called “law”. I week before I was supposed to get my disability check, I received a letter from Sedgwick that I was no longer entitled to benefits because their Dr contacted my Dr, along with my Neurosugeon and my employer who all said I could return to work. Now we all know that no Dr from Sedgwick contacted anyone! As a matter of fact, when I showed my Dr their letter stating they actually spoke to him, he wrote a letter regarding no conversation had ever taken place and he would take action himself if they used that against me for denying my benefits. Sedgewick then stated it was an incorrect statement and that their Dr (who I don’t even believe exists) stated that after examining my old job description back from dec. 2011( my last day of work) that I was able to perform that job function. I contacted Sedgwick to discuss their decision and try and figure out if they had paid me benefits for 18 mo., my conditon has only been documented to them as “worsened” how could they figure I could go back to work? Here comes the big one… The resonse I received was, and this is from a manager for claims was this verbatim…” you can appeal this claim, you can get an attorney, you can do whatever you want to do, I don’t care, but I will make sure you claim is never, EVER re-opened or approved”. As angry and as appaled as I asked her if there was anything else she had to say? And she hung up on me. This is Sedgwick manager people! I don’t believe in getting nasty as that gets you nowhere. I do have to say it has been 2 months and I’m still angry and simply in awe that Sedgewick thinks it’s ok to treat people like they do. Just like everyone else who has dealt eith them, we paid into this insurance in case we had problems right? We did everything we were supposed to do even though we are all in pain in one way or another right? And most importantly, we all need the income or we would not have filed for benefits in the first place right? Have I filed an appeal? Of course! Did my attorney get involved and was he copied on that appeal? Of course! Can I afford to go through all of this and have NO INCOME while I wait for them to make a decision? NO!!!! But I will never give them the satisfaction of just letting this go. I will get them and they will never know what hit them. I WILL get what they owe me since I have been paying for LTD for as long as I have been employed. Sedgwick needs to have a eye opening experience. I hope that this group of attorneys that allow us to let everyone know how awful Sedgewick really is. I hope they figure out a way to help all of us get what is owed to us. I am ready to go to Washington right now and let Congress know how Sedgwick treats their people who have paid into these benefits for years and in return they get nothing in return but rude and horrible treatment when you are in a time of need. I don’t know how these people or these liars that work for this company can possibly look at themselves in the mirror every day. if you havo no choice but to go back to work because you need some source of income, go to the Sedgwick “careers” section and see what’s available… Do you think they would hire someone who can only sit for 10 minutes then take a 45 minute break? Do you think they would hire someone who tries to work and when they go to stand up they fall down, then have to be walked to their car? I would think….NOT! I wish all of you the best and hope you get your benefits. As for Sedgwick, I hope they get what’s coming to them. Maybe a couple of back surgeries to that manager who spoke to me the way she did so she can get a taste of her own medicine. I would love to be the one to Hanley HER case! Good luck Sedgwick… Someone is going to sting you and when they do? You’re going to feel the burn! I hope it’s this group of attorneys who gets the good fortune of bringing you down!

    Funky BellaApr 22, 2014  #259

  • I think this is a great service you have where people can vent and others can see they aren’t alone but I am uncertain how many really has a law suit. What I have learned:

    Sedgwick stopped my short term disability approx. 45 days before it would have turned into long term disability which Long Term is something I purchased from SunTrust Bank as their employee to protect me in the event of a long term disability.

    When my short term was denied I filed an appeal w/ 4 doctors who said I was unable to work yet Sedgwick was able to say I didn’t meet their guidelines.

    Once they denied it the appeal there is no other recourse that ended it and at the same time ended my Long Term claim since I needed those final 45 days.

    I have since filed for my Social Security disability. Now, if I had of gotten the long term approved and then my Social Security disability, any back payments would have been paid to Sedgwick for long term payments that are owed them. Therefore, my case isn’t worth anything to a lawyer.

    My complaint is that SunTrust and Sedgwick are doing this to people and we have no way to fight back. I could (if I had the money) hire an attorney and pay out of pocket but that wouldn’t not be financially beneficial it would just be to make them answer for their behavior.

    I feel so defeated and abused by the system. Nothing will stop this company, and I would never, ever work for a company (if I were able) again that has any involvement with Sedgwick.

    Withheld for PrivacyApr 18, 2014  #258

  • Sedgwick WC claims person never returns calls, never follows up with emails…. In head on car crash in company truck 3-10-14….had a few days of PT for hands and later have had shoulder pain for 2 weeks…no one will get back with me. Supervisors also do not return calls.

    kpApr 16, 2014  #257

  • Randy,

    I think they will be hard pressed to make the argument unless it is deemed the PCP is not the proper category of physician to treat your condition unless the language in the policy as to what constitutes appropriate care allows them to determine same. Please note that this is not to stop Sedgwick from denying the claim based on those grounds, which will then prompt the need to file an appeal.

    Stephen JessupApr 5, 2014  #256

  • I have been working through all of the Sedgwick hoops since 1/18/14. My PCP sent me to a specialist for my back injury who refused to fill out leave paperwork our disability paperwork. My PCP took up the reigns and continued with the physical therapy and medication prescribed. Sedgwick called yesterday and told me that I’m only approved until my follow-up visit with my PCP on 4/9/14. She claims after that my PCP will no longer be enough to continue my disability and that they will require a specialist to do any extension. With this not being a workmans comp claim is Sedgwick able to dictate which physician is valid? My employer already extended my leave till 5/9/14 via notice from my PCP.


    RandyApr 3, 2014  #255

  • Wendy,

    Thank you for sharing. As you can tell, Sedgwick does not have a stellar reputation. In order to potentially secure the three weeks of STD benefits, you will have to go through any designated administrative appeal process for any claim denial.

    Stephen JessupMar 31, 2014  #254

  • I work for UHC and we have Sedgwick. I had a total knee replacement on 01/28/14. When I went for my 6 week check up with my doctor he told me I was not going back to work at 6 weeks but my Dr. stated he wanted me off till 03/30/14 and to go back to work on the 31st. I advised my Sedgwick rep and she said she would have to get the info from the Dr. Well she requested alot of reports and my doctor’s office charged me $25.00 before they would send them to Sedgwick. So here I am getting less my wages and I have to pay for the reports that Sedgwick wanted. And gee, guess what, they denied my claim. So now I did not not get paid for the last 3 weeks that I was off from work. During the whole time I had to do Sedgwick’s job, my doctor’s office would send the info they were looking for and I would call to make sure they got it and they always told me no. I have had intermittent claims for other medical issues and it is always the same thing I have to follow up every time to make sure they got the paperwork. What or how do I fight Sedgwick for the 3 weeks pay that I have coming to be that they denied? I am going to fight them on this just because they are jerks. It is really funny, I goggled “total knee replacement disb will not pay me all my pay” and this website came up with all this info on Sedgwick and what crocks they are. I am calling them in the morning and asking for my rep’s boss and her rep’s boss and her rep’s boss till I get to the head person. Not dealing with the idot that makes decisions and have to medical training at all if my Dr. says I should be off from work then they should have no right to do what they do.

    Wendy B.Mar 30, 2014  #253

  • David,

    Please feel free to contact our office to discuss how we may be able to assist you.

    Stephen JessupMar 30, 2014  #252

  • Monique,

    Have you received the denial letter? If so, please feel free to contact our office to discuss what options your husband has at this point.

    Stephen JessupMar 29, 2014  #251

  • So I was supposed to get a decision on my appeal for Short Term Disability today. I shouldn’t have had to do an appeal in the first place. Sedgwick placed my doctors notes in the wrong file. I have a letter stating I would received something in writing by 3/30/14. Today being the last business day, I get a call from the claims examiner. She can not make a decision because she has not received the report from Sedgwick’s doctor that is reviewing it. I was told that he had 7 to 10 business days. that was 3 weeks ago. Meanwhile 2 months without pay is a big pain in the butt. Anyone know a good lawyer? Like I can afford to give away a percentage of the nothing I have now.

    David ThorneMar 28, 2014  #250

  • My husband works for Comcast Cable as a Tech Support Agent. They recently changed from Liberty Mutual to Sedgwick’s, and I must say this is the worst experience ever. For those that don’t know, Comcast is already a stressful company to work for and they have a high turn over rate. My husband took a short term disability, which he pays for monthly out of his check. Hardly ever took vacation or anything. He was “conditionally approved” for leave and now they are denying his claim stating that for what he is going through should have only been for 10-11 days. And of course they are going to want whatever they paid him back. Our Dr. states that they are going to battle them on it because he authorized my husband to take the leave for 3 weeks. At this point we are not sure of what to do because we are just using my income at this time and there is no way we are able to pay back something that should automatically be given if we pay monthly for it. Any solutions would be great, thanks.

    MoniqueMar 28, 2014  #249

  • Sedgwick has caused significant physcological harm and are trying to harm me physicaly by using the UR system to cut off my medication since I am being forced to sell out my future medical claim. I became a cancer victim in august 2013 and Sedgwick automaticly started to cut my regular pain meds when I received a breakthrough med for cancer pain. I was able to fix that for awhile but this past January they dropped the bomb on me with a UR report stating that I am on a weening program. This is not my Drs plan their UR Dr is a anthesiaologist with so-called expertise in pain management. I thought was lucky I was able to get a expedited hearing at the WCAB and the judge told sedgwicks attorney that they were over stepping their boundaries. He told us to have a talk but I was taken advantage of again, was told not to worry and they would override the UR report. Well got a new one. same thing I still on a weening program. If get cut off my meds I will die. This is nefarious I didn’t choose to be in pro-per but I do what I can do. If anyone knows anyone who can help me please contact me. Sincerely, John Nelson

    John NelsonMar 23, 2014  #248

  • I’ve filed a workers compensation claim for an accumulative back injury. I sit for very long hours, back to back, 10 days in a row, twice per month. We’re given 2 fifteen minute breaks and a half hour lunch – which is standard. Time-wise/efficiency-wise, it’s counted against us, when we take a health break for the restroom and it’s considered a “deviation” of work time, so the time is taken away from our efficiency score. If we utilize the breaks to use the restrooms (4 – 7 minutes, yes I’ve timed myself); then, get a refreshment (3+ minutes if microwaved, purchase from vending machines, etc.), that can consume most/if not all of the breaks. The company is within the law, because our work schedules are still within the Sunday through Saturday (7-day) timeframe. It’s very hard on the human body, to work 10 days in a row, back to back, sitting all day long, repetitive arm/hand motions. If you’re higher on the seniority list and if management “likes you” you may get 2 days off in a row. The rest of us have to take a number and stand in line, obediently. I’ve called my local CWA union, but have been informed they cannot assist me, because local laws prohibit the union from assisting people with disabilities (SDI). My doctor gave me a release from work until May 10, 2014; or, until my employer (a major telecommunications provider) can provide a sit/stand workstation for me. I have been diagnosed with sciatica (accumulative back injury) and neuropathy in both of my legs. This multi-billion dollar corporation is dragging it’s feet to provide the job accommodation. I have not been “denied” the sit/stand workstation as of today; but, it’s been over a month since I’ve placed the job accommodation request, and it still has not been provided. I’ve been informed that I do not have a “disability” by another attorney; therefore, my employer is not required by law to provide the accommodation. I spoke with DOL and they’ve said this is considered disability discrimination. I don’t understand all the legal requirements to get this into a “disability” status. Sedgwick handles it all, EEO, SDI Workers Comp/FMLA, code of bus. conduct/compliance. They’ve sent corporate newsletters bragging they never find any discrimination or violations by corporate; also, send monthly newsletters terminating employees for non-compliance FMLA/SDI/Workers comp., etc. They won’t go bankrupt to provide and most sit/stand workstations are in warehouses; not a burden to this corporation. It may cost only for labor $5-800. I’m average height for a woman, so there shouldn’t be problem locating a chair to match, in these large empty buildings, with vacant work spaces everywhere. I guess if your disabled you have to just fend for yourself, if the union cannot assist us.

    AliceMar 17, 2014  #247

  • Cynthia,

    Hopefully your relationship with them will come to an end sooner than later and you’re well enough from surgery to return to work.

    Stephen JessupMar 17, 2014  #246

  • They did a MRI on my back and found a Hernia aided disc and then the sorry people from Sedgwick denied treatment after five months of pain.

    LarryMar 16, 2014  #245

  • Mr Jessup,

    Thank you. I have another claim with Sedgwick, for FMLA due to arthritis in my knees. They are playing the same game with me over this, saying that they have called three times in March, 4,5,6. Since I have been home due to my short term disability, and I have records of all my calls in March, I find this to be very unlikely. While the calls may come in with an unkown number there is no record on my missed calls or voicemail calls either online or in my voicemail as I have been checking daily. While this claim right now has ten days left, it does indeed follow the trend they have set with short-term disability claims. Calling in to customer service again appears to be a nightmare, the representatives insisting that they are right, and having no understanding for what I am trying to explain. Getting hold of the claim manager again, the most ridiculously hard thing to do. I have no expectation of a call back. I will be home all day Monday, 03/17. All I can say is let’s see what happens.

    Again, thank you for being available to assist with matters of concern regarding Sedgwick short term disability. My Dr dictated a treatment plan and sent it Friday, March 14th. He said he does not understand with the information they have sent, why I would be denied for any period of time.

    Having to be the Segwick Police was not high on my list of priorities while recovering but I guess it is the only way to keep things on an even keel.

    CynthiaHMar 16, 2014  #244

  • Colt,

    Any potential severance is something you will have to address with your company.

    Stephen JessupMar 15, 2014  #243

  • Is there any way to negotiate a severance with my company versus fighting with Sedgwick? I am sick and do not have the energy to fight them. Thoughts?

    ColtMar 14, 2014  #242

  • C.,

    Unfortunately, you are not alone in your struggle. This type of action happens every day to people on disability.

    Stephen JessupMar 14, 2014  #241

  • I work for SunTrust Bank which offers Short Term Medical for a period of six months. I purchased through SunTrust, Long Term Medical which will not be allowed unless I am on Short Term for the 6 month period. During my fifth month, my adjuster went on leave and a new one took over. All at once my claim was denied and they said I had to submit an appeal. I have 4 doctors, physical therapy and psychologist who have submitted forms for me and evidence. I submitted everything for the appeal and found out today that I am denied the appeal saying medical doesn’t support my claim.

    My neurologist has twice submitted paperwork saying I am completely disabled and not a candidate for occupational or vocational rehabilitation. He has advised me file my Social Security disability and I told Sedgwick that during the appeals process.

    These health care providers see me monthly and some of them weekly. How can a doctor who has never, ever seen me tell me that all these other doctors are wrong? Supposedly, during the appeal process they make calls to the doctors for phone interviews. Interestingly, my neurologist who would be the most qualified to speak with, they didn’t talk to.

    I truly feel SunTrust Bank is behind a portion of this and that they are in collusion to avoid paying benefits. I have called and requested a case file but was told my original adjuster would have to handle it. However, she hasn’t called me back. I am so depressed over all this and embarrassingly enough am feeling so defeated and alone and find myself just wanting to fade away. I can’t even get the health care I need now as my insurance will cancel now as well. Why do we have to be pushed to file a separate law suit which could take years and how do people survive during that time? I will do whatever I have to do and may never get any justice but this is such an inhumane way to treat employees.

    C. SmithMar 14, 2014  #240

  • Cynthia,

    I am glad to hear! Hopefully there won’t be any more challenges between now and your return to work!

    Stephen JessupMar 11, 2014  #239

  • I actually ended up having a positive outcome on my claim. Tonight, shortly after 5 PM supervisor Ebony Miller called to say that my claim has been re-opened, she explained what information is needed to extend my claim past the March 19th date it is set for now.

    Sedgwick really needs to improve on the information flow, I received a letter today, dated February 26th, saying my claim was denied. My primary claim representative called me February 28 at 4:30 as I stated in my earlier post. The postdate on this letter is March 3 and I received it March 11. This is way too long for correspondence to be sent on an issue like this. While I appreciate the amount of mail they must handle, in this day and age, it occurs to me that there are other alternatives that will speed up the information flow. It looks like even though this was post-dated March 3rd it did not get sent out for several days.

    Again, if I did not continue to call over and over again, deal with reps, some of whom can have some terrible attitudes, and others who were ok, this would not have been resolved by escalation through Comcast. Sedgwick told them, it could not be escalated and they, Sedgwick, want to do the right thing for me. I called BS on this when my manager told me and informed her that Ebony told me she could indeed override the decision.

    When all is said and done, Sedgwick is very difficult to work with due to conflicting information being given, lack of details, and according to my Dr, being in the business of saving the company money. People who are genuine and having major issues don’t have a very good chance of dealing with all of this. It has been stressful beyond anything I have had to deal with so far. The illness itself, a horrible hospital stay, coming home and having to fight for the tools and assistance I needed to start a recovery, then this. I was at the point of a breakdown. This is getting well in America.

    I hope to go back to work between now and April 15th. Ebony gave me a pretty clear picture of what I have to do. I need to get the information sent, the be the Sedgwick police to make sure everything is in place and I am protected.

    Thanks for this website. I will keep you in mind if I need further assistance.

    CynthiaHMar 11, 2014  #238

  • Cynthiah,

    As you have experienced, Sedgwick is a nightmare to deal with. We have represented individuals under the Comcast policy when it was administered and insured by Liberty Mutual and now as it is by Sedgwick. It is my opinion that Comcast did its employees a disservice by leaving Liberty Mutual for Sedgwick.

    Stephen JessupMar 11, 2014  #237

  • I am currently off work, due to Guillain Barre Syndrome, and incurable, disorder where my antibodies began attacking the nerves in my hands and feet, causing nerve damage, and inability to walk without physical assistance and the use of a walker.

    I became ill, December 26th with the onset of a very severe upper respiratory disorder. It was very sudden, and given the fact that an infection was running rampant at work, I called my Dr. for antibiotics. He, knowing my history called those in. This was on a Thursday Dec 26, I started the antibiotics immediately. The infection showed no change, I scheduled an appointment with my Dr for the following Tuesday. He thought I had pneumonia at this time. He sent me for a chest x ray which came back negative. He continued to treat me with steroids, and strong antibiotics. One more week passed, and my legs started to feel like jello, and my feet and fingertips were tingly and numb. I went back to my Dr and he sent me to our local hospital ER. From there I was sent to another hospital for neurological follow up. The hospital stay was a nightmare, which is not the issue here.

    Fortunately, my health care advocate got the short term disability going for me. I was in no condition to deal with anything while being treated.

    Sedgwick has been chosen by Comcast to manage short-term, long-term and FMLA leaves this year. While I was in the hospital, apparently they had no choice but to approve a short term leave. I have received checks for about 6 weeks of leave at this point, my case was up for review, February 18. I have never received anything in writing about this, it was told to me over the phone. I scheduled a follow up with my primary physician, for February 11th. At this point I was still having severe issues with the nerves in my feet and hands, and he was treating me for pain. The prognosis for recovery is good, but the healing process takes an undetermined amount of time. I had spoken with a Sedgwick representative who told me the three page form and Dr notes needed to be submitted. The Dr I deal with is very good about paperwork and following up. The information was recieved by Sedgwick by February 20 according to their records.

    On February 24th. I received a call from Iris, saying that she needed Dr notes. I called my Dr’s office and Denise faxed the information again, she said his notes were included with the original fax. This fax was sent immediately on Feb 24th.

    February 28th at 4:30 in the afternoon, Iris then called me to state she did not get the Dr notes and my claim is now denied. When I became emotionally upset about this, she said to me: “You need to settle down so I can tell you what you need to do.” I repeated to her word for word what she told me, I was listening. She just told me my only income is being denied, and I was emotional but not hysterical, she did not explain the process of an appeal just that they needed a written request and the Dr notes. I could not do anything, and she did not explain just what the term Dr notes mean. It was the weekend, I could do nothing, I became so stressed that I was sick over this. Symptoms, such as the tingling in my feet returned and pain was exacerbated. She told me there was no faxed information on the 24th.

    Monday morning, March 3, with the assistance of my health care advocate through accolade, and my Dr office We made a plan to fax the information to Sedgwick once more. Denise from my Dr office told me she also mailed a hard copy to them. March 5th everything was sent. They had it in the system by March 7th. At this point I was being told it can take up to 45 days for an appeal. I cannot wait that long. I have tried to escalate this through Comcast, and they have told me that once this happens, my health care advocate is not needed.
    I did not feel comfortable with this since my Comcast manager told me no, when I asked for the Comcast representative who would be handling this, I have not heard anything from them either.

    I called Sedgwick myself March 7th and spoke with a representative by the name of Jennifer, who treated me with respect and escalated my issue to John, her supervisor. The policy to call back is within 24 hours. Monday March 10, I spoke with 6 different representatives, some of whom were rather rude about my continual calls. I remained firm about my need to speak with a supervisor, and I left John numerous messages. I never did speak with a supervisor.

    Today, March 11, I spoke with a supervisor by the name of Ebony. Again, she said they need notes from any Dr that I have seen, I explained my primary care Dr is now the only Dr that I will be seeing. I explained the nature of my disorder and that at this point, it is a matter of time and pain management for my nerves to heal. My Dr has recommended that I do not return to work at this time. I asked her to define Dr notes, she again used the term Dr notes, nothing more. She said that she has the ability to override the appeal process. She could not get into the computer system at this time, since she just got back from vacation. She promised me a call back before my Dr appointment today. I told her I need to leave at 2:30 for that appointment.

    It is 1:30 now I have not yet heard back, and from the attitude and actions so far, I do not trust I will get one. We will see. If I do not get approved for a check by Friday, March 14th, I will not receive any compensation until April 4th, if not then April 18th. By then eviction proceedings will be filed, and I will not be able to pay debts that I have been working on diligently for years now. Some programs will not work with me. This stress is causing me physical and mental duress now.

    My manager at Comcast has told me that she was told my case cannot be escalated. That Sedgwick wants to make sure they are doing everything to help me. The exact opposite of what Ebony said. More conflict.

    CynthiaHMar 11, 2014  #236

  • LP,

    I am sorry to hear of your misfortune. Is Sedgwick denying a claim for medical insurance or disability insurance?

    Stephen JessupMar 11, 2014  #235

  • i had a stroke on 1-24-2014 was 2 month’s from retirement. my fiancee had no information on my medical from chrysler. she tried bto figure it out the best she could. my promblem now is chrysler has terminated me becauce my doctor hasn’t fax back the paperwork. sedgwick said paperwork not right. we were in the doctors office a couple of weeks ago and had my doctor try to talk to the lady from sedgwick. she was did not believe the he was the doctor. please HELP!

    LPMar 11, 2014  #234

  • BjroninsonH,

    It would be in your best interest to consult with a worker’s compensation attorney.

    Stephen JessupMar 7, 2014  #233

  • Sedgwick is the co. that’s working with me on my worker comp case. I’ve gone to all Dr appointment turned in all paper work. Two days ago my supervisor called and asked me did I receive my termination paper because I failed to turn in nonpayment leave paper work in time. Was given the nonpayment phone no so I called and I called Concentra to find out what happens. Lois one of the front office ladies said my paper was filed so the Dr never received it. I called Concentra at least 3 times to make sure paperwork was given to Dr. I admitted at this time I should’ve followed up on this matter now I had to make sure paper work was turned in and I had to do letter of appeal. Still may lose my job ok now it look like I’m stuck will I still receive benefit or will they stop because of this.

    BjroninsonHMar 5, 2014  #232

  • Matt,

    As you have probably discovered, you are not alone in your experience in dealing with Sedgwick. Please feel free to contact our office to discuss how we may be able to assist you.

    Stephen JessupFeb 28, 2014  #231

  • My doctor did not release me back to work. Sedgwick says I should be at work, nothing wrong with my knee. I can not return to work at the plant without my doctor releasing me back to work. I’m confused. Sedgwick is a nightmare to deal with. I have been shown no respect, or common courtesy what so ever unless they are recording the conversation. Accused of lying about the hours and days that I work, who I allowed to inject cortisone in my knee… and so on.

    I need help with the appeal. I will lose my medical, my job, everything if Sedgwick gets away with this. My PTO is almost depleted for the year.

    John DoeFeb 27, 2014  #230

  • I am employed by AT&T. I work outside and have a very physical and demanding job. I made the decision to have my left elbow elbow operated on December 2, 2013. The recovery time my doctor noted would be approximately 12 weeks. Sedgwick approved the first 4 weeks. After the fourth week, I was told to submit doctors/physical therapy charts notes so the claim could be reviewed for denial/approval. To no surprise, they denied my disability and stated they needed more information to support my claim. After going through two shoulder surgery’s and hernia surgery over the past decade, those words were very familiar. My case manager stopped returning my calls and went MIA. After fighting with them for 2 weeks, I was finally able to convince them I needed more time than 4 weeks to recover. I wasn’t so lucky after 8 weeks came and gone. I’m still fighting them for wage benefits as I type. I’ve faxed every up to date doctors/physical therapy notes that include my restrictions that include no lifting over 10lbs or use of left upper extremity until my next March 17, 2014 doctors visit. I’m still recovering from surgery and going through therapy weekly under my doctors recommendations. I tried to return to work early on February 23, 2014 since I wasn’t receiving pay starting February 10th. I was sent home by management since my department doesn’t offer light duty. As of February 25, 2014, I cannot be accommodated for light duty by my employer and Sedgwick has denied my recent claim. My situation is becoming a financial hardship on my family and my attitude has changed for this worst. I don’t understand how the laws allow these individuals (case managers) to make medical decisions without having a medical license. After dealing with this no caring, piece dirt company known as Sedgwick, I might be filing mental disability.

    MattFeb 25, 2014  #229

  • Ms. Skov,

    The situation you have described is a workers compensation claim. You definitely need to consult with a worker’s compensation attorney. Our firm only handles disability insurance claims for short and long term disability insurance benefits. Sedgwick handles both workers comp and disability insurance claims.

    Gregory DellFeb 21, 2014  #228

  • I was employed at Office Depot BSD in Fremont, CA from 2000-2005 as a CSR Lead in the call center. I was at the end of my work shift and headed to the lunch room where the time clock was located. I entered and there was a large group of warehouse workers and a janitor whom was at that time mopping the floor. I turned to punch out and slipped on the wet floor, landed on my hip which resulted in a sprained lower spine. I did have a co-worker in the lunch room, she was at the vending machine. There were absolutely no signs in the room regarding the wet floor and no one assisted me in getting up. I immediately informed the admin for my department and the next day I returned to file a workers comp report. I did see their doctor on 2 different occasions and the case didn’t get handled or looked at for years. Office Depot reported and appealed my fall with an Attorney needless to say I got the run around and am still missing a full years pay from the time of the accident to the time of our case being heard. The court papers do not look legit! I have kept every piece of paper that I was given in the matter. ‘Til today I am still feeling pain and at times unable to get thru a days work. They considered me to be Perm/Partial Disabled per Sedgwick letter and the few workers comp check stubs. If any one has any suggestions on how I can go about getting the monies I rightfully deserve please respond to my complaint. I appreciate any and all suggestions you can provide. Thank you!

    Ms. SkovFeb 20, 2014  #227

  • Connie,

    No words could ever properly do justice to the struggles and loss you have experienced. My deepest condolences go out to you. Thank you for sharing such a powerful, personal story as I am sure it could not have been easy.

    Stephen JessupFeb 18, 2014  #226

  • My husband Michael was a hard working man. He was a former Marine and was in very good physical health and quite smart. He worked several jobs throughout the years after being honorably discharged from the military. His last job was as an electrician working for International Paper. He worked there for around 15 years I think. I do know he was making over $60,000 a year and it was a good job. He was the type person who was always working either on his job or at home. A true handyman who could work on anything. Something started happening to his health in 1998. We didn’t know what it was. The doctors didn’t know why tendons and muscle tore in his legs. He ended up with a distinct limp in his left leg where a tendon or muscle whichever it is called in the soleus tore completely away at the bottom of his ankle in the back of his left leg. It was never repaired. He had another tendon rupture at his right knee. It was repaired but months later a muscle in the center of his thigh tore apart. He always said as long as he had 2 good arms he was going to work. I had to wrap both his legs using all kinds of support braces and ace bandages before he went to work, but that man kept trying. Those were the visible things he was going through. In 1999 he tried to commit suicide and put a .38 in his mouth and pulled the trigger. Thankfully God intervened and he didn’t die from that although at the time the paramedics had me believing he was dying. The law enforcement report stated that he tried to kill himself. His health problems started happening in 1998 and seemed to continue for several years afterwards. There were other issues like tendonitis, numbness in hands & legs, jerking movements or arms & legs, etc. He continued to work even through all this. He also kept trying to get a desk job if 1 became available because his legs were getting worse and weaker. For a few years it seemed like he was at least stabilizing in his health somewhat as it seemed to stop getting worse. I thought maybe he had a chance of recovery from his many health problems. In 2004, his health issues started getting bad again. In 2005 the rupturing of tendons also came back. This time both his arms were damaged. He had nothing left to work with. Everything that had previously happened before with his health became far worse. He applied for disability and Sedgwick handled the claim. He was denied several times. He also applied for Social Security Disability. Seemed the only question Sedgwick wanted to know when we spoke to them was if we had heard from SSD yet. Sedgwick always wanted our paperwork on time limits that were set but they were late several times going past dates to respond from their side. It didn’t do any good to complain even to the union. Seems like all my husband got from paying union dues was an expensive turkey or ham each year. Times were very hard at this point since we didn’t have an income. In 2006 I finally found out what happened to my husband’s health. After years of searching, it was a medicine that he had taken. An antibiotic called Cipro. He had taken it in 1998 and also once again in 2004. Both times after taking it the rupturing began around 11 months afterwards. All the other health issues he suffered from were listed on the adverse reactions as well. Sedgwick denied the claim and my husband was fired in 2007 from International Paper. My husband had an appointment with a Social Security doctor and his report made it possible for him to be approved for SSD. Most the doctors from Sedgwick never saw or even spoke to my husband and yet they made this determination. I remember an appointment that Sedgwick made with 1 of their doctors. It was at least a 2 hour drive away from where we lived. I told them we didn’t have the money to get there. I guess it didn’t matter if we were there or not. Their doctor thought my hubby had no mental problems even though they had a copy of the law enforcement report he tried to kill himself. Perhaps if I had spoken up and told them about the other attempts maybe it would have made a difference, but I couldn’t do that cause the 1 thing my husband feared the most in life was being locked up and away from his family. I couldn’t do that to the man I loved so much even for money. I could do very little to protect him after he became disabled. He had always protected me but I couldn’t protect him no matter how hard I tried. We hired a lawyer to appeal his disability from IP. The lawyer told us to be very patient and that it might take many years before we heard anything. After a few years, we finally contacted the lawyer only to find out he said he had sent us a letter telling us he had dropped it. We never got that letter and time ran out for his claim I think. In Feb 2012, Michael passed away in his recliner at the age of 55. He had lived the last few years of his life from a recliner where he also slept. He only got up from that recliner to get something to drink or go to the bathroom. That in itself was a challenge cause there were always accidents from either 1 of those times. He fell a lot and couldn’t move very fast. There were very rare times when he would leave the house and they were mostly for doctor appointments. To me he was the bravest man who ever lived. Even though his life was pitiful, every morning he would smile at me and tell me he loved me. I miss that so very much. He never saw a dime of pension benefits from International Paper. I applied for spousal pension benefits at the amount of a little less than $155 a month. There was nothing we could do about International Paper, Sedgwick or Bayer who made the Cipro. Sometimes life isn’t fair and justice seems so far away. I’m still here though and am thankful for this day. I still miss my husband though and will until the day I die.

    ConnieFeb 17, 2014  #225

  • Randy,

    You would need to review your policy or speak to HR as to how they determine what your short term disability payment is based on.

    Stephen JessupFeb 15, 2014  #224

  • My problem is very simple with and only in place to save my employer money via Sedgwick start date games. Yesterday I was informed that my approved disability claim was short of the weekly benefited amount because the first day missed started on a Tuesday. I work four 10’s Tue-Fri. I injured my back on Saturday the 18th and my official first scheduled day missed was the 21st. The disability benefits are paid 5.7 hours per day Saturday-Friday. I missed 40 hours in that Tue-Fri and only was considered to have missed 23. I haven’t lost a major amount of money here, but if Sedgwick is aware that it works on a Saturday- Friday bases and I was injured on Saturday the 18th why didn’t that begin my 14 day wait period? I’m tentatively due to go back on Tue March 4th but they had the Dr. put Saturday the 1st because that’s the beginning of that weeks payroll. I not able to use benefited time for that lost Sat, Sun, Mon because I’m never scheduled for those days and I’m not getting paid for the Sat, Sun, Mon on the week I return. Know your payroll system if you’re unexpectedly injured outside of work.

    RandyFeb 14, 2014  #223

  • John,

    I am not quite sure what exact guidance you are seeking. If it is on account of your company terminating your employment, you will need to consult with an employment attorney.

    Stephen JessupFeb 13, 2014  #222

  • I worked for 31 year for this company, 15 as a plant manager. My plant was closed and I was transferred to run another plant. After 6 months (August 18 2012) I went to ER with chest pains, anxiety, all of this due to lots of issues at work. Came back to work and on September 10, 2012 had the same symptons, was off for two weeks, my boss would call me and check to see how I was doing, ask me to come back only few days per week and work half days but only if I feel better. Went back on Sept. 25, 2012, we had a meeting, got projects to work on, a few hours later he came to my offices and wanted to talk about me, told me things were not working and the best thing was to give me a 60 day notice and a 12 week severance package. It was like a bomb. I din’t know what to say, was very upset, after my half day I went home very sick and went to the Dr. and been off since then. Last month my Dr. told me that I could not get more time off due to health carrier rules. I was getting paid by Reliance Group after STD and LTD run out of payments. My Dr. gave me a note saying I could work no more than 4 hours. My work told me I was no longer disabled and wanted to talk about my exit from the company. Got my vacation paid, and have 45 days to sign the agreement for the severance pay, still no reason as why I was let go, they simply say things didn’t work but never got any thing in writing nor nothing about warnings etc. I have a great reputation and history with the company, the company would use me to help other plants with their problems, production efficiencies, I had to travel to other states, been away from family to help the organization. I was not expecting anything like this. By the end of this month my health plan will be canceled. From the beginning HR convinced me not to report this as a WC issue, saying that if I do they would investigate my family, our personal lives would be revealed etc. We agreed not to at that time since my family was very concerned about me during the first 3 months. They didn’t want to go through this, it was already painful enough. I don’t know what to do, is this a case where I can sue them for wrongful termination or negotiate a much better package? The person I replaced was working there for two years when he was let go. He got two years of pay so he could not work for a competitor, I went there to do his job.

    JohnFeb 12, 2014  #221

  • RG,

    We hope your Worker’s Compensation attorney is able to get you what you deserve. You may also want to inquire to see if you have any disability insurance coverage from your company that you may be entitled to.

    Stephen JessupFeb 9, 2014  #220

  • Wife had a stroke. She received short term diasability from one insurance, then the time came for the long term and wow it was Sedgwick. The first thing they said was this was a prexsisting condition and they will denie the claim. Been four months now still working with them to provide all the info needed but no check. They told us it’s in the mail but we haven’t received anything. I feel I need to go to Calibassa California Office and kick someone in the butt. What a run around. The claim person never answers the phone but will call you back when she feel like it. No luck.

    Slow And No GoFeb 9, 2014  #219

  • I was in the workforce for 39 years and never unemployed and was hurt in an industrial accident in late 2010 at age 56. I ended up with a blown disc with only 10% of my L-5 disc left. When this first happened I tried everything the company suggested, doctor visits, pain relievers, muscle relaxers, chiropractors, PT, etc… we finally got the insurance company (Sedgwick) to approve an MRI after months of trying to get approval. Over 1 year later after the injury in late 2011 they approved the MRI and guess what, L-5/S-1 disc blown out, bone on bone I was told. By this time I had some serious problems besides my back I had numbness and tingling in my feet, especially my big toes and the front of my feet, calves and buttocks aching etc… so my doctor took me off work. They then wanted me to do an EMG and that showed that I had “weakness of dorsiflexion and eversion of the left ankle with absent Achilles reflex on the left side, with chronic denervation of motor units in the right and left lower extremity’s involving multiple muscles, along with chronic L-5/S-1 radiculopathy. After that report Sedgwick didn’t like it so they had me do another EMG with a different Neurologist which turned out worse than the first one. At that time my doctor ask for approval for me to see a Neurosurgeon at a major Spine Institute in California for a expert opinion, that approval took 9 months to get approved while I suffered. Next it took months to get a discography approved at the same Spine Institute which turned out that they advised an anterior fusion/disc removal with hardware etc… while in there the doctors shot steroids and pain blockers into the disc which helped for about 4 months but… need another and here we go again! Not sure what I will end up doing at this time I can still walk and I am told the surgery probably won’t help with my neurology problems only my back, great huh, all because Sedgwick fought me all the way with everything money, approvals, etc… Why? I have even had a partial AME that the doctor said the injury definitely happened at work when I said it did and when I had turned it in at work (no prior back problems). Now I get to pay for the rest of my life! Tried to be a good guy in the beginning, thought they were there to help me but, I have an attorney now and I hope he is good enough to help me. I have been screwed by Sedgwick and it’s probably not over yet (BEWARE).

    RGFeb 8, 2014  #218

  • My husband recently had shoulder surgery. While we were lucky enough to have our claim approved, Sedgwick has decided it’s time for him to go back to work. He has not yet completed his physical therapy nor has he been released to go back to work by the surgeon. However, Sedgwick wants him to go see a doctor at his work place and if that doctor says he can go back to work, he has to go. About an hour after making the appointment, Sedgwick decided to call and harrass my husband with threats of being cut off short term disability if he misses his appointment. She then, in a sarcastic tone said to him, “we know you’ve had another claim before”. As if this was a crime or he was doing something wrong. My husband had a quadruple bypass in 2010. That was his other claim. He has artery disease. It runs in his family. This woman called on the phone with the specific intent of harrassment. Does she really think he wanted a quadruple bypass just to have time off work. He suffered terribly for the time he was off work. He was back working within 12 weeks time. I don’t know anyone that would rather have open heart surgery rather than go to work.

    Pamela Lenartowicz SineFeb 4, 2014  #217

  • The reason the last information was marked ‘no exception’ is because it was dated and provided on a date after I returned to work. Even though they needed additional information which I requested at my next appointment on 12-26, and the information stated no work from 12-2 thru 12-15 due to weight bearing pain and narcotics, it is denied because the date at the top is 12-26 and I returned to work 12-16. Sigh, just can’t win.

    MicheleFeb 2, 2014  #216

  • Barbara,

    You will need to consult with a Worker’s Compensation attorney to best advise you of your rights.

    Stephen JessupFeb 1, 2014  #215

  • I was injured in the job in 2009 and my luck Sedgwick is my employer’s insurance. It started out OK then became a nightmare; I had two shots in my back, sent to physical therapy and lots of pain meds. After all this and months of pain I got back surgery but because they took so long to get me in the neurosurgeon said I might have nerve damage and guess what, I do, I now have no feeling in my foot, leg spams that are quite painful, on many meds. Sedgwick decided I could go back to work by saying my back problem was not a work related injury, I just strained my back. My problems are now old age and not their problem. That is just the tip of the iceberg. Long story short, I need another surgery and they again are saying not related to my injury. Just fed up, not sure where to go from here!

    BarbaraJan 31, 2014  #214

  • CB,

    I am sorry to hear about your experience dealing with Worker’s Compensation. Do you have an alternative disability plan you can apply for benefits under?

    Stephen JessupJan 31, 2014  #213

  • Paying Doctors for Findings/ Withholding Evidence.

    Sedgewick CMS has the ability to contact doctors for Independent Medical Evaluation (IME) and “express” what the doctors need to “find”. One doctor in particular, is an IME whore. This doctor literally spends a large portion of his business doing IME’s ONLY for insurance companies. I do not understand how this is legal, but because the doctor does not treat patients for anything, so there is not doctor patient confidentiality. Insurance companies select doctors for IME’s that have a proven track record of siding with insurance companies. Insurance companies pay upwards to $5,000! And yes it comes up as long as your lawyer is good enough to do their home work.

    Also, Sedgewick deliberately withheld the transcripts and recordings of communication with my Workers’ Comp case nurse from Bunch & Associates. I contacted Bunch & Associates for these records and was told these records are owned by Sedgewick.

    In the end I lost my case because the lack of evidence to back up my “here say” from the content of discussion with my case nurse, which deemed me non-credible by the judge and also an IME doctor who did not perform any type of evaluation except ask questions was found credible. I spent a total of 15 minutes over two appointments with the IME doctor. One time I did not even change out of my street clothes during the examination and mysteriously the “pain diagrams” that patients fill in before seeing doctors disappeared for the IME doctor.

    Now the employer I work for told me they do not know if they have a job for me or not and told me to wait a few weeks for a response. Are you serious?

    CBJan 30, 2014  #212

  • Michele,

    I would recommend all communication be written with signature confirmation of receipt so you can track and document your attempts to contact the claims person.

    Stephen JessupJan 27, 2014  #211

  • Two weeks of my claim was denied after knee surgery. At the time, I was on narcotics for weight bearing pain. The narcotics knocked me out. They put ‘no exception’ on the last information submitted by doctor stating I was not to return to work due to narcotics and weight bearing pain. I can’t get my claim adjuster to return my calls. I don’t know what this means. I don’t know what they want.

    MicheleJan 26, 2014  #210

  • Marie,

    It seems that your claim is a work related injury and your claim one for worker’s compensation benefits? If so, you will need to consult with an attorney specializing in worker’s compensation to best advise you of your rights.

    Stephen JessupJan 23, 2014  #209

  • I opened my case with my Employer a DDS and Sedgwick 17 months ago. EMG proved carpal tunnel and also excruciating head ache, neck and arm pain. Had carpel tunnel surgery then released back to work ignoring my neck issues. Finally a MRI was done showing some disc bulging. Saw a neuro surgeon who recommended surgery. Sedgwick denied it, saying it is not really medically necessary, now being sent to a pain management doctor. In the meantime I struggle with weak painful hands and neck. Meds aren’t even helping. It’s all I can do to struggle through a work day to double up on Meds go home and go to bed with heating and ice packs.

    Marie S.Jan 22, 2014  #208

  • Josie,

    Unfortunately, there is no boilerplate for appealing a claim denial as each appeal is as unique as the claim. It is imperative you submit all medical documentation supporting disability, and can make whatever arguments as to the denial of benefits as you see fit.

    Stephen JessupJan 19, 2014  #207

  • I am trying to help my friend write a letter to Sedgwick for her husband’s Final Appeal. He has retired from AT&T after 35 years and his FMLA was approved. So his attendance is protected but he did not receive any money because his disability was denied per Sedgwick. How do we even start the letter? This has been going on since June 2013. Do we really have to add all info from each Dr.’s visit and include all the verbiage and treatment? This is so confusing and Sedgwick has already received this info. Or do we just type a form letter pleading his case and then attach a spreadsheet with all the Dr. info? Please help ASAP, this is due 1-23-14 so time is of the essence. Thank you.

    Josie R.Jan 17, 2014  #206

  • I am a manager at AT&T. I just had my second disability in 42 years. It was a for a knee arthoscopy. The last two weeks of my disability were denied by Sedgwick. The doctors notes from my followup appointment stated “painless range of motion. Return to work 12/16.” This was sent to the medical advisor for review and I could understand this one. They wanted a meeting with my doctor that week. My doctor was on vacation so they talked to the PA and another doctor and denied my disability. When I found out my disability went to the medical advisor for review, I called everyday to check on the decision. There was no decision until after two days after I returned to work on 12/16. At my next followup appointment, I discused with the doctor who issued revision number 1 “Do not return to work until 12/16 due to pain and narcotics”, also denied. Called the doctor and asked for more information to be submitted to explain pain. 3rd revision “weight bearing pain, on narcotics, return to work 12/16”, also denied. I am at a loss at what else I need to do. I followed my doctors instructions and have missed out on two weeks pay. I spoke with a claim person at Sedgwick and asked her if submitting my physical therapy notes would help. The PT found my range of motion on 12/11 8 to 80 on my right knee, 130 on my left knee. She said that might help so now I’m trying that. This is ridiculous. I was not able to relax and recoup because of being tortured by these people the entire time I was on disability. I have much stress in my life right now and this caused me to have to take anti anxiety mediciine just so I could breathe and sleep.

    ShellyJan 16, 2014  #205

  • Connie,

    I am sorry to hear of your troubles. Unfortunately, as indicated in all the negative experiences with Sedgwick, you are not alone. Please feel free to contact our office to discuss how we may be able to assist you in appealing the claim denial.

    Stephen JessupJan 12, 2014  #204

  • I am an employee for a very large bank who uses Sedgwick for their claims management. I have been on Short Term Disability for 5 months and should be moving to the long term at the 6 month mark. During the holidays, I called Sedgwick on multiple occasions and asked they help get updated medical from my doctors as my doctors requested a fax request even though it was an extension. I have four specialist who says I am unable to work at this time and two who says I’ll probably never work again. My case manager went on leave and a new case manager took my claim. When I requested she fax the forms she got extremely nasty with me and told me that was something I could do. I explained my doctor wanted this form and she told me again in a very nasty tone that they don’t have anything like that. In desperation I went to the internet and found a website I didn’t know existed which explains how if I have trouble getting my medical records to call Sedgwick and they will be glad to fax a request to the doctor. In the meantime, my short term was denied. Now I have no income and am at my wit’s end with them. After the holidays, my doctor did fax in some more information but now I have to appeal their decision. They have always talked to me in a demeaning way. They have made me feel as if my medical problems are nothing or non-existent. I have ended up in tears after three separate calls with their employees. This process has done nothing for my well-being and if anything has made my healing and progress even slower. I am proud my employer offers this benefit and I am certain it is abused, but there has to be a better way than this.

    ConnieJan 11, 2014  #203

  • My Dr. told that I was not to go back to work for 3 months. Sedgwick called me and said that I have to report myself back work. Only a month went by, they said that my Dr. released me. He didn’t see me, how can I be released without the Dr. seeing me. Can that be done?

    JJan 8, 2014  #202

  • Dragongirl,

    I am confused as to the nature of your claim being administered by Sedgwick. It seems that it may be a work related injury claim (as you state the will not authorize treatment). If so, there is little I would be able to offer in guidance as a worker’s compensation or employment attorney is the proper counsel.

    Stephen JessupJan 7, 2014  #201

  • I was injured at work in Dec 2010. My first claim with Sedgwick CMS was denied (because they sent info I needed to fill out to the wrong address). The second claim finally in July 2012 was accepted. I have been on TTD for almost a year and a half for torticollis. The problem is Sedgwick will not authorize any treatment for me. I am getting worse now. I go and see my treating physician and he just says “oh well denied”. He sees me for 5 min.

    Meanwhile they follow me around (like I really can’t do anything anyway) with cameras. I probably leave the house every two weeks for food, always in pain. Believe me I if I could afford to fix myself I would just tell them to… off. My workplace laid me off saying I was too hurt to do my job? What? I will never be 100 percent again, can’t do my regular job. My attorney ? is he in on all this. He tells me the insurance company wants me to see another doctor. All doctors I have seen say I need treatment. Sedgwick CMS and the whole system suck. I paid into this insurance for nine years? What happens when the 104 weeks of TTD wear off and still not treated or settled? I just want my life back SEDGWICK CMS!

    DragongirlJan 7, 2014  #200

  • Carol,

    Thank you for sharing. I would recommend you speak to a worker’s compensation attorney to discuss the rights available to you.

    Stephen JessupJan 7, 2014  #199

  • In my experience, Sedgwick is the most unscrupulous of all CMS’s that I personally have had experience with since my 1984 Industrial Injury.

    They promote themselves as being “cost-effective”, which simply means that they do not pay the physicians, they do not authorize referred physicians from Primary Treating Physicians, and they do whatever they can to delay and obstruct medical care. This is not only true for myself, whose case was inherited through the California Insurance Guarantee Association, but it was also true for my sister, who was injured while working at Ralphs.

    Their licensure should be revoked because they clearly do NOT have the patient’s interests nor physicians’ interests in mind. It is time that Sedgwick be banned from Work Comp altogether.

    If an injured worker such as myself is not in their network, they simply ignore requests. In my case, it nearly cost me life, and their 4 years of procrastination, which ended in a denial, of a repeatedly requested colonoscopy procedure ended up causing STAGE 3 Colorectal Cancer.

    Sedgwick is corrupt to the core. They just ignore referrals, deny even AME recommended treatment, evaluations, and physicians. How in the world do they get away with it?

    Can’t we file a class action suit to ban them from work comp?

    S. Carol RossoJan 6, 2014  #198

  • The doctor I go to monthly for pain took almost a month to fax records and the STD form to Sedgwick. I faxed them the forms on 10/17 and they were faxed back on 11/18. Before this I received a letter from the Sedgwick caseworker that another doctor, my neurologist, had approved me to be off until 1/15. I had given them my neurologist’s name but he wasn’t given any forms to fill out. When I told him of this he sent a memo to Sedgwick that they should not have used his name because he said nothing about my return to work date. After receiving the forms and records from my pain doctor on 11/18 they sent me a letter on 11/19 that I was approved for full disability through 11/2/2014. Prior to 11/28 I contacted Sedgwick to confirm this date and they agreed this was accurate. At this time they should have already scheduled an IME for 12/11 but didn’t mention it. I should have received a letter with the details of an IME scheduled for 12/11, but I did not receive it. The first I was aware of this was on the afternoon of 12/24 when I retrieved my mail from my apartment mailbox. There was a letter dated 12/18 with details of an IME scheduled for 1/15 with a Neurology Clinic doctor located in Kokomo, IN selected from a list of IME’s provided to Allison Transmission Inc. by Sedgwick.

    Another dated 12/17 said I had missed an IME scheduled for 12/11 and due to this they had suspended my benefits on 12/16. They would remain suspended until I attended the IME on 1/15. The soonest I could call Sedgwick was on 12/26, which I did. I explained to my caseworker what had happened and after some discussion he agreed to pay my benefits and was to call me on 1/2 after speaking with an Allison HR employee. Allison was closed from 12/24 through 1/1, returning on 1/2. I called him again on 12/30 to be sure he understood how important it was for them to talk on 1/2 and to contact me. I left a voicemail with a person in HR, whom I know, about the situation. I called him again on 1/2. I emailed him on 1/3 along with another person. I received an email from HR at Allison that they were looking at my case but hadn’t made a decision yet. I then called the caseworker who said he was currently discussing the case with Allison and he would call me. I explained that it was not my fault I didn’t receive the letter on 12/2, and also that I would not have a way to drive to the doctor for records, to pay for records or gas to drive from Indy to Kokomo without receiving benefits. Allison is aware of some of my medical conditions from the past (started in 1998 and 2004). My supervisor is also aware that I have medical problems. I have been on STD before and had to return after the IME. I have also been on FLMA but couldn’t afford to use it without pay. My file should show problems at work and I also have problems at home with my 2 sons. This is ruining my life. I have an appointment with a soc sec disab atty on Tuesday, 1/7 and will discuss this with him. I will be seeing a psych tomorrow, 1/6.

    Thank you,
    Christine Platt

    Christine E. PlattJan 5, 2014  #197

  • Rob,

    I would agree with you as to the crooked nature of Sedgwick. Their claims handling is horrible to say the very least, and they are often insulated from any real monetary damages as they are not an insurance company, but rather an third party administrator of your company’s disability plan. That being said, unfortunately, under the law they do have 45 days to render a decision on appeal.

    Stephen JessupJan 3, 2014  #196

  • I work for UHG. I have congestive heart failure and a pacemaker/ICD. Also have severe anxiety and dysthymia. Applied for STD to undergo testing, with no less than four doctors helping me. Sedgwick took a month to “review” my application, only to deny it due to lack of “observed impairment.” Doctors appealed claim within 48 hours. Sedgwick then advised their appeals team is allowed 45 days to make “decision.” Meanwhile, no pay, no benefits + additional anxiety for me. Sedgwick are white-collar criminals who need a massive class action lawsuit brought against them as well as a federal investigation.

    Rob DouglassJan 2, 2014  #195

  • Confused,

    Without a review of your policy and denial letter it would be difficult to provide any guidance. Please feel free to contact our office to discuss how we may be able to assist you.

    Stephen JessupDec 31, 2013  #194

  • Wow I seem to not be the only one having issues with Sedgwick. I injured my knees at work, while working for Walgreens. The manager took his sweet time turning it into them. Finally after months of waiting for an approval for an MRI I got it. Thankfully it “appeared” normal. Then they sent me to an IME. Well that was a joke and 3/4’s. They didnt provide this Dr. with half of my medical records, and he didnt bother to request them either. However he was very astute in referencing it mentioned the other Dr.’s and there findings in his report, but never bothered to follow up with them and request my files. Then they go and deny me. Well that was after sitting on the IME report for almost a month to two months! Then they denied to pay some of the offices they sent me to visit, so now I get nasty grams saying I owe or its going to collections. Even one shows that clearly sedwick denied that part of the bill but paid the others. Talk about some clowns! I have 4 Dr’s. All 4 with different opinions for the MOI, and against the MOI (due to lack of “evidence” in their opinion, they are the ones Sedgwick directly paid.) Yet I still have constant pain, and I am only 28 years old. Some days I hobble around like an elderly person, which one of the doctors has seen, any mention of that in the “reports” sedwick furnished to the IME, yep you guessed it that was omitted. Good think I took notes during this whole thing. I was told from day one they would try and screw me, and they did. I am hoping the attorney I am having look into my case will accept it. For I had one out of state look at it, and said that there is something going on in his opinion. Before you go saying that is unethical etc. He is a family friend, and I simply asked if he thought something was fishy one night when he was over to a gathering. I just think that its sad that they get away with this. Even the reports show they have taken there sweet ‘lil ole time on dealing with this issue.

    JamesDec 31, 2013  #193

  • I broke my ankle, off the job in Nov. Doc says I can return to work with many restrictions in Jan but won’t be 100% until around March. Walmart says no, I can’t go back until I am 100%. Sedgewick handles Disability. They are saying they won’t pay me because it’s an “accommodations claim” so they don’t have too. How is that?

    Confused and WorriedDec 30, 2013  #192

  • Thayne,

    It is good that you have a lawyer to keep pressure on Sedgwick. Unfortunately your company has entered into an agreement to have Sedgwick manage your claim. Sedgwick is often very difficult to deal with and they will likely never make things easy for you. Be persistent and ALWAYS deal with them in writing.

    Gregory DellDec 19, 2013  #191

  • Well, I work at Crest Beverages. I hurt my neck June 28th of this year. I have severe pain in my neck, down my arm, and my leg. I cannot lift anything with my right arm, and have severe trembling. I have NO strength in my right arm since the accident, and can’t lift more than a few pounds. That scares me. I am so uncomfortable, I can’t sleep at night. I also get severe migrains, that coincide with my neck pain. Sedgwick did not accept my claim until October. It’s now been 6 months. I’m hurting WORSE than when it happened. I have a Lawyer. But, even with the Lawyer, I have yet to have ANY treatment authorised! They have also denied my prescriptions. I was sent to an orthopedic surgeon, and they feel I’m a candidate for neck surgery. Sedgewick is trying to say it’s degenerative, and I’ve had it for years. Currently, I’m being paid bi-weekly. Two weeks ago, my check came on Monday, 3 days late. I still haven’t recieved this check. It’s 5 days late. Supposedly, it was issued on the 9th. This place is a complete joke Oh, and I am depressed. I probably won’t be able to do my job ever again. I work in a beer warehouse, throwing cases. I was at Coca Cola, doing same thing, for 11 years. Im 46.

    Thayne ZitoDec 18, 2013  #190

  • Stumped,

    I would recommend you consult with a worker’s compensation attorney if you haven’t already.

    Gregory DellDec 16, 2013  #189

  • William,

    I would advise you to speak with a personal injury attorney to discuss your wife’s options.

    Gregory DellDec 16, 2013  #188

  • My wife fell on some ice in Krogers parking out a year ago. I was told by others CMS will try to ignore my wifes claim in hopes we will forget about it. Kroger seems to be trying to help by calling CMS without any help. My wife had to go to the emergency room and received several staples in her because of the nasty cut she received from the fall. She also a blue tooth ear piece in the fall which was never recovered. All we asked for was to pay the medicial bill and replace the blue tooth ear piece. Kroger felt that wqas very reasonable. We are very good customers and still shop at Krogers, but we don’t know what to do about the claim, I don’t want to get an attorney for something like this. With this long wait you think my wife should be also compensated for the delay?

    Thank you.

    William ClemensDec 16, 2013  #187

  • This is some really messed up information I am learning about Sedgwick. I work at Kmart and I was injured on september 6th 2013 while I was working. I was getting ready to unload a truck and I was moving a heavey metal row bar that had really heavy football team jackets and hoodies and I tripped on a empty palette. while trying to move this row bar it started tipping and I was trying to prevent it form happening it hit my left wrist swelled up immeditly put a ice pack on it and it got worse was sent to our loss prevention person and he did a claim this is when I got introduced to sedgwick. i was sent to my local five star office and they did xray told me it was severly sprained and sent me on my way with a wrist band. I went back the following day and worked still having problems. I finally tried contacting Sedgwick back to be referred to somewhere diffrent and I was to my local ER. They did a second x-ray and said it was not fractured but they were treating it as if it was then I got refreed to an othropedic Dr. He took me out of work until further notice. Not even a week in to me being out of work I was contacted by my work and asking me when I am going to return to work. I was like what are you talking about, I am under the influence, I am out until further noticed. They were like no, we have a note stating you can come back to work as long as we can accommodate, which was a joke in itself. I went from having almost 40 hours a week down to nomore then 1 day a week for not even 5 hours then I was told by my boss I was milking it lying and just plian not wanting to come back for more hours. Then I preceeded to tell my worker comp person that and she tells me it’s my fault why hours got cut down because I was complianing about my wrist (not true at all). I have had so many diagnoses I don’t know what’s true; I was having severe panic attacks just being near Kmart and I got sick of it so I went and talked to a lawyer. I just can’t believe Sedgwick treats thier clients like that. It’s near the end of December now and I am still having problems being referred to a physical medical doctor. Hoping I can get some relief from this consant swelling and popping in my wrist. I was sent to a medical specialist through Sedgwick and he states I have blunt trama to my upper aspect of left distal forearm just above the wrist.

    Stumped Kmart EmployeeDec 16, 2013  #186

  • My name is Robert and I’m writing on behalf of my wife, Helena who is a Registered Nurse by profession. She used to work at Kaiser Permanente Medical Center in Vacaville, California, when she had an unfortunate lifting injury involving her right hand 3 years ago, June 17, 2010. Compounding the injury is the fact that she is right hand dominant. After the incident, she called her immediate supervisor minutes after it happened but was not relieved of duty until 7 hours later because of staffing issues. Although, she had a letter from the ED MD that she needed her hand to rest for three days, her immediate supervisor, told her to come in to work the next day because she was the only senior preop nurse that he had on schedule. After 3.5 hours of work in the preop area she asked to go home and did come home because of excruciating pain.

    She sought medical care with the Occupational Medicine Dept. They initially diagnosed a wrist sprain. Although she followed medical advice and restrictions, she continued to have severe pain and sought the opinion of a hand specialist. The specialist diagnosed a torn TFCC that was prominent in the MRI, which the specialist had ordered. She immobilized my wife’s hand with a cast for 8 weeks before she performed an arthroscopic TFCC repair on August 30, 2010. After the cast was removed my wife started working with an occupational hand therapist who reported slow progress. We were told that it generally takes a year for the hand to get better but, my wife noticed severe pain after every therapy appointment. She reported this to the Occupational MD who ordered another MRI, which showed severe avascular necrosis. Therapy was discontinued at this time.

    I went with her to see three different hand surgeons that all suggested another surgical procedure. On July 30, 2011, a Dr. of Kaiser Permanente, performed a Proximal Row Carpectomy. My wife’s arm was immobilized for 8 weeks after which she resumed occupational therapy, which lasted 4-5 weeks. At this time, we decided to move out of California because of family and monetary reasons. Although she was enthusiastic about getting better, my wife was skeptical because of her previous experiences. We were told by the Dr., and the occupational therapist, that her wrist was stable and that there was nothing she could do to re-injure it and that she should be able to resume activities as tolerated. My wife was then medically released by the Dr. to return to work starting in January 2012.

    We returned to California so she could start work in the pre-op area (with obvious weight limitations), the first week of January 2012. On Feb 15, 2012, while releasing a tourniquet from a patient’s arm, my wife aggravated her right wrist and sustained severe pain and swelling. She sought medical help minutes after the incident and was given ice and a right wrist brace. She then tried to get an appointment with her Dr. but was unable to see him. She went back to the Occupational Health Department and was immediately placed on work restrictions. After this second injury we returned home to Tennessee, where we still reside.

    After 4 months of temporary disability, because Kaiser refused to accommodate her with modified work, her hand continued to deteriorate with severe pain and limited mobility. Another MRI confirmed a severe tear of the TFCC and S/P PRC. A Dr. from the Kaiser Occupational Health wanted my wife to consult with the Dr. regarding this matter. He suggested cleaning the wrist up, but not reattaching the tear. At this time we requested for a second opinion. She continued to have severe pain and continued to fly out to see the Dr. from Kaiser until October 2012. Due to pain, hopelessness, financial difficulties mental anguish and the inability to get the right medical regimen from Kaiser, she was no longer able to travel back and forth to California to fulfill Kaiser Permanente’s requirement to get a letter from their Dr. with job restrictions.

    With my support, and that of family and friends, my wife decided to try and was able to get a position starting January 7th, of this year, at Vanderbilt University Medical Center as a Recovery Room Nurse. All the while her right hand/wrist continued to have severe pain and obvious mobility changes. It was during this time she consulted with a hand surgeon from Vanderbilt, who, after a thorough assessment and examination in February of this year, proposed a Right Hand Arthrodesis with Implant. This surgery was performed September 24, 2013, and his diagnosis was a Failed Proximal Row Carpectomy with Allograft. She is currently on her 10th week, post surgery and has completed Occupational Therapy. She saw the Vanderbilt Hand Surgeon December 6th, for follow up. He wants’ her to return on the 6th of January, 2014, for another follow up and X-Ray. He may release her to return to work on January 13th, 2014.

    We may need your assistance in correcting the obvious mismanagement of her care by Kaiser Permanente, from the date of the original injury until now. This has been debilitating and exhausting. Even though she has representation by a Workman’s Compensation Lawyer, she has not received any financial compensation from Kaiser since her state temporary disability pay was exhausted. Sedgwick CMS handles Kaiser’s cases now. Based on the latest AME report her subsequent injury and surgeries were a direct result of her initial injury in June of 2010. She has not seen any monetary compensation since November 2012, when her temporary disability was exhausted up to January 2013, when she became employed at Vanderbilt. Since this is an on-going case, she should have been receiving compensation from the date of her latest surgery until she returns to work in January 2014.

    I want the public to be aware of how Kaiser treats their injured employees. Specifically: The pain, suffering, lost income, and, in my wife’s own case, the probable permanent disability, due to the loss of use of her right hand/wrist, all because her supervisor failed to act in a timely manner.

    My wife has been a Registered Nurse since 1980 and has worked in Critical care areas such as Trauma ICU, Medical and Surgical ICU, ER, and Cath lab and has never had any injury at work until June 17, 2010.

    RobertDec 13, 2013  #185

  • S,

    We do not handle EEOC claims. I would advise you to speak to an attorney that does.

    Stephen JessupDec 13, 2013  #184

  • I was a former employee of Sedgwick in Washington, DC. I currently live in California. I filed an EEOC claim and now have a right to sue letter. I need help, fast! Class Action is all over this.

    S. SmithDec 13, 2013  #183

  • Sedgewick CMS for United Healthcare denied my Short Term Disability claim in 2011 in which we are still fighting. This is how it has unfolded. I went to their preferred mental healthcare provider, called them, it seemed like every other day to verify the medical documentation was received by Sedgewick, was instructed on many different occasions it was not received… called the mental healthcare provider, was assured the information had been sent… this went on for over 90 days… bear in mind, if the required documentation was not received within that 90 day period, the entire claim would be denied. Here is the reprehensible part… their preferred mental healthcare provider was not a licensed Psychiatrist, and could never do the cognitive testing required to approve my short term disabililty claim, but Sedgewick CMS failed to notify the healthcare provider or myself that the medical documentation would not be considered until received by a Psychiatrist… Sedgewick CMS allowed me to continue my treatment with a provider who could not meet the criteria of their policy provisions set forth in the mental health guidelines of the short term policy for the entire 90 day period so they could in turn, deny my claim for short term benefits. (I am still unaware of this)… I finally got tired of the run around, and made an appointment to go to my previous mental healthcare provider whom I had seen many years before, and had to pay out of pocket, who was a Psychiatrist, and she did the required cognitive test, and promptly sent the documentation to Sedgewick CMS, mind you… the 90 day period for this information to be received has already passed. But, because I was not told all my previous efforts to provide them with medical documentation to support my case wasn’t supplied by a Psychiatrist, my entire claim was denied, which in turn voided my benefits for long term disability. We are now at the court stage of my case, and all my hope resides in the Judge’s ability to see that Sedgewick made it impossible for me to provide the necessary medical documentation within the 90 day time frame which would have proven my disability and resulted in the approval of my short term mental health benefits. If that isn’t bad faith, I have no idea what is. I have been in mediation and of course to no avail… they have destroyed the lives of myself and my family, not to mention exacerbated my illness, and they are doing this on a daily basis, and hiding behind ERISA. I have no right to a jury, I have no right to mental anguish, I have no right to pain and suffering, because ERISA which was originally put in place to protect disabled persons, has been used by these corrupt corporations to shield them from large sum pain & suffering awards due to the disasterous effects their actions have on disabled people and their families. I am stripped of my right to a jury trial, and they are protected from large sum payouts… until severe fines and penalities are put in place against this type of practice, there will be no reason for these corporations to stop this type of bad faith practice, which continues the vicious cycle and many, many more innocent lives destroyed.

    Destroyed EmployeeDec 9, 2013  #182

  • Antuan,

    You are definitely not the first person I have heard this from. I have handled disability cases under the Comcast plan when it was administered by Liberty Mutual and in my experience I found Liberty Mutual to be much more professional and competent than Sedgwick.

    Stephen JessupNov 27, 2013  #181

  • I’ve been at Comcast for 7 years 5 1/2 years as a Technician and 2 years as a Customer Service Agent in Michigan. Comcast just recently switched to Sedgwick in 7/2013 from Liberty Mutual which I never had any issues or problems with. Sedgwick is one of the Most Unprofessional Ignorant Company that I have ever Dealt with, I’m also a Disabled Veteran. I was on FMLA (Family Medical Leave of Absence) With Liberty Mutual 2 months prior to Comcast Switch to Sedgwick, I had 2 knee surgeries from returning from Iraq and since being Employed at Comcast, I’m on all types of pain medicine for my knees and get my Cortizone shots for pain and all my other medicines for my lungs and back. I contacted Sedgwick for short term Disability in August because my Doctor wanted me of work from 8\2013 till 11\2013 I filed my Claim with Shakia White and processed all the paperwork that she asked for, after going back and forth to my Doctor because they said he did not fill out the forms correctly before any deadline they denied me and never called to tell my, I found out by calling the Automated service very upset about that then I called to speak to her manager and she told me that they could not read my Doctor’s handwriting which was a slap in the face after my Denial to her that even though no one ever said it before. I Appealed it and spoke to Kerry Clay and she was mean and arrogant from day one and threatened me that if my Appeal was Denied then I can’t file another one, this Company is the worst ever and I called Comcast Corporate Office to voice my concern Multiple Times and warned them of A Lawsuit and Kerry Claw and she pretty much said I don’t care do what you have to do, I told Comcast what she said and that I’m writing a letter to Congress and also going to the News Media as well as The Social Network to voice my Concern so someone can Put Sedgwick on Notice about Mistreating Claimants and their Unprofessional and Rude Behavior as well as their inexperienced Agents rendering claims and turning people lives upside down.

    Comcast said they are now investigating Sedgwick because there are other Complaints from other Comcast Employees beside myself. Only 5 months with Sedgwick and I hope it’s a short lived partnership.

    Antuan CharleyNov 26, 2013  #180

  • Diana,

    Is your case for worker’s compensation or disability insurance? If it is for worker’s compensation I would suggest you consult with an attorney specializing in that area of the law.

    Stephen JessupNov 25, 2013  #179

  • Ann,

    It is unclear as to what your disability status with the company would be, and as such I would not be able to provide any guidance. Please feel free to contact our office to discuss your situation further.

    Stephen JessupNov 25, 2013  #178

  • Sedgwick scheduled a medical appointment for me to visit their doctor to continue my long term disability claim. Sedgwick’s doctor ended up saying I would need surgery because I did have significant issues. Sedgwick’s claims manager actually falsified restrictions for my employer as if it was from their doctor to help my employer force me back to work before my long term disability ended. Sedgwick then terminated my disability claim. I filed an Appeal but Sedgwick denied it of course. As a result of Sedgwick’s false medical restrictions I suffered with a lot of pressures by employer. I eventually lost my job all together as a result of complaining about a incident that occurred as a result of Sedgwick’s fake restrictions. I tried reporting Sedgwick to the insurance commissioner but they stated Sedgwick is a third party insurance administrator only so they could not do anything about their practices in the sorry state of California.

    True or not I cannot believe this place got away with doing this and helping to cost me my job altogether.

    NatNov 24, 2013  #177

  • My claim management was transferred to Sedgwick one month ago after my employer (in WA. state) sold to another. Without any notice, Sedgwick has denied payment for my medications. I have been on these meds for 2 1/2 years and require them to keep my complex regional pain syndrome under some control. I acquired CRPS after an entrapped nerve following reconstructive foot surgery due to a crush injury. I am not fixed and stable according to my physician and I continue to see him every 2 months. Sedgwick has also informed me that they are making appointments with IME doctors. My claims manager also let me know that my medications are very expensive. She also stated that my employer had tried to settle with me several times, but that is an outright lie. There has been no contact whatever with me regarding that. Which I found very unprofessional, at the very least. I honestly feel that I am being railroaded out of my recovery. My experience, although brief, with Sedgwick is one of OMG! I cannot believe that this company is still in business. What options do injured workers have with this company?

    DianaNov 21, 2013  #176

  • You know I was suspended from AT&T after my Dr. wanted me off. This Sedgwick company is now denying my claim to disability saying I am suspended pending some investigation, but I am not fired. Don’t know why… what should I do, apply for unemployment?

    Ann T.Nov 21, 2013  #175

  • Oh and forgot to mention that despite my Doctor saying I need the time off and can’t function, Sedgwick decided I had enough time off!

    Ms. BotheredNov 19, 2013  #174

  • It’s been a nightmare dealing with Sedgwick. I had surgery on my hand earlier this year. I do a lot of typing for my current job so it is imperative that I completely heal before going back to work. Well, according to Sedgwick, they felt that after about 10 days post-op, I was able to go back to work because they claim they didn’t receive my medical records in time to warrant the rest of my time off and not only that, the information they did receive did tell them I experienced pain and did not have full function in my hand. However, according to Rep, the notes did not mention my range of motion status, so it was denied. Well, my first post-op visit was the removal of sutures…does that count for anything? It makes no sense! The doctors office sent in requested medical documentation at least 4 times and still, the rep claim she did not receive ANY records. Needless to say, I was still in pain and experienced stiffness. They sent in a form asking questions about my status and still, the answers guven wasnt good enough. I ended going to physical therapy for a couple of weeks an then foun out that my cyst reappeared as that te stalk wasnt fully removed an was attached to a nerve. This is why I was experiencing pain, weakness, numbness, etc. Still, this wasnt good enough for Sedgwick. I ended up with a second surgery about 4 months after the first one and still had to go through the appeal process because they considered this to be the “same claim”. This has been a total nightmare!

    Ms. BotheredNov 19, 2013  #173

  • Valerie,

    That is the million dollar question. Sedgwick is known for their incredibly frustrating claims handling. Hopefully you will not have to resort to hiring legal representation.

    Stephen JessupNov 12, 2013  #172

  • Why does some idiot in a cubicle have the right to override my mom’s doctor decision on how often I need to be off? I am allowed 12 weeks of FMLA whether I take it all at once or here and there. The diagnosis is chronic and I have medical power of attorney. My next step will probably be an attorney.

    Valerie HardwickNov 11, 2013  #171

  • Randal,

    Unfortunately your situation is not uncommon. The insurance company, or as is the case with Sedgwick acting as a third party administrator, does have the right to make ongoing determinations as to entitlement to disability. As most STD benefits are paid weekly, this can mean weekly. Please note that your doctor’s refusal to speak with Sedgwick could have adverse effects on your claim.

    Stephen JessupNov 9, 2013  #170

  • CB,

    Thank you for sharing your story, and I am sorry that you had such a difficult experience. As you can tell, you are unfortunately not alone.

    Stephen JessupNov 9, 2013  #169

  • I am a cancer patient on STD from AT&T, my cancer is inoperable but the Sedgwick calls keep coming after or even before my Endo appointments. Now they are trying to get my Endo to submit to a peer to peer review over the phone and he refuses. I expect any day now to be denied further STD.

    Since no surgery is forth coming what am I expected to do? DIE?

    Very little to no compassion from the AT&T machine.

    Randal DicksonNov 8, 2013  #168

  • I was working in an extremely loud environment for several months and developed tinnitus in my ears. When I filed a workers comp claim, Sedgwick was going to make me wait two and half months to see a doctor. During this time, the person assigned to me was impossible to contact and rarely returned my calls. My condition was unbearable and after two months of waiting I couldn’t endure the suffering any longer. They wouldn’t let me use my normal work insurance to seek medical attention. They told me that my regular insurance would reject any claims sent to them since it was workers comp. I learned that the doctor they were going to send me to was only a GP and was going to evaluate me to then see a specialist. This was going to then take several more weeks beyond the two and a half months. I had to plead with Sedgwick to drop the claim so I could seek medical attention sooner. They finally did drop the claim and I was able to see a doctor. Unfortunately I learned that there is very little medical science can currently due for tinnitus. I am out of pocket for all my related medical expenses. There are some therapies that are supposed to help, but insurance won’t cover them and they are far too expensive for me. Sedgwick is a horrible disreputable company that gives their clients nothing but disservice.

    CBNov 8, 2013  #167

  • My wife FMLA claims are processed and administered by Sedgwick. We have a 8 year old son who suffers from Severe Autism. We have had a intermittent FMLA case where by she was able to take time off to attend to my son need at time of flare ups and aggressive temper tantrum. My son school cut his hours to half day in August and are planning to cut to just one hours of schooling. My son needs to be watched at all time as he has no understanding of his surrounding and would often engage in self injurious behaviors amoung multiple other things. His speech is limited and often had to be engaged properly to understand his need from feeding to toileting and dealing with medication side effects. His condition is very debilitating.

    last week we were notified that her FMLA case is closed because she reached zero hours remaining. It was .50 hrs remaining however. The asked us to send a new doctor’s certifications and process a new case. She builds up her FMLA hours based on hours worked last year. She will accrue 8 hours this Sunday 3rd Nov and 8 hours every Sunday after that. We have our Son’s Doctor already faxed the completed certification and we were asked to also sign and fax them a very open Auth of release of my son’s medical info, which we already did and faxed them.

    I have a strong fear based on my conversation with the claim specialist and his supervisor that they will make it difficult for us. Just to let u know the FMLA is non paid and also forces us to use our vacations first. I will know more next week but am very concerned. Sedgwick took over processing this year, thus first time dealing with them.

    SKumarNov 2, 2013  #166

  • Karen,

    The policy is essentially a bargained for contract. The terms written into the policy are the ones paid for by the employer and then provided to the employee at no cost or at very low premiums. The adage, “you get what you pay for” is very much the case. To purchase coverage that isn’t limited one would have to secure a private policy, which comes at a substantial premium rate, and even then many disability insurance companies will still only sell a policy with a two year limitation for a mental health claim. Although I understand your frustration there is no applicable lawsuit for “discrimination” as the terms are a bargained for benefit.

    Stephen JessupOct 17, 2013  #165

  • Stephen,

    Yes, I understand that my policy states the limitation. My argument is that insurance companies that write this into their policies need to be challenged because this is gross discrimination against a large number of Americans. I can’t find anyone that is willing to challenge this discrimination. I understand that back pain is hard to determine but there is not a limitation on that disability. I just would like to find someone who is willing to challenge this policy. If not for me, but for future mentally disabled Americans.

    Karen B.Oct 16, 2013  #164

  • Karen,

    Almost every employer provided disability insurance policy limits claims for mental health, with the most common time period being 24 months. Unfortunately, it is legal for them to write such a restriction and if your policy has this language there is very little that can be done.

    Stephen JessupOct 16, 2013  #163

  • I have been approved the whole time for my LTD insurance. My major complaint is the disability time limitation for mental illness disorder claimants. I will receive LTD for 2 years only even though I worked for my company, a bank, for 28 years counting the time I’ve been on disability. I think I am being discriminated against because of my disability. I was told by Sedgwick that this is a typical practice of insurance companies. I think it is extremely unfair. Mental illness is just as debilitating as any other illness. Sometimes even more.

    Karen B.Oct 15, 2013  #162

  • Liz,

    I am unsure as to your question. Can emotional stress be a disabling condition? If so, yes, but most carriers will deny benefits based upon emotional stress/depression/anxiety, etc that was not being consistently treated for prior to the period of disability.

    Stephen JessupOct 15, 2013  #161

  • I am wondering if there is anything that can be done in regards to emotional stress. My Doctor put in for worker’s comp for the repetitive injury to my right wrist and it was denied. I put in for STD as I need the money badly. After 2 1/2 months that was denied. They are saying not medical reason for being off work. I have fought with them for the past 4 weeks and have gone in to a deep depression from it. Last time I sought help for it I was off work for 3 weeks per doctor’s requirements due to suicidal thoughts from the medication and we denied STD at the old employer. I am afraid to continue the appeal on this one with the additional stress. I have a special need son and we suffer serveraly fianacially.

    LizOct 14, 2013  #160

  • Rosemary,

    I am sorry to hear of your difficulties. If the claim was denied you would have to go through any mandated administrative appeals that may be required of the policy.

    Stephen JessupOct 14, 2013  #159

  • I filed for short term disability through my employer’s representative Sedgewick CMS due to my diagnoises of Recurrent Major Depressive disorder. The dates I provided to Sedgewicks were to commence 14July2013, however prior to the onset of my episode I did report an OJI and missed the days prior due to OJI and Dr appointment for OJI, which commenced on 05 Jul 2013. I did receive a denial of my benefits based on lack of medical documentation supporting my leave commencing on 05Jul13, the day my OJI was filed in office, and this in contrary to our companies policy, instead of the date I provided of 14Jul13 which all medical documentation does support. As of today I have yet to return to work but have lost all my benefits included my health insurance although I do continue my therapy and pay out of pocket for my meds to assist with my depression. My claim is under appeal, and my workers compensation case is now being handled by an attorney, however I have since been evicted and myself and my youngest daughter are staying with one of my other daughters, her boyfriend and daughter in a one bedroom apt. I have also lost my mode of transportation due to not able to make payments. I have since been approved for unpaid medical leave for original dates provided by myself by same company and have been advised by my employer not to worry about my job but they have put me in such an awkard situation I am almost forced to go back before I am really strong enough and my current situation is only making it harder. My disability is a DSM IV disability w/ the ADA and was noted as such by my therapist, and I fear going back too soon will only set me up for failure. At this point are you able to advised me of my rights. I am so sick of living in fear and ending in failure….

    RosemaryOct 12, 2013  #158

  • P.W.B.,

    If the action is one for Worker’s Compensation, you will have to consult a Worker’s Comp attorney as to same. Additionally, if there are any concerns regarding any issues related to her employment with GM those would be best addressed by an employment attorney. However, please note that since the facts surrounding your mother’s claim occurred some 32 years ago chances are any applicable statute of limitations has expired.

    Stephen JessupOct 12, 2013  #157

  • This is an old Worker’s Compensation case. In 1981, my mother was injured while working on the assembly line for General Motors Corporation, in Fremont, California. After filling out the Accident Report, she was sent to the GM company doctor. After the doctor examined her, he released my mother back to work, with a note placing her on restricted work. When my mother returned to work, she was assigned non-restricted work. As a result, she was re-injured. When she returned went back to see the company doctor, he wrote a letter to GM stating that “despite” his recommendation, my mother was re-injured because they could not accommodate her with restricted work. In the letter the doctor stated that my mother will be permanently disabled in the future. While on disability, there was a Model Change and the plant was closed. “While on disability,” my mother was sent a letter from GM or the Union, placing her lay-off status. How can this be when she was already on disability? Since 1981, my mother has been seeking benefit payments. Recently, my mother was labeled as a vexatious litigant because she keeps filing requests in court for a hearing. Her case has been taken off calendar several times. Although my mother has “all” the evidence to substantiate her claim, her request for benefit payments keeps falling upon deaf ears. The case was never settled after 34 years.

    P.W.B.Oct 12, 2013  #156

  • Jessica,

    When you say waiting for your court date, I assume your claim is for Worker’s Compensation benefits? If so you will have to consult with an attorney specialising in that area of the law to be better informed as to your rights.

    Stephen JessupSep 25, 2013  #155

  • Am I allowed to sue anyone for all of the additional problems I am having? While I sit and wait for my court ruling I am suffering severe financial loss. I am now facing eviction because worker’s comp. is trying to say this is not a work related injury. My bills are two months behind with late fees and I am facing my utilities being turned off. I am a single mother of three young boys and have tried the assistance programs in the area. It has been since January of this year so I have used all of the help in the area. I am so depressed and don’t know what else to do… Are there any laws to help the worker that is being smacked around like a rag doll?

    JessicaSep 24, 2013  #154

  • Mr. Jessup,

    I just settled with both companies yesterday. I wanted to fight but my attorney didn’t, so I’m not happy about the outcome but at least it will be over.

    Crystal W.Sep 20, 2013  #153

  • Jessica,

    I am sorry to hear about your experience. So it appears that you are awaiting a worker’s compensation ruling? If so, then there would be no information I could provide to direct you one way or another. With respect to the long term disability denial, if the coverage is based on an ERISA governed group disability policy then you must be sure to file all required administrative appeals within the mandated deadlines.

    Stephen JessupSep 18, 2013  #152

  • I have had an ongoing claim since Jan. 2013 and Sedgwick has been horrible. From missed payments, wrong amounts, and disgusting comments made to me on the phone. I had returned to work at reduced hours in April and during my “light duty” I was asked to move 68 pieces of heavy furniture in my four hour shift with one person to help me. Needless to say I re-injured myself and was removed from work by the doctor in May. I was not paid by Sedgwick my lost wages while on reduced hours. Once I was removed from work the second time Sedgwick sent me to their doctor. He was rude and aggressive and didn’t even fully examine me. He made a recommendation that my injury was related to and accident that I had 18 years earlier that did not even affect the portion of my body my worker’s comp claim involves. In July all payments from Sedgwick stopped. They sent me a notice that they are ceasing my payments based on their doctor’s recommendation that it is not work related, mind you my injured area never caused me any issues in the past 18 years, just started in January when I was crushed at work. Sedgwick also did jot send me a copy of the C-11 form as required by law. I am unable to receive any of the medical treatment or physical therapy to get back to work. I have used all of my savings and loans from my 401k in order to support family. My lawyer waited until the end of August to apply for a hearing and I am still stuck waiting. I do not know what to do now. I’m still in pain, my lawyer is dragging his feet, and my long-term disability claim has been denied… Next time I het hurt on the job I won’t say a word if this is how employees get treated.

    JessicaSep 17, 2013  #151

  • Crystal,

    I am sorry to hear of your difficulties. What is the status of your claim now? Please feel free to contact our office to discuss how we may be able to assist you.

    Stephen JessupSep 16, 2013  #150

  • I had 2 claims with Sedgwick. My first was a short term disability from the end of September 2011 – November 2011, they stopped my disability early and didn’t pay my last payment. When my doctor didn’t clear me to return to work Sedgwick bought in a doctor who never spoke with me or even examined me to say I was not sick. I ended up having 3 more surgeries after I was told by my employer (LabCorp) I had 2 days to return to work… I did but I got sick on the job and ended up having another surgery. I filed again and was given the temporary approval so they could verify my surgery but I was told by my doctor that they never did. When I got out of the hospital there was a COBRA package on my bed. Yes LabCorp fired me and Sedgwick screwed me.

    Crystal W.Sep 15, 2013  #149

  • Becky,

    As all claims are different, from the limited amount you have provided, it would be hard to determine chances of success on appeal. Please feel free to contact us to determine how we may be able to assist you.

    Stephen JessupSep 10, 2013  #148

  • I have severe rheumatoid arthritis. My doctor prescribed Humira for my condition. My insurance company mandated that I use Cimzia before Humira. Cimzia quit working after 5 months and I had a very severe flare up and went on STD. Sedgwick, of course. I was out 18 weeks due to this flare up. Sedgwick denied the last two months of my claim. The doctor’s notes don’t support the time off. I saw 5 other physicians for conditions related to my rheumatoid arthritis during that time. Sedgwick is unaware of the other physicians visits. I plan on appealing my case with Sedgwick by providing the medical records from the other physicians. If I lose my appeal I will be terminated by my employer. I have never taken time off for an illness or used any form of disability insurance before. Do you think I can win my appeal? There is an added twist to this. Please email me. Becky.

    BeckySep 9, 2013  #147

  • Sedgwick denied my request for intermittent FMLA leave. After I had outpatient surgery and was off 2 days, my eye doctor recommended that I be permitted to work on a reduced leave schedule (3 days per week) for a period of about a month following the surgery because my eye was still healing. Sedgwick wrote me a letter stating that my employer would not accommodate ANY request for reduced schedule leave, and the only way I could qualify for intermittent leave was for “flare ups.” But the purpose of my leave request was not “flare ups,” it was to limit my time at work so that my eye could recover. When I had the 2nd eye done, I got in trouble at work for taking 9 days off including the day of surgery – but I knew there was no way Sedgwick would approve my 2nd request for intermittent leave.

    CeciAug 18, 2013  #146

  • Jen,

    If you Policy allows Sedgwick to reduce your benefit by other income that you have been receiving, they would have a right to recollect the money.

    Stephen JessupAug 3, 2013  #145

  • They said I got overpaid and now I have to pay them back. I call 4 times about how much I was getting how I was get paid every week I was told every thing was fine it was right. Now they say I never told them when I did and they just found out when I need more time off when I called them now I am not getting any money this time it will be going to pay off the money. Told them now it me that has to pay not right. Help. Thank you.

    Jen SylvesterAug 2, 2013  #144

  • Karla,

    Unfortunately I am not able to answer your question. You will need to consult with an attorney that specializes in worker’s compensation cases.

    Stephen JessupAug 1, 2013  #143

  • Pat,

    Unfortunately, if your doctor is unwilling to cooperate with filling out claim forms then it could provide your carrier reasonable grounds to deny your claim. This is not an uncommon occurrence as many doctors do not want to be harassed by insurance companies. Outside of finding a new doctor, there is very little advice to give.

    Stephen JessupAug 1, 2013  #142

  • Hello, as of January 2013 I found out that I had an workman compensation claim that had not been paid out the social security contacted me to let me know about this. In October 24, 2005 I had a work injury when I lived and Baton Rouge Louisiana and I hired and attorney but he told me not to hold my breathe because I probably would get nothing. Well, I went on with my life and forgot about it until January 2013 when I got that phone call from Baltimore Maryland Social Security Payment Center.

    So, I had no way to find who had this information so I begin to do a lot of research until I came around Sedgwick CSM so I called them and I told yes we are handling your claim and we just need information I told no problem what do you need. I faxed them the letters from social security and now no one will contact me back. Why?

    I wrote the White House about my situation and they had a represented from Baltimore Maryland payment center contact me again and they said we need to get the bottom of this and gave them my adjuster name and number but they never contact them.

    I am sick and tired of people avoiding me I have the right to know… All they said to me tell the social security office you have never been paid, your money is still here… So, my question is very simply why is it taking so long to get back to me?

    Karla TerrellJul 31, 2013  #141

  • I have been off work for almost a year with 2 bulged discs, multi-level degenerative disc and it is severe in my L-5/S-1 area where I had surgery 16 years ago. I have also found out I have moderate arthritis and bone spurs in my right hip along with sacroiliac joint pain. I have been treating with a doctor at the spine center since December 2012, I have had a steroid shot in SI area, an injection in SI joint (which made things worse)as well as a hip injection. I have gone to physical therapy 2 different times and both time have stopped due to reach a point of nothing helping. The steroid injections have done little to help. I recently was diagnosed by my GP has having panic disorder that he feels has been brought on by the injections. I was scheduled to have a third injection in my lumbar spine, per my GP request I have postponed that injection at this time. In the meantime I received papers from my ltd carrier for a 6 month review requesting all visits, tests, etc. as well as their form to be filled out and if not received by 8/31/13 my benefits will all be stopped including insurance and cash. I saw my doctor at the spine center to discuss other options at this time, he stated he doesn’t feel that the injection have anything to due with my panic disorder and wants to send me to the pain clinic so I can be sedated for the injection. He totally refuses to fill out the insurance forms stated he deals with spine issues. He is the Dr. on record and has been treating me. What if anything is there that I can do? My employer will not allow me to return to work until I am 100% with no restrictions and currently I am unable to return due to my inability to function normally with daily activities. Everything I do increases the pain and inflammation. The doctor has not released me and is now sending me to the pain clinic. If my benefits are stopped I will have no money to survive on and no insurance to continue my medical care. Is there anything I can do? Any advice would be greatly appreciated.

    PatJul 31, 2013  #140

  • Robert,

    I also worked for UnitedHealth Group and had issues getting paid, I would suggest you contact United HR Direct and talk to a payroll specialist. They were able to help me out once I was approved.

    KarinJul 30, 2013  #139

  • Robert,

    If your claim is governed by ERISA, unfortunately there is no recourse for “hardship.” Under ERISA the only damages an insured is entitled to is unpaid benefits. However, I would suggest filing a complaint with your state insurance commissioner, so at least the state is put on further notice as to what Sedgwick is doing. With enough complaints there stands a chance that the state insurance commissioners will enact stiffer guidelines for disability insurance carriers/administrators in the state.

    Stephen JessupJul 28, 2013  #138

  • Sedgwick approved my claim but due to financial hardship I requested an off cycle payment since I have not been paid in sometime the denied it with no reason why and my processor has never called me. I work for Optum RX, do I have any recourse for the hardship they have created for me?

    Robert J Healey JrJul 26, 2013  #137

  • Shea,

    You can file a complaint with your State Insurance Commissioner and explain what Sedgwick is doing and the errors they are making in computing the repayment.

    Stephen JessupJul 15, 2013  #136

  • I got approved for LTD in 2009 and finally found another job in another state that I could do because it fit the restrictions late last year. Sedgwick was dragging their feet on continuing the claim and approved continuance the day I was loading up to move. While the company who employs Sedgwick approved my claim through 12/2014, Sedgwick kept having me fill out qualifying paperwork/re-examination every 3-6 months. Every dealing with them set me back in my recovery efforts. It was like I was a criminal. So the last month of their disability I notified them I thought I went over the benefit amount with income so they needed to close my claim. I knew I would owe them 1/2 of the salary I earned for the qualified days for that last month… 25.5 days to be exact. First they sent me a letter saying I owe them zero. Previously they had taken 2 months more out of the lump sum SS payment I received which made the offset even or that I was getting the SS offset for one month in advance instead of arrears as they now claim. I can prove this. So after they sent the I owe zero amount overpayment, a few weeks later (after I’d spent the money I had set aside to reimburse them of course), I get another notice that I owe them a full one half the salary for the entire month. Obviously the salary that month was more than the benefit amount since that income ended my claim. They want me to reimburse them $1000 more than what they paid me in benefit that last month! I keep telling them they can only take half of the income up to the benefit amount they actually paid me! No. They keep running me in circles on the phone making me relapse from their bullying. I’m so sick of this. Who can I report them to? This is the office in soCA and the LTD plan who hired them is in another state. They should be put out of business under the ADA for their horrible discrimination and harassment of disabled people. It is completely insane what they do to people. I just cannot deal with them anymore.

    SheaJul 13, 2013  #135

  • Christina,

    I am truly sorry to hear about your troubles. I wish I could say that this is uncommon with Sedgwick, but I think a review of the comments and complaints on the internet make it clear it is all too common. Please feel free to contact us to discuss how we may be able to assist you in the event your appeal is denied.

    Stephen JessupJul 11, 2013  #134

  • I was injured in an automobile accident on Jan. 23rd and have not been to work since the accident and have not been paid in a month. I have a team of 8 doctors and those collaboratively agree I should not yet return to work. I have had three, nearly four IME exams where the first doctor agreed with my doctors plan. They didn’t like that answer so sent me to another which I did not go to as I brought it to their attention this doctor along with my last were being sued in Federal court for violation of the RICO statute. Two of the doctors they have tried to send me to are being sued in Federal court. They have since sent me to two more IMEs who say I am fine to return to work. Their doctors don’t care about my medical records. I am suffering from neck and back pain along with post traumatic stress disorder, anxiety and depression and migraines. In addition my insomnia has worsened and my medication titration is not yet stable. They just denied my neurologists claim that I am disabled and I am to report to work because I cannot continue to go without getting paid. I have made an official appeal but have yet to get the results. This company is dirty, I am really at a loss as to how to proceed. By the way, my employer does not pay for anything but my paycheck, my medical benefits have been paid by my husband’s employer and auto as secondary.

    ChristinaJul 10, 2013  #133

  • SA,

    I am sorry to hear of your struggles with Sedgwick. As I am sure you have learned, what you are experiencing is not uncommon. Please feel to contact us should you have any questions on how we may be able to assist you.

    Stephen JessupJul 9, 2013  #132

  • I was recently denied short term disabiity from Sedgewick for a major depressive episode. I have been employed with United Healthcare for 13 years (exceeds expectations ratings) and had this episode after finding my daughter was addicted to pain medication. After getting her to treatment and to a halfway house, I left work with near fainting and heart palpitations and unable to function. I went to the hospital but did not stay overnight. This was after several years of severe work stress where I was threatened in meetings, dealt with employee who had cancer and died, an employee who became pregnant by a leader, etc. My doctors are adamant that it is too soon to go back to work. I feel this hurt my credibility with my employer. I am about to appeal for the first time and my doctors are suggesting legal involvement.

    SAJul 8, 2013  #131

  • Jessica,

    Is your claim for worker’s compensation or for disability benefits? If it is for worker’s compensation I would suggest that you speak to a worker’s compensation attorney to determine what your rights are.

    Stephen JessupJun 23, 2013  #130

  • I was injured on the job back in late January of 2013 and have had to deal with Sedgwick. I have caught them in numerous lies where they stayed they were not paying me because they claimed they never received my pay stubs to prove reduced earnings, when a week prior I was told they had them and “the check is in the mail.” My claims adjuster vocally blamed me for my problems and told me its not her problem. I re-injured the same body part after returning to partial duty and am now back to full temporary disability. My claims adjuster started yelling at me so I hung up on her. It has been 39 days since my doctor requested physical therapy and Sedgwick still has yet to approve or deny it. Mean while as o wait my entire ankle and arch has begun to collapse causing extreme pain that has me in tears every day, and now my doctor says I may have permanent damage that would require surgical implants of more than three rods and six screws to rebuild my foot and ankle that could have been avoided if I had been able to do my p.t. over a month ago. Sedgwick is the most incompetent company I have ever had to deal with. They are lairs, cheats, thieves, and a disgrace. Lack of timely case management from proper payment, to pain management, and timely medical authorizations led me to have a complete nervous break down, Sedgwick refuses to acknowledge that part of the claim… They are literally destroying any chance of full recovery I had and slowly killing me…

    Jessica R.Jun 22, 2013  #129

  • Jill,

    I am sorry to hear of your struggles. It appears from your account that your claim is for worker’s compensation and social security benefits. Do you have a private or employer provided disability benefits? If so have you filed for same, and what is the status?

    Stephen JessupJun 22, 2013  #128

  • Thank you for speaking with me. Where to begin? Back on Sept. 24th 2012 while working at my store (GM family dollar)i was moving around dog food and throwing out the expired products I was almost finished and was sweating which I brought my right forearm up to wipe across my forehead I glanced very quickly and noticed a spider on my right forearm not thinking I just knocked it off my arm and continued to work. Later that eve I was in my office doing schedules and I noticed what looked to be a little pimple on my right forearm still not putting two and two together I put some neosporine and a band-aid on it.

    Left work and came home around 3am I woke up and was achy,hot and then cold so took some Tylenol laid back down got up around 5:30 am and went to work. My director was there helping me set up Xmas she asked if I was OK and I said yea think I just got a touch of the flu and continued working still not putting two and two together my arm was killing me but put it out of my mind.

    Finished up and came home that’s when I noticed that the little pimple was now the size of a half dollar so I put neosporine and bigger band-aid on it went to bed and woke up and got ready for work. It was Friday and pretty busy but I was not feeling well at all. Dizzy,sweaty and hot and cold so I went and sat down in the office one of my employees came to check on me and he said Jill your arm is huge what happened I said not sure and that’s when he replied did u get bit by something on that arm and that’s when it clicked I had been bitten by that spider. I called the nurses line that our company has and she told me to call 911 which I did and was transported to Cabell Huntington emergency room and that’s where the nightmare started.

    My arm the size of a small watermelon with a bulls-eye in the middle. I was released being told I was bitten by a brown recluse spider by the way the markings were also circled my arm in pen and told me to return if the redness went past that mark. Well it did and early morning I returned to the er and was admitted saw several infectious disease dr’s and they had discussed debreeding it,packing it and wound vacuuming it but the next thing I know I was released and nothing was done.

    I have been in and out of the hospital over 24 times and still nothing was done except for lots of iv meds and pain meds. Still they never opened my arm and still to this day. Since it happened at work its workers comp which we use Sedgwick. I went for almost 3 months with no caseworker come to find out she was on family medical leave for 3 months and my file just sat on her desk til she came back. meanwhile I’m running all over trying to get help with my arm. Back and forth I went but still no one would open it. Then my caseworker went out again and this time my file was passed onto many caseworkers but I couldn’t get in contact with anyone for months from Feb. 2013 til end of May 2013 no one was returning my calls and my arm had now lost feeling and shakes horribly.

    This is just a small part of this story. It has and will become a huge case. From medical malpractice, social security and workers comp attorney have all taken this case. This has changed my life see because im very athletic and can play no more. I hope this sparks interest to hear my story because this can happen to anyone, even worse a child. I have documents that have been falsified by Sedgwick, hundreds of pictures and a lot more to this story.

    All I want is to be heard and helped! Oh, almost forgot reason I was denied hyperbaric oxygen chamber is… ready for this I am a 47 year old male who uses illicit drugs, I smoke and am an alcoholic. First of all, I am a female, I don’t smoke, use drugs or drink, I am an athlete and the Dr. Sedgwick had look over my case was a family practice Dr. not a specialist. I am taking this huge insurance co. to court!

    Thank you,

    Jill BarberJun 21, 2013  #127

  • I have been dealing with Sedgwick in one form or another (workman comp of Texas) since 1993. I recently moved from Texas to Winder, Georgia last year. I have already had to pay for airfare to Texas twice to see my doctor, Dr. Paul Geibel of South Texas Spinal Clinic. I can only go once every six months. That’s what is allowed by Sedgwick. Plus it taks me 6 months to save for ticket. I’ve asked my adjuster Betty Connally for the neurologist’s name and number in my area; now she says she doesn’t know anyone in Georgia. I’ve had a Lamenectomy in 1994 and a spinal fusion in 2001. I saw my Doc. on June the 7th 2013. He has requested another M.R.I. I don’t go back ’till Dec. 10 2013. Maybe someone can help.

    Jamie C. BacaJun 18, 2013  #126

  • I just went out on May 1, 2013 for back problems. I have had 3 surgeries on my back in the last 10 years. Going back to work this week, June 12, 2013.

    Dr’s papers sent to Sedgwick said I was disabled from May 1 to June 27, and also said that I could not do any work during this time. Sedgwick didn’t care, they denied my disability claim. I have sent in the appeals form, but haven’t heard anything from them yet. I am sending a letter and information to the Georgia Insurance Commissioner to see it they can help. People need to get together and put these people out of business.

    William. L. Lane jrJun 10, 2013  #125

  • This is on behalf of my wife. She’s 60 years old and has worked 18years for a company that Sedgwick (or Sludgewick) represents. (I say Sludgewick because they are a bottom of the barrel co.) My wife has carpel tunnel syndrome so severe that she can’t move her fingers or thumbs without being in severe pain. She needs surgery and has needed surgery for five years. Her claim has been held up by Sludgewick for almost 5 years, she won two decisions and now they, Sludgewick, want to take it to Superior Court in a last ditch effort to deny my wife the care she needs. Her thumbs are notably worse and they denied any treatment for them. They have lied, paid off doctors and manipulated everyone involved in her case. I am sure they treat everyone they deal with the same manner. This company is the most evil and sinister of any company known in modern times. Their policy of intimidation and aggressively attacking and fighting anyone that has a legitimate claim is morally and ethically wrong. I can’t believe that there aren’t class action suits against them and if there are, we will gladly join.

    Ron O.Jun 5, 2013  #124

  • Jay,

    Battling for two weeks benefits is frustrating and time consuming. You should submit a written appeal if it is worth the money to you. You have a good chance of prevailing if you submit proper medical support. Due to the limited benefits you are seeking, hiring an attorney does not make any financial sense in this situation. Please use the information on our website to help you.

    Gregory DellMay 30, 2013  #123

  • My wife just gave birth to our first child. The delivery was highly complicated requiring extensive labor (5 hours pushing), episiotomy, forceps assistance operation, loss of half her blood requiring a transfusion, kidney shutdown postpartum, and an operation to remove excess massive clots that developed the morning after delivery. Needless to say it was not a “normal spontaneous” delivery and the doctors recommended 8 weeks recovery as opposed to 6 which is standard for NSVD. We sent the paperwork showing 8 weeks immediately off to Sedgwick.

    We called Sedgwick when the benefits only showed 6 weeks approved the following week and were told the doctor could not just give 8 weeks without first seeing her at 6 weeks. So at six weeks checkup the doctor writes papers for 8 weeks as my wife is still anaemic (despite the transfusion) and has difficulty moving around. Today I heard she was on a phone all day with the Sedgwick administrator and was told her 8 weeks was denied (but she can take 2 more weeks unpaid).

    We are thinking of giving up because we can see it is a bunch of inconvenience being pushed on us, but how can they flat out deny what her two doctors have indicated as the medically necessary recovery? We asked for a Sedgwick supervisor to call us back.

    Can you please suggest anything to help? We are talking about two weeks compensation but we cannot afford to lose the pay and I am worried about my wife’s recovery if she tries to return to work next week against her doctors’ advice.

    Jay LooMay 29, 2013  #122

  • Rory,

    It depends on the language in your policy. From what I gather, it appears that you have returned to work and are working 8 hour days, although with difficulty. As such you may not be entitled to any benefit as you have returned to full time work. If your policy does not offer residual/partial disability you may have no means to collect. Please feel free to contact us if you would like to discuss your claim further.

    Stephen JessupMay 24, 2013  #121

  • Greetings,

    I am a Labcorp employee, and on January 18th I suffered a systemic stroke. I was hospitalised for 4 days, and the stroke affected the left side of my body. The left side of my mouth is twisted slightly, and there is a constant burning that gets really bad when I have to speak, eat, and especially when I brush my teeth or rinse with mouthwash of any kind. My left hand is numb constantly, mostly my fingers. And whenever I type the pain really kicks in and become very bothersome. My left arm and left leg down to the sole of my foot also are still tingly and numb, but not as much as my mouth and hand.

    One week after coming out of the hospital, I suffered a new fatal drug reaction to the “carbomonzapine” prescribed to treat my stroke after affects as described above. I spent 5 more days in the hospital and could not return to work for several weeks. I am a customer service support representative and my job is to answer calls for the lab. Our quota is 90-100 or more calls per day. Before the stroke I was averaging 140 calls a day. Each call consists of typing nearly every word the caller is saying and troubleshooting any problems. After being out of work for over a month, I went back to work and had to be placed on restricted or 4 hour days. Sedgwick paid me for two weeks.

    Since that time I have been in and out of work with pain. Sedgwick stopped paying my claim and denied any further disability payments. I am struggling with eight hour days when my doctor clearly stated that 4 hour days until I am ready to function normally, if and when that ever comes about. My stroke left me in lots of continuous pain and limitations that the doctor has diagnosed as irreversible. What should I do to get Sedgwick to pay up?

    Rory H. Garrison, Sr.May 23, 2013  #120

  • CJ,

    Complaints can be filed with your respective state Insurance Commissioner or other State Agency that overseas the regulation of insurance companies in the State.

    Stephen JessupMay 23, 2013  #119

  • Not only should Sedgwick CMS be sued and closed down, the IME doctors that they are sending you to are making false medical reports and should be reported to AMA. They are charging enormous fees to make false reports to please Sedgwick, this is a crime against the medical profession an it should be stopped. Who is over Sedgwick CMS, what government agency can we file a complaint to? They are playing with people’s lives, which can result in further injuries or death. The more who stand against this type of action by this company & IME doctors, the faster we can stop this. Sedgwick can without doubt be closed down. You must fight against this type of company for your rights. The government closed down banks and mortgage companies because of their fraud practices. Who is Sedgwick? They should go also, along with these bad doctors.

    CJMay 22, 2013  #118

  • Robin,

    You can complain to your State insurance commissioner, or the entity that overseas insurance companies in your state.

    Stephen JessupMay 20, 2013  #117

  • I have MS – I went out on STD in November. As long as I stay inside, calm and stress free, I’m not suffering from the bad tremors, vertigo, etc. Probably won’t be able to return to work, I know that. But my STD was supposed to be for up to 12 months per my employer, a County agency. I’ve been cut off, because I had been told to only write it for 6 months at a time or through 5/15, and at the end of the 6 months the supplemental form online has dead links – when I called for it to be sent to me, they said they can only send it to my doctor. I asked for it to be faxed on the 7th when I had my neurologist appt. (one of many specialists) – my doc’s office received it several days later (on the 10th) and wouldn’t complete it without me and since I don’t drive I didn’t get there until Tuesday the 16th, but they faxed it right out as Sedgwick’s fax history proves. I logged in and discovered I was terminated! Guess no COBRA or any insurance or assistance for me… what is the agency that provides oversight to such companies? Who do I complain to?

    Robin McMullenMay 17, 2013  #116

  • RH,

    We are sorry to hear about your struggles and experience. Unfortunately, until something changes on the federal legislative level, insurance companies will continue to act in a way that seems inherently wrong.

    Stephen JessupMay 2, 2013  #115

  • Valerie,

    I agree… if not a “class action” that can be addressed (still don’t get that) but what about “BAD FAITH”, totally the “poster” for bad faith… but it seems no-one can touch them! I guess they have WAY to much money and power… that’s all I can get out of it! I was actually told from my attorney that I could get interest on my back benefits (close to 5 years of them), all the attorneys fees paid, and costs, then… nothing… my attorney is now seeing me for all the fees, and he said he could get all of this through the ERISA statute! Joke’s on me AGAIN! After going through an absolutely exhausting Med Mal case! I wish there were people out there that “cared” but they don’t… it’s insane to hear ALL of the people here (and I’m sure thousands more) that have to go through this… and like was said, the people that are on welfare (that we pay for) don’t have any of these problems! The “state” takes care of them! So, so… disturbing! Where is our voice?

    RHMay 1, 2013  #114

  • Kevin,

    We got a lot of requests for a class action against Sedgwick. It is not impossible to do, but has a low likelihood of success due to the Federal Class Action Rules. In a class action all of the Plaintiffs need to be “similarly situated”. In disability insurance claims, every claimant has a different medical issue and each claimant is being denied based upon their medical condition. A group of employees from the same company with the same disability policy would have the best chance of bringing a class action. We have sued Sedgwick on multiple occasions and have cases pending now.

    Gregory DellApr 24, 2013  #113

  • What I would like to know is with all the complaints against them why is it only threats to take them to court? Why won’t an attorney represent someone and take them to court? I have a claim, it’s not long term, which means no attorney wants it, I didn’t break or tear anything, just collapsed at work and was hospitalised overnight and they will not respond. How can they get away with this? Why can’t we do a class action and be heard? Stop asking on video and start asking in court in front of a judge!

    Kevin CarrApr 23, 2013  #112

  • Sedgwick CMS shorted my TTD checks in 2007 and has never reimbursed me to date, April 2013. The AME said I could return to work with restrictions, but not back to my usual customary job. My work comp doctors “disagreed” to the AME’s permanent & stationary finding.

    My employer offered my usual customary job back to me, said if I did’t take this job offer, that I would no longer work at this warehouse. So I took my same job back.

    I was reinjured and suffered new injuries. Sedgwick’s utilization board denied “all” of my work comp doctors requests for MRIs to prove new injuries, repeatedly. Sedgwick denied my claim, stating that, ‘after careful consideration, there is “no medical evidence” and that “employee did not work since the first injury”‘ (!?)

    I went back to the AME, he rates my injuries as “strains” as there are no test’s to prove anything! My work comp doctor’s continued to fight with Sedgwick to get MRIs and all sorts of medical treatment. Finally almost 2 years later, exactly “22” months later MRIs are approved! They show the “true nature of my injuries”!

    The AME rates me properly. Sedgwick’s “attorney” depositions the AME “ex-parte” and gives the AME old and incorrect information in which to base his answers to. The AME figures some of the defence attorneys tactics.

    To date, I have a neuro genic bladder of “severe” retention from my injuries, a bone spur in my neck (from the injury that healed somewhat) causing stenosis in my neck, debilitating atrophy in my arms, that keep me from using my cane that helped me walk.

    Sedgwick sucks… Their despicable tactics, denying medical tests to prove injury, denied medical treatment that has caused further advancement of “irreversible” symptoms, “neurogenic bladder, atrophy, bone spur causing more nerve damage”… denying TTD, when clearly the AME said it was owed… It all makes me sick!

    How come Sedgwick CMS is not on “insurance, welfare, and social security disability “fraud list”!? They deny legitimate claims, that welfare, state disability, and or social security disability picks up! They deny legitimate claims, so we (the injured worker) have to use our state disability, 401k’s and now I’m on “social security disability.

    Unless a person has an attorney that has time to properly address all the bad faith & “ERISA” that Sedgwick continuously gets away with, the injured worker is just screwed…

    ValerieApr 15, 2013  #111

  • R.H.,

    The experience you have described with your attorney sounds unusual. I am not sure if you hired an experienced disability attorney, but I have never seen a situation where the attorney received all of the benefits. In most cases the attorney received an agreed upon percentage of the disability benefit paid and the remaining amount is paid to the client. You experience and battle with Sedgwick sounds horrible and unfortunately sounds common for people that have to deal with Sedgwick. There are no class actions against Sedgwick at the moment, because a class action requires everyone to be similarly situated. Sedgwick’s action may be consistent across the country, but every claimant’s claim is different, which will usually defeat any class action.

    Gregory DellFeb 8, 2013  #110

  • I have had an ongoing disability claim with Sedgwick/Chrysler for over 4 years now, this was a claim associated with a Medical malpractice claim that just settled last march (2012). I can not explain in words how tormenting, how insane, how absolutely criminal (on Sedgwick’s behalf) this process has been! Even with an attorney, who in my mind, also doesn’t know how to fight them! And hasn’t fought them.

    I was told by my attorney that if we prevail in the disability claim (which, like I said has gone on now for over 4 years) Sedgwick would have to pay ALL attorney fees, interest on my past benefits, taxes, and the retainment fee I had already paid initially. This, my attorney had told me, that at that point of my case, through the ERISA statute, this is what Sedgwick would be responsible for paying. Then, my attorney (without notice) got Sedgwick to start paying me my back benefits and future ones, all of a sudden, then told me “I” owe him all the attorney fees ($24,500.00 to be exact), did not get interest, Sedgwick is not paying the correct amount, did not get taxes, anything that my attorney had made it clear to me that I would get, he has said he is done, until I pay him this money, and has left me in a whirlwind, an extremely bad position with my employment, my benefits, and my mental, emotional and already physical exhaustion!

    If I weren’t aware of the fact that I am alive, I would honestly think I am living in hell with this entire experience! It is so emotional to me to hear all of these stories of unjust! People going through a holy hell and nothing they can do with it! If there is EVER a class action suit that should be brought to any business… it should definitely be brought on to Sedgwick and even the companies and corporations that use them! And “I” want to be part of that class action lawsuit! Please notify me if that takes place! I have asked my attorney about a class action, a bad faith claim, all of it and it was cast aside and was told there wasn’t a case for any of that!

    I feel like almost everyone in this situation is corrupt, I can’t trust anyone, it has changed my life and my way of thinking! I had a doctor’s negligence, then an insurance companies’ negligence, then the attorney I was referred too, was negligent! Where or who can you trust from there? How does Sedgwick keep getting away with this criminal activity? I do know in one of Sedgwick’s doctor’s deposition, he admitted he was “paid” by Sedgwick! That this was not an independent examination!

    So my question is… who else do they pay to keep their criminal empire going? I’m sure we will never get the answer to that question!

    R. H.Feb 7, 2013  #109

  • I haven’t filed a disability claim but I have filed FMLA claims. They are consistently denieing my claims. I always have to get the doctor’s office involved to get anything done. The most recent claim they are trying to deny is because they said the doctor only prescribed over the counter med. When that was proven to be not the case they said because I work a swing shift that I was not out of work for 4 days. I explained that if that be the case then I will never be able to file a claim. Funny thing is my trouble didn’t start until last year when I filed a claim and the person I talked to asked me my age, date of birth and how many times I had filed in the past. So is it really about me being 61 years of age?

    Jimmie R. ReeceFeb 6, 2013  #108

  • Des,

    Sedgwick beats to their own drum and they are not obligated to follow any findings by EDD or social security. You should notify Sedgwick of the EDD approval.

    Gregory DellJan 28, 2013  #107

  • Hello, I am currently experiencing some challenges getting my STD approved by the third party processor Sedgwick. One main question I have is, I’m wondering if EDD approved my STD claim, can Sedgwick really deny the claim? It seems really odd to me that one entity would deny benefits & not protect my job under STD benefits, but EDD, using the same medical information, time frames & being CA State approve the claim. Thanks.

    DesJan 27, 2013  #106

  • I don’t understand why a company totally devoted to helping sick people can be so cruel. I was hospitalised after they first denied my claim, depression is no joke, I am surprised they have not been sued for emotional stress. I had not been working for UHC that long, but long enough for Sedgwick but not Sate benefits.

    When they called today I thought they were updating me on the recent approval of my disability, they wanted to know when I was returning to work, I wanted know where my check was (it had been two and half months with no money). They assumed I was getting $1000 from state! I have never heard that amount nor does it read anywhere on the form to call when you’re NOT receiving income, the forms also say in big bold letters that they coordinate benefits with the state department, if they had the ability to see I was making this “phantom income”, they have the ability to see my claim was denied. I am so depressed right now. I don’t want to be hospitalised again, but all my bills are behind, I can’t even afford gas to go to therapy, and I keep accumulating medical bills instead of being able to pay them. I cant believe this company has no mercy.

    Depressed and BitterJan 25, 2013  #105

  • On Nov 4, 2011, I was taken by ambulance out of my place of employment (ADT now Tyco). Diagnosed with Vertigo, I went on FMLA with Sedgwick no problems. I went to Dr. Tyler Lewark who saw me when first diagnosed and prescribed therapy in which phone tag was played and never set up. The episodes started to get more frequent and severe I went back to Dr. Lewark and he was upset I never went to therapy and set it up for me and stated “it would cure me, that it cured his wife”. I applied for short term disability which Dr. Lewark’s approved for 6 weeks, but when it came down to the paperwork he stated my only restriction was driving so my claim was denied and I had to return to work with no pay for the four weeks I was off. I did appeal it, I started to get the episodes at work and also had three episodes while driving and my therepist gave me the number to Dr. Robert Muckle who did further testing and diagnosed me with Meniere’s Disease, he started me on treatments with medication with my body not tolerating any of them. I filed another short term disability claim in which again it was denied due to the paperwork being late, a decision was due on the first appeal by Dec 31, 2012, received phone call from caseworker stating her Drs had all the paperwork from both claims and I should hear back by the following week. Meanwhile, the HR Department starting sending me letters and calling me saying I need to return to work since the claims were denied. I was told I was being terminated and was asked to resign my position. I explained that I would be having surgery and be back to work as soon as possible. I since have kept Tyco updated on my surgery date of Jan 31, 2013 and be able to report back to work on Feb 13, 2013 if all goes well. I have been off work for three months altogether and have not received a penny. Stress and Fatigue are the number one factors of bringing on episodes, so Sedgwick and Tyco thanks for the episodes you have contributed to my condition.

    Dayna VigilJan 16, 2013  #104

  • I work for Walgreens. I was injured on the job by a palette of soda crushing my ankle 6 years ago. I never missed a day of work; had to work overnight as the only mgt. on crutches for 6 weeks. The first Dr. wouldn’t do anything. When I went to him my whole ankle was black, I lost feeling in it. After a few visits and him not helping I finally got referred to someone else. I was told I had extensive nerve damage and it was to time consuming and to expensive to fix. Which was not right, I wanted my foot back to the way it was before the injury. I was sent to another Dr. to do surgery after they found the bone wasn’t sitting correctly anymore. The Dr. they sent me to flat out said it was a workers comp case and wouldn’t do anything for me. From that point on for 3 years I fought with the Dr. and Sedgwick; the Dr. would not let me make an appointment with him and the insurance company wouldn’t change my Dr.. Every time I could no longer handle the pain I went to the ER and each an every time they found out it was a workers comp case and turned me away. Now 6 years later and the claim has finally been closed I’ve been able to get a Dr. to look at my foot. The injury caused my right foot’s arch to raise extreme cavus while the left foot is normal. Since its been so long, it has affected my right knee, my right hip, an the right side of my back. I worked through the pain. Every time it got unbearable I would struggle until I got use to that pain. And each time it got worse that’s what I had to do. I shouldn’t have had to suffer. I didn’t ask to be injured and honestly I’ve had to change my whole lifestyle. Stop doing things I enjoyed like ice skating, skiing, roller skating and even walking for periods of time. I don’t think it’s right that a company can treat people in this manner. If you have the chance to sue them for any wrong doing, do it. I tried but I was told I had to quit my job and sue my company. I didn’t want to go after Walgreens, just the insurance company. If I knew then what I know now I would have sued them. I hope no one has to go through what I have and still do.

    MVJan 11, 2013  #103

  • I have been on Sedgwick for 2 years for an on the job injury, and without notice, they cut me off in the middle of December. I just got the paperwork last weekend. The claims adjuster made a subtle comment during a phone call that they could be closing the claim at the end of December so I hired a lawyer. Their IME (sent me to the same one twice) on the last visit claimed that I was fit to go back to work at my regular job. My primary physician said there was no way that I could return to my position-this was backed by a pain specialist and a physical therapist. Sedgwick even hired a vocational manager to do a job analysis in December with my HR and manager, and did not even tell him that they closed the claim 10 days later – I had to inform him of it today. Sedgwick is not providing the complete medical file to my lawyer, and has not provided any of my medical information to their vocational manager! After seeing your videos and reading the stories of others, it all makes sense now.

    ConfidentialJan 9, 2013  #102

  • John,

    Sedgwick would probably not approve your anxiety claim unless you were hospitalised. There are supposed to rely on what your doctor tells them, but they will likely not examine you and find their own doctor to review your medical records and say something different. You need a medical record that complies with all findings for Anxiety as stated in the DSMV-V.

    Gregory DellJan 8, 2013  #101

  • I work for AT&T. What does Sedgwick consider a functional impairment for anxiety?

    JohnJan 7, 2013  #100

  • I was denied STD from Sedgwick CMS as the third party administrator for AT&T. First denial was because medical information did not indicate disability.  The appeal was denied (thorough medical information was provided, MRI, treatment, etc) because they could not talk to my physicians on the telephone!  Then AT&T sent me the “return to work or it would be job abandonment”.  I back to work with an accommodation list from my drs and only worked 4 hrs.  That was painful enough – only to lose my job over 2 hrs FMLA time that a form wasn’t submitted by my DDS on a timely basis in APRIL 2012.  This all was coming down October 2012.  I did everything right and everything turned out wrong.  I am here in severe pain..cannot walk due to spinal stenosis and nerve damage.  After all of this, I would like to know how can a two-cent employee at Sedgwick deny my claim when I had also filed for SSDI and it was APPROVED first time through.  HOWEVER, because I was forced back to work – no benefits for the 5 month waiting period and of course, no retroactive benefit.  No medical insurance as I have lost my job.  I need help – don’t know where to turn.

    Linda PhilippsJan 2, 2013  #99

  • Thanks Greg. You are right, it seems that finding Doctor’s that are willing to cooperate with Sedgwicks demands on their time line is completely impossible. I thought that the people at work that put our times in would just continue to ‘approve’ my times. However, I just saw my last paycheck. So far 8 hours of pay has been removed. I suppose this weeks pay will have Zero$$. Real nice thing to happen after what turned out to be over a $2,000 Doctors appointment ….

    MLBDec 20, 2012  #98

  • John,

    You are in the typical strong arm position from AT&T and Sedgwick. You can appeal their decision and also return to work for a short period of time if you can. You can then refile again if you don’t feel that you can make it at work. You can also decide to not return and just appeal the decision.

    Gregory DellDec 13, 2012  #97

  • I work for AT&T and I am on disability for anxiety and depression. My doctor has sent numerous letters and office notes explaining why I am unable to work. Sedgwick denied my claim and even sent the case to physician review and spoke with my doctor one on one. They still denied my claim. They are telling me that I do not have a functional impairment. What else do I need for a functional impairment? Now I received a letter that if I don’t return to work by Friday, it is job abandonment. What should I do?

    JohnDec 11, 2012  #96

  • MLB,

    Sedgwick is very hard to deal with as you are aware. You need to make sure you treat with a doctor that knows how to deal with the paperwork required for disability claims. Without strong doctor support the chance of getting approved for benefits is very slim.

    Gregory DellDec 8, 2012  #95

  • Unfortunately, I can relate to everyone here when it comes to Sedgwick. I have had on-going back and neck issues like degenerative disk disease, bone spurs, stenosis, spondyosis, hernias, bulges ect… for many years and have worked physically demanding type union jobs for my company for 24 years. I decided to try a less physical type job due to my chronic pain but that required going to very intensive training to be an electrician. Being in a classroom situation for 6 months was still painful because of the sitting, and it destroyed my neck because of the studying but I was not at risk of lifting, climbing, pulling ect… I was suddenly and unexpectedly removed from the classroom situation and put back in the physically demanding job because I did not pass a test. Love the job but by the end of the first day I was nauseous with back and neck pain. By the 6th working day I couldn’t move at all, called out and decided that this was the time to seek a new medical treatment. Since I have been with my company for 24 years I am entitled to plenty of sick time days. However, Sedgwick has made impossible and bizarre demands and has made threats to put a stop to my pay. They require me to get a Doctor to ‘recommend me not to work’ within their time frame when they knew from the very beginning that my appointment is December 11th. Their ‘time frame’ was a mystery until 3 days before there ‘deadline’, I told them that I have no control over how fast I can get an appointment and my Doctor will not fill forms out or write any ‘sick notes’ until he sees me for the first appointment. I also can not control my Doctor’s actions and if he will ever fax anything for me to them or how long it will take. He has an extremely large clientel! Then I found out that she already called my Doctor and told him HE was responsible for me being on short term disability. Which is not the case, it is automatic after 5 days. She already caused friction between me and a Doctor I haven’t met yet. Today my supervisor called me and said that Sedgwick has emailed him saying as of today December 7th, I am to have a ‘stop in pay’ because they have not received information from my Doctors. I am at home in severe pain and they feel the need to torture me. I had to go back on high blood pressure meds after the first conversation with them. My bp went from 128/78 (the previous day) to 168/104 after talking with Sedgwick. The Doctor I am going to doesn’t ‘do’ insurance so it’s very expensive, $425.00 for the first appointment. If Sedgwick stops my pay, it will wipe me out and I won’t be able to afford my Doctor! I just can’t believe they are legally allowed to torture people like this, I can’t believe my company would hire such a crooked company! I have documented everything that has happened since the first day I called out just in case it would help me in some way.

    MLBDec 7, 2012  #94

  • I was injured on my job, June 22nd. I was told by my employer that Sedgwick Claims Management Services, will be handling my claim. I was assigned to an administrator, Kathleen Shallow. After a month, I called to check on the status of my claim. I spoke with Ms. Shallow, who was very nasty in her disposition, told me, “Mr. Brown, I am very busy! I’m getting ready to go on vacation!” I replied, “So, you are telling me that I have to wait until you come back from vacation, to handle my claim?”.

    After five weeks, I spoke with another claims administrator named Justin Tarsi, who told me of the situation I had went through with Ms. Shallow. Mr. Tarsi was worse than the previous administrator. He lied to me, as well as, lied on me, stating to my supervisor (not knowing I was listening via speakerphone) that he stated something that was not true.

    When I started receiving my checks, I was told that a check was sent, that actually wasn’t. Mr. Tarsi admitted that the reason being, was unknown.

    Lastly, a check was sent. I deposited it into the bank. Sedgwick CMS had stopped payment without notice. This is a very incompetent, derelict operational company. If anyone has to deal with these people, please get an attorney.

    RobNov 16, 2012  #93

  • Derek,

    We would be happy to take a look at your denial. AT&T requires two appeals to be filed before a lawsuit can be filed. It is possible to win at the Appeal level but not very common due to Sedgwick’s unreasonable claim reviews. AT&T and Sedgwick seem to have a technique which forces disabled people to return to work out of fear of losing everything.

    Gregory DellNov 9, 2012  #92

  • My name is Derek and I recently was wrongfully terminated by AT&T due to a medical condition. I have had an on-going issues with my back and have been treated on an on-going basis with my medical doctor and other doctors in the field. I was diagnosed with herniated disk bulging and degenerative disk disease. I have been suffering from consistent paid, numbness, losing feeling in my legs, back and feet, head aces and so on. I was provided plenty of evidence via documents that was flexed over to the disability department under Sedgwick. I was also provided a note saying that I needed reasonable work accommodations and that was never fulfilled by AT&T. I have had an MRI, X-Rays, pain management shots and been though physical. Seen by many doctors over the past year and have had plenty of “objective” and subjective evidence but yet was still denied. I hope that Dell & Schaefer Law Firm will be able to help me.

    DerekNov 8, 2012  #91

  • I worked for a claims company when I became ill with a permanent and chronic condition and was placed on their long term disability policy. The company was then bought out by Sedgwick. They don’t take any better care of employees than they do claimants. First they reneged on continuation of benefits, then on the life insurance policy that was supposed to continue as long as I was disabled (or at least to age 70) and now they won’t allow distribution from my 401k… they are forcing me to roll it over to an IRA. They are bottom line only… just as miserable as an ex-employee as they were to work for. I haven’t read a complaint yet, either by employees or ‘victims,’ that doesn’t ring 100% true.

    DebraNov 2, 2012  #90

  • I work for the Boeing Co. making 737 wings, blew 3 disks in my neck and had them fused in 09, went back to work and after 8 months my manager put me in another area to help him get caught up. After repeatedly telling my manager that my neck was hurting after a month went to Boeing medical and they sent me home. Went to doctor and fusion didn’t take and blew disk above my fusion… Sedgwick has determined that it is genetic and there for “not job related”… Like building 737 wings had absolutely nothing to do with it. They closed my claims and haven’t been paid since March. “Starving me into submission” didn’t work for them, because my husband makes enough money to cover our bills. Hired an attorney in March… what a joke… Sedgwick is now trying to have me terminated and almost was this last Monday, but I took care of… called my attorney at 8:30 and still have not gotten a call back from him… confused and don’t know what else to do… If I don’t go back to work by Jan. 7th 2013 Boeing can terminate me. I Love my job… really LOVE my job and do not want to lose it… but can not go back ’til I get fixed.

    DeannaOct 30, 2012  #89

  • Thank you very much! By the time the appeal goes through, I will probably have no job! I will hire you if anything. This is a clear-cut case of disability discrimination. I have anxiety papers in which I was diagnosed by NYU dating back to 1999.

    MattOct 25, 2012  #88

  • I wish this wasn’t so but this seems to be the norm. I am a 13 year General Motors employee and have been treated like nothing short of a criminal. I have chronic heart problems, 4 years ago I had my heart reconstructed yet my problems have returned and I have been prepared for a life-long battle. I am the just a statistic and am facing multiple surgeries. My Dr.(s) have provided books-worth of monthly tests reports and office notes etc. AND even gave a return to work date of 2014 at best if not permanent disability. Get this, Sedgwick even reported to my employer I was a voluntary quit until I got the Union involved to get this changed and almost a month of terminated health care coverage amiss my treatment etc. This has been nothing short of a nightmare. I’ve lost everything and this company still manages to find a way monthly to turn what is left of my life completely upside down. I called today and was told payment will be withheld till each surgery so I get paid once a month or every other month at best. I would be more than happy to file suit with anyone willing to tackle this horrible company. We used to have MetLife as our disability admin and I never had this much difficulty. They need to be stopped.

    Marc ChasteenOct 25, 2012  #87

  • Matt:

    AT&T requires you to submit two appeals before you can sue them. Sedgwick CMS handles all of the disability claims and it is very difficult to get Sedgwick to approve a claim. The AT&T policy language for short term disability benefits requires you to be able to do any work, but Sedgwick will never tell you the type of work that they think you can do. You need to keep fighting them and have your doctor write another letter for you. You need to send a letter to AT&T and explain to them why you cannot do any work. Your doctor should describe any side effects that your medications may have on your ability to work.

    Gregory DellOct 21, 2012  #86

  • AT&T employee denied benefits due to anxiety and depression. My doctor wrote 3, very detailed, 3 page notes describing why I’m out of work. NYS disability approved my claim and paid me… Sedgwick has not. Please help!

    Matt DeLuccioOct 20, 2012  #85

  • Today Sedgwick told me to get back to work on the 31st of Oct. and I am not scheduled to work. The woman told me my company is going to terminate if I don’t go to a doctor. My doctor told me to come back in 2 more months. I was called on a Sunday at 830 am by a Sedgwick claims examiner and harassed. My doctor’s office has tried to return calls to Sedgwick but they never call them back. Sedgwick calls me and bullies my until I am literally having a nervous breakdown. I am already very upset that my injury has taken 3 years away from my normal activities. I told Sedgwick I would rather take not money from them and be released back to work to never have to deal with them. They are causing me to have severe anxiety problems and are causing me to be put in a bad place with my employer. They are ruining my life and need someone to help me. They are so horrible I get so depressed that it is hard for me to keep things in perspective. The representative said to me why are you having so much trouble paying attention to me. I have ADD lady, my kids just walked into the house from school and didn’t know I was on the phone, she wouldn’t leave me alone! I have chest pains from them.

    KristinOct 20, 2012  #84

  • I currently live in Puerto Rico but work out of Chicago, IL. I need to be operated and unfortunately I have not received medical attention from them, nor have I received money that is due to me nor benefits that I’m entitled to. They did however start paying for medication, but as of September they stopped paying my medication. I have had to pay all my medical visits to every doctor I have seen. I never received my August 15th paycheck because the company claimed an over payment, of what I don’t know. I have been without any work payments since the end of July, using what I had saved up for medical treatment. I have run out of money at this time yet my bills keep coming in. I was told I will get re-payment for cash payout to my doctor’s visit but that has not happened as well. My medical coverage has ceased due to non-payment because I have no money coming in. I have an aging mother and if she were on my medical claim that would be another form of disaster without any medical coverage. I have a sick animal at home I cannot take to a vet at this time as well. My mother has kicked me out of the house on numerous occasions where I have had to seek help from a friend. I cannot count on my mother for any income for she receives very little from the state. I called for an appointment for “La Reforma” medical coverage from the state of P.R. and I am currently making arrangements to apply for food stamps from the state as well. I have car payments and not sure how long I will continue to have my phone service. I had to give up the place I was renting in Chicago when I needed to stay there because of my job. I had to be put on anti-depressants a month or so ago because of the stress with so many issues, and the constant pain. The longer the insurance agency makes me wait for my treatments the worse I become. They are impeding my health care strongly and they should in no way impede my health care. They are also causing financial damage to me and my family. I have a lack of health service from Sedgwick, no income and no insurance. They have inflicted emotional distress, which has resulted in injuries separate and distinct from the injuries I have suffered while working at American Eagle. They have deprived me of workers compensation benefits, and I have had to pay expenses. They only have their own interest and profits at heart. You can’t put profits over the well-being of people – it is cruel and inhumane. I have sent in so many medical documents with no results. I am in urgent need of medical attention. I don’t believe Sedgwick CMS is acting in “good faith”. I am currently making letters to go public with my issues for the governor of P.R., and the governor of Chicago. However, I’m seeking legal representation.

    CarmenOct 11, 2012  #83

  • Reece,

    Sedgwick is usually very unreasonable and follows nothing but a script. Their claims people are like robots. You must got to the FCE, but if your doctor thinks that it would be harmful for you to go, then you should get a letter stating as such. You can also ask Sedgwick to clarify the scope of the FCE activities so that you can discuss them with your doctor. You should videotape the exam so that there are no inconsistencies. If you would like assistance with dealing with Sedgwick, please let us know.

    Gregory DellOct 9, 2012  #82

  • I am a liver transplant recipient with a complete colectomy and permanent ileostomy. I haven’t been able to work for years, and have been on Sedgwick Ltd, and am now at my two year review. I was awarded SSDI and have multiple medical source statements that that’ve been submitted to them both by my own physicians, a physician they hired, and a psychiatrist of their choice, all saying I cannot work. I was notified last Friday by my PCP nurse that Sedgwick requested a functional capacity exam. My wife and I are both also nurses, and believe this is just outrageous. We have read the CFR, and know that medical source statements are to be given the highest weight when making rulings, so this FCA is totally unnecessary. However, if I don’t go, Sedgwick can deny me for non compliance. What I disagree with regarding the FCE is that it only represents a snapshot in time, a short duration of a couple of hours, and from that says the individual is capable of working full time – 8 hours a day, 5 days a week. It is physically and mentally impossible for me. I am immunocompromised due to my transplant medications. I have to take meds to control my pain and this affects my cognitive ability. There is so much documentation over the past two years and it isn’t enough! My rep even called and told me I’d be getting the two year renewal letter and not to freak out. Looking at this board, however, I’m not the only one.

    Reece S.Oct 8, 2012  #81

  • Karen,

    Please contact us privately and we will review your husband’s claim.

    Gregory DellOct 4, 2012  #80

  • My husband was poisoned from PTFE while machining at Boeing of Portland on Feb. 14, 2011 through Feb. 18, 2011. He was diagnosed with polymer fume fever which enflamed his face, neck, ears. It actually gave him flu-like symptoms with body aches, fever. His appearance was so bad that the first Dr. visit the nurse wouldn’t take his fatals for fear that he was contagious. But because he was a good employee who didn’t like missing work, he never took 3 consecutive days off, but missed over 3 weeks of time off, here and there. He already had been told he had COPD, but this caused him to be much worse. It has also affected his blood, hormones and vision. The company says that yes he was made ill, but that there are no long term injuries. Since than he has retired due to the inability to work due to his health issues. We have hired an attorney that I’m not sure gets what is happening. The research we have done on this product indicates that this is a common event when dealing with it. Since my husbands poisoning, Boeing no longer uses this in the Portland plant and once agan uses vendors to make the parts he was asked to run. Our appeal is Nov. 27, 2012 and we need help.

    Karen MillerOct 3, 2012  #79

  • Five months I’ve waited; they never returned my calls after leaving hundreds of messages. Nicole, my claim worker, told me at one point she was too busy.

    I’ve been out of work for five months and they just denied my claim and will not tell me why? Or send a denial letter. Very poor custom service…

    Keith SmithOct 1, 2012  #78

  • Sedgwick is a trickster, trying to discredit each claimant, harass if possible, deny bills, refuse to call back and easily cover it all it by backdating information. This group needs to be exposed for what they are. After contracting CRPS from falling at work, they are now denying necessary pain meds, refusing suddenly to pay for appointments and calling my insurance provider claiming to be my work comp attorney stating that “Sedgwick will not cover bills as of ___ date, so contact us if you have any questions. These claims should be put under the insured’s personal health insurance”. These illegal tactics, lies and lack of care for human beings while the bill our companies and pay themselves before paying our medical bills needs to be stopped. There has to be a way to expose how criminal their actions truly are.

    MarySep 27, 2012  #77

  • I work for the “Daughters of Charity” Ascension Health/ Seton Healthcare. How ironic that I have been a stellar nurse since 1987 that now, in my time of need I am denied (by Sedgwick) the short term disability benefit that I long ago elected to pay for every two weeks. This is not a workmen’s comp claim. I suffered a traumatic brain injury elsewhere. I have been denied monies for September. I cannot continue to pay the co-pays to attend all the required therapies, so this will in fact hamper my recovery. My friends are feeding me, and not sure what will happen when the rent and car payments come due. To say the undue stress of this is hurting my recovery is an understatement! Each time I call, I am given new terminologies, new requests are made of me, this can change DAILY! I talk to a new person each time because both times I was given points of contact, their voicemail then states they are “out of the office”. I cannot believe these people can get away with this. I am incredulous that the “Daughters of Charity”, Ascension Health / Seton Healthcare would subscribe to this service! I don’t know how the Sedgwick employees that participate in the blatant mistreatment of deserving folks can sleep at night! This is what I get after devoting over half of my life to the compassionate care of others as a nurse. This so saddens me, what kind of world is this?

    Becky S.Sep 25, 2012  #76

  • R,

    It’s horrible that AT&T refuses to do anything about Sedgwick. Since your plan is self-funded, which means that AT&T pays the disability benefits, it almost seems like AT&T expects Sedgwick to deny a high percentage of the people that apply for coverage. I can not verify, but I recently heard that in the recent Union negotiation in the southeast that the definition of disability for short term disability is going to be changed to “own occupation”. This could be a great thing for most AT&T employees that need to file a claim in the future. I spoke with several people at the AT&T Union and I think they were able to get this done. Check with your Union for accuracy of my thoughts.

    Gregory DellAug 31, 2012  #75

  • Update on my May 2012 post “Yet another AT&T employee dealing with Sedgwick“:

    I have just received notice from Sedgwick that my final appeal for short-term disability benefits has been denied. My disability was initially approved for two weeks, but the subsequent extension requested by my doctor was denied. My condition had not improved, however, and my doctor said there was no logical reason for Sedgwick to treat the second disability period differently from the initial period that it had approved.

    After repeated appeals and medical peer reviews – all denied – I submitted my final appeal. At the urging of my health insurance company (which had assigned a caseworker to monitor my health progress) I included a letter in the final appeal, detailing:

    – work responsibilities, to help Sedgwick understand the specific functions that I was no longer able to perform

    – the potential damage to AT&T if I produced any work that was not perfect

    – feedback from my human resources partners and my colleagues urging me to take time away from work until I felt well enough to do my job.

    Sedgwick’s final denial letter was comical – it found no physical reason I could not perform my “sedentary job function.” Despite the documentation, interviews, test results – the FACTS, in other words – Sedgwick’s denial was based on whether I was capable of sitting at a desk!

    I am lucky – I was able to survive on unpaid leave until my health improved. My heart goes out to all the AT&T employees who have not been able so fortunate. There must be a special place in hell for Sedgwick and its masters at AT&T.

    RAug 30, 2012  #74

  • Eric,

    With the large amount of people that contact us on a daily basis from Sedgwick, I wonder if the Sedgwick employees are worried about losing their jobs if they approve an AT&T employee for disability benefits following their initial application. It is rare that we see an AT&T employee that is approved for benefits following an initial application. We will review your claim and let you now ASAP if we can assist you.

    Gregory DellAug 28, 2012  #73

  • I have worked for AT&T for 15 years. In those years I haven’t given as much trouble as I have gotten from Sedgwick. I have had 3 back surgeries in 12 months, the last being a l4,l5,s1 fusion. At first everything was fine but after I reached the 90 day mark I have been denied. I haven’t been paid since July. Sedgwick sends faxes to to my neurosurgeon for recent medical and they send all that is requested only to find out that it want enough. They request more and it’s sent only to find out there is more needed. Sedgwick went as far as to tell my Dr. that all they need is for him to fill out a survey on my condition to get the approval process underway. He did it and guess what? It wasn’t enough. So now they told my Dr. to send them a letter to them explaining why I can not return to work. My Dr. will do it but I can almost bet you my house that they will say its not enough. I will file an appeal. I am going to send a certified letter requesting all my documentation and policies be sent to me from AT&T and from Sedgwick. And I will be waiting to hear back from Dell & Schaefer as to if they can help me. I am losing sleep worrying about paying my bills and keeping my home and I am sure the additional stress isn’t helping my current condition.

    Eric J.Aug 27, 2012  #72

  • Christine,

    It saddens me to hear your story. You have tried so hard to work through your condition yet Sedgwick makes a mockery out of your efforts. Sedgwick should have sent you a denial letter via mail. You need to appeal their denial in a timely manner and have your doctor write a strong letter of support for you. It will also help to have your employer write a letter explaining why you are unable to do your job or any other job. You should also apply for SSDI benefits. Contact us if you would like assistance.

    Gregory DellAug 25, 2012  #71

  • I am a 49 year old female and diagnosed 2 years ago with end stage renal disease. I am currently do home dialysis which is approx. 10 hours 7 days a week. When first diagnosed I decided that since I still was able to function I wanted to continue to work until it became too difficult for me to function. 2 weeks ago after suffering from chronic nausea, constant fatigue, and continually swelling legs my doctor agreed that I should go out on disability. He filled out the paper work and I faxed it to Sedgwick who stated they would call me back when they received it. 2 weeks later after no response I called them and was told by a supervisor that there was no documentation that supported me being off from work. He stated if I did it for 2 years I should still be able to do it. I tried to explain that the longe you are on dialysis the harder it gets however he hung up on me. Sedgwick uses bullying tactics.

    Christine ArmesAug 24, 2012  #70

  • Mark,

    We are sorry to hear about your experience. Good luck with your claim.

    Gregory DellJul 3, 2012  #69

  • Sedgwick has strung me out for almost 20 Months! I’m supposed to be getting to settlement soon but my attorney wasn’t specific (I thought it would be finalized as of June 30th). A nightmare to deal with, I have to drive Six Hours Each Way on Sunday-Mondyay July 8 & 9 in order to get an OK for Pain Medications for my Back Injury. They STINK!

    Mark A. ForretteJul 3, 2012  #68

  • Thanks for taking my call, the information provided was appreciated. However after days of faxing and leaving voice messages, Sedgwick one again comes up with another delay tactic and act of stupidity. They posted a notice on their web site, that they were trying to reach my wife’s doctors for additional information. In response my wife left several voice messages that she needed to know what doctors they were trying to reach and the information needed.

    I faxed request everyday for four days and finally got a response. You need to know we have already spent alot of money on co-pays, back in March and April, providing them with a heavy amount of responses. One staff became so upset with Sedgwick they faxed almost every thing they had.

    Sedgwick came back with a request with a complete list of all the doctors, they wanted information from all four, but they did not inform us what kind of information they were in need of. They informed us that if they did not get this unknown information in 19 days they would denied the claim.

    My response was simply accusing them of losing all the previous faxes, and it would help if they picked up the phone and take our calls so we would know want was needed. I simply said that the next 19 days was in their ball park,
    we can’t give them information nor the doctors if they don’t responded to our request, pick up the phone and return our calls.

    I wrote a full page length fax covering several issues and noted their unknown request for information, I told them that we would fax this request everyday for the next 19 days, until they either denied the claim or contacted us as a professional service should and provide us with their request.

    I also informed them that from the CNN talk site that is covering the young girl that was suffering from the strip eating virus, I have been involved in exchanging information on the topic. I have taken the opportunity to mention Sedgwick name and issues, surrounding their failures to provide proper professional services. I am now receiving emails from around the country and intend to share with my wife’s Human Resource Dept, which is the state of Arizona.

    Mike JohnsJun 17, 2012  #67

  • Mike,

    Please contact us privately. If your wife is seeking disability payments from Sedgwick, then you should be receiving written correspondence from Sedgwick?

    Gregory DellJun 4, 2012  #66

  • I am posting this in behalf of my wife who simply cannot sit long enough to complete the task. She contacted what is know as Necretizing Fachistis know as flesh eating strep. You probably heard of the young lady that lost her leg. Well, my wife lost her complete left buttock and almost her leg and life. It required being in the hospital over one month in a wound center, over 100 bags of of antibiotics and a wound pump for two months. She needs to have reconstructive surgery done so she can walk again. The surgery was six months ago and the wound still has not closed. The experience with Sedgwick has been a nightmare. We are almost at the 90 day mark and they still have not responded to our calls. A Terri Eriwin is her case manager, she tried to make us believe she had a grip with medical terminology only to discover she had no command of medical issues. They continue to post a note on their web site that they are trying to reach her doctor, and we might want to call the doctor’s office to help. This is the fourth time this has happened with Sedgwick, we have called and left several messages, my wife has four doctors and we do not know what doctors they are requesting information from. We have called all the doctor’s office staff and they have had no calls that are requests from Sedgwick. They continue to claim they have 90 days to respond, claimed they had to read 45 pages, on half page of this report sends doctors flinching, it takes very little. I was laid off my job after a number of years with one company, I went through chemo and radiation treatments for over a year because of lung cancer, by the grace of God I am in remission. But I just turned 62 and just received my first social security check, and work 35 hours a week at a disgusting call center. If we had not received help from family services at the last minute the eviction notice would have gone into effect. As it stands we lost our home because of my cancer and ended up in a trailer park. I am playing catch up on bills with what little money I have, but if we do not get a check from Sedgwick soon we will be on the street, i am already behind.

    Mike JohnsJun 4, 2012  #65

  • I was working on the Music City Center in Nashville, TN on loan to another steel erection company. There was no service elevators to take employees, equipment to the 8th floor. There was only a series of stairs with 2 landing between floors. I had to climb & descend these stairs numerous time per day. I calculate about 24 flight up and 24 down, each landing turning 180 degrees, while carrying a 25# survey instrument like a suitcase in my left hand. On the fifth day at the site I turn and heard a popping sound in my left knee. It swelled to the size of a softball. The following day they sent me to Concentra Urgent Care. The date of injury was 12-05-2011. After maybe 2 months they finally approved my MRI. My MRI results showed at least 4 tears to my ligaments. So I hobbled around until my surgery was scheduled, which was 4-09-2012, so I had to live on pain medications all that time up to surgery. I have been in PT for 4 weeks and have 5 to go. Today is 5-31-12 and I have had no contact with Angela of Sedgwick for a month now. I used all my vacation to recover and avoid a lost time injury, for whom I really don’t even know. I think its time to talk to someone legally. My claim had been approved since 12-05-2012, yet I have no idea what’s to happen now.

    Tom SchardanMay 31, 2012  #64

  • Rose,

    You still need to file an appeal if you want to try to recover your 3 weeks of pay. We don’t handle short term disability appeals seeking 3 weeks of benefits, but you should try to get what is owed to you.

    Gregory DellMay 26, 2012  #63

  • I just got denied for short term disablity from Sedgwick, but my FMLA was approved due to my diabetes and vertigo. Sedgwick told me if I was going to be out longer than 1 week I had to file for STD. I have been out since 4/26/2012 from work. Just got note today that it was denied, they said because inconstancy with medical records. Records were faxed, they didn’t say how much records needed to be faxed. That is 3 weeks of pay I was denied due to an illness that I couldn’t control, good thing I return to work next week.

    Rose YelvingtonMay 24, 2012  #62

  • Tera,

    You have only received one person’s opinion at Sedgwick and you need to appeal their decision in a timely manner. It is surprising Sedgwick even paid you for a few months. You need to request a claim file from Sedgwick and ask your doctors to comments on the opinions rendered by Sedgwick. Contact us if you would like assistance.

    Gregory DellMay 24, 2012  #61

  • I have worked for eBay for the last 6 years. I am a excellent employee, who is dedicated to my job. With that said, I filed a STD claim with Sedgwick 12/11/11 because my feet were swelling and I had pain all over my body that progressively got worse. I literally had to call Sedgwick daily. They played the oh we didn’t get the paperwork you sent us, oh we never got the doctor’s paperwork, etc. I would have to call my doctor’s and ask them to fax again, then call Sedgwick back frequently. Then they would tell me oh it takes 7-10 business days to review. They approved some of my time, but they were always behind, causing me to have to call into work every night. In March the doctor’s finally figured out that I had fibromyalgia. Since the pain was so severe I had stopped moving around and stayed in bed a good portion of days which then led to diabetes. I became severely depressed and anxious. My therapist said I needed to destress and my regular doctor and rhuematologist said it would take time to get the meds right. Sedgwick approved my time until 4/1/12, however they then required me to see a 3rd party therapist and refused to pay me until they decided. I saw the 3rd party therapist even though my family doctor and my therapist said I can’t work yet. I called Sedgwick. Heather, my caseworker, told me that she sent her recommendation to her supervisor which was to deny my claim. I asked why and she said because the therapist said I could work. I had an anxiety attack which is pretty normal after talking to Sedgwick. If I am constantly in pain, can’t sit or stand for long periods of time, have physical therapy 3 times a week, have massive anxiety attacks, and have crying spells, how am I supposed to go to work? The denial leads to no back pay or future pay, no job, and no medical insurance. How am I gonna get my medications, see doctors, and get treatment? Sedgwick doesn’t care. They told me I should have thought about that before I filed my claim. Now I am even more depressed and anxious.

    TeraMay 23, 2012  #60

  • Charles,

    The laws for IME exams are different in every state. As long as a doctor is licensed, then they can do an IME exam in most states. ERISA regulated policies require a doctor with the appropriate specialty to conduct the IME Exam. So if a person has a cardiac disability, then they should be examined by a cardiologist.

    Gregory DellMay 15, 2012  #59

  • Mr. Dell, a major concern for all Sedgwick/AT&T short term disability claimants I’ve talked to is regarding Independent Medical Examinations. Where in law findings can one find minimum requirements for physicians performing these exams? I know multiple times where Sedgwick has chosen doctors who don’t even practice in the area of concern. For example, orthropedic surgeons who have licenses but have ceased surgical practice for years, have no hospital credentials or teaching/faculty relationships. Basically, they are retired and strictly do independent medical exam work. I would hope this is addressed somewhere in law (outside of workman’s compensation). What are your thoughts on this abuse and where are any resources for us?

    CharlesMay 12, 2012  #58

  • R,

    You must appeal again as Sedgwick requires AT&T employees to appeal twice. They will probably deny you again as Sedgwick only listens to their own hired doctors. If you get denied, please contact us and we can review your claim to see if we can assist you.

    Gregory DellMay 9, 2012  #57

  • Sedgwick has really done a number on me 30 days after total knee replacement surgery they put me in “Administrative Denial” status even though my surgeon clearly stated I was taking heavy narcotic medicine, required a walking device and could not sit for any period of time. So they sent notice two days before an IME exam. I called and told them law required at least 7 days written notice. Two weeks later I got another letter regarding an IME exam. I checked the doctor’s license and other information – he has not performed orthopedic surgery in years, has no hospital affiliations and no faculty association. He just does IME work. So I called MCN about my concerns about his qualifications. Samuel told me “we can reschedule with an active surgeon”. Sedgwick then advised me I was in denial status for a missed appointment despite MCN sending a request to reschedule a new appointment. The AT&T/Sedgwick abuse is hurting my mental health.

    ThomasMay 8, 2012  #56

  • Yet another AT&T employee dealing with Sedgwick.

    My short-term disability was approved initially, but when my doctor extended my leave, the extension was denied due to insufficient justification of not being able to return to work.

    Following Sedgwick’s appeal process, I had that doctor as well as another doctor I am seeing (several doctors are treating me) conduct medical reviews with Sedgwick. Result of the consultations: Denied again.

    Sedgwick rep. told me I can appeal the denial, which I will do, but I don’t understand how they can ignore the recommendations of two separate medical providers. I offered to see a doctor of Sedgwick’s choosing, and was told they don’t employ doctors and they don’t operate that way.

    If i’m denied again I’m going to ask my state attorney general about appealing through the state’s employee protection law.

    I’m also eager to hear about that class action law suit.

    R.May 7, 2012  #55

  • Steve,

    Sedgwick is out of control. Please contact us so we can review your denial letter and discuss your options for presenting a strong appeal. CIGNA is not as bad as Sedgwick, but they are a close second. You need to be prepared to deal with these insurance companies as they don’t like to pay. If you would like assistance, let us know.

    Gregory DellApr 24, 2012  #54

  • I have been a retail manager for over 25 years. On Dec. 2010 I lost sight in the right eye due to an accident. Sedgwick approved Short Term Disability for 2 weeks for surgery. During 2011 I continued to work, had 6 surgeries in hopes to restore eyesight. On 12/2 I was told my sight could not be restored. Now being treated for depression and diabetes. Went out on disability on 12/18/2012 after a knee injury due to my vision impairment. Sedgwick approved my FMLA due to “a serious health condition that makes you unable to perform the essential functions of your job.” Yet they denied STD based on the condition had not worsened which suggest a lack of severity of condition. Blind is Blind. Filed the appeal and denied again. Attending Physician Statement states I am not able to return to work. Doctor complete Medical Report Form from employer stating I was not able to return to work and that I pose an imminent and substantial degree of risk to my own health and safety if I returned to work. Do not have a release to return to work from my doctor, yet my employer, based on Sedgwick’s process, expects me to return to work on 5/1. I do not feel I can return. My disability backpay is now over $29K. What steps should I consider to appeal Sedgwick’s 2nd denial? CIGNA is handling my Long Term Disability. I have failed the claim. Should I expect the same complications with CIGNA?

    SteveApr 24, 2012  #53

  • Karen,

    Your experience with Sedgwick is unfortunately typical. Keep fighting Sedgwick. You can probably sue them now since they have delayed making a decision on your claim. Please contact us if you would like us to review your potential lawsuit.

    Gregory DellApr 21, 2012  #52

  • I have been on appeal with Sedgwick CMS for 20 months! My pension provider told me that Sedgwick sat on my claim for six months without doing anything. Now that I am denied by pension provider said that they had another disability provider reviewed my file and they still denied me. I am so stressed out and my physical and emotional issues are so overwhelming that my hair is falling out and I am showing signs of Cushing Syndrome because of the increased cortisol caused by the stress. I was approved for Social Security but they say that they have higher standards and that was why I was denied. I do not trust any insurance companies!

    KarenApr 20, 2012  #51

  • M. R..,

    Any company can offer a buyout of a claim. Acceptance of a buyout is voluntary and you are free to reject it if it does not interest you. To learn more about buyouts, please see this page on our site.

    Gregory DellApr 6, 2012  #50

  • Alan,

    The only way to file a lawsuit as a group is through a class action. The class action laws are very complicated and make it difficult to get a class certified. All of the claimants in a class action need to be “imilarly situated”. For example, multiple employees of AT&T with Sedgwick disability insurance claims could join together and file a class action lawsuit. We are currently in the process of researching a class action against Sedgwick.

    Gregory DellApr 6, 2012  #49

  • My wife has been on total and permanent disability from Delphi/GM managed by Sedgwick. Sedgwick is now offering a buyout of the claim which would remove her disability payment and health insurance. Can this be legal?

    M. R.Apr 5, 2012  #48

  • Is it possible to file a civil lawsuit as a group against Sedgwick? With all these numerous claims of inappropriate actions by them, I’m surprised that a lawsuit has not been brought against them.

    Alan SmithApr 5, 2012  #47

  • Dear Dell & Schaefer,

    I can’t express my personal gratitude enough, for your efforts in the constant battle against the injustices perpetrated by Sedgwick Claims Management Services against America’s Sick, Injured and Disabled workers. I have been doing all that I can (with limited success) to expose these despicable deeds and to assist where possible. It is my sincere hope that your firm will not only continue to assist injured workers, but also use your influence to thrust these issues to the highest levels of government. Remember, Sedgwick provides claims management services for agencies that are funded with tax payer dollars and as such should be held accountable under state and federal laws.

    Thank You!

    Rob DelsmanApr 4, 2012  #46

  • Sabrina,

    Thanks for sharing your experience. Every day we battle Sedgwick in an effort to stop their wrongful conduct. You should also take a look at our Facebook page to see the discussions about Sedgwick and their unreasonable claims handling actions.

    Gregory DellApr 4, 2012  #45

  • Hello,

    I have been dealing with the Sedgwick CMS crap from July 2010 when my company changed to them. I still have claims that have not been paid by my former STD company Standard and this deadbeat company who took 9 months to pay for an urinary tract infection with kidney stones. I am well over $3K in back STD wages, even with the payment of approx. $1.5K. I have proven record of violations of the HIPPA privacy act three times now and last just today.

    This company, based on my own experiences, does not tell the truth. They go out of their way to delay and when confronted on delays they have no idea why someone gave me this information. I have turned them into health and human services and will again tomorrow for another violation of my privacy. I even have a letter from department of labor advising they can not use the ERISA law it strictly for retirement act and it doesn’t apply here. It is bad when you fax them a copy of this and yet this still try to delay.

    I have repeatedly asked to have this current claim examiner removed from my cased when I caught in on suppose to be a recorded call not telling the truth. I brought this to the supervisor in charge of my company and she advised lying is a willful act and she doesn’t see this representative willfully doing this. I advised pulling the recorded call and she advised this is quality and training purpose and not for legal purpose of calls. I advised had I known this I would record this call myself and then play back the lies that were given to me. I am OK if I need to be a land mark case on my history to have it where they never do this another person for any company they service. Now when I call today and the rep read the notes that the claim examiner put in a supervisor advised they are not allow to release this information and it can only come from claims examiner which is another contradiction from his supervisor.

    I am telling I have never seen a game played and no accountability as this company does.

    Sabrina M.Apr 3, 2012  #44

  • Jerry,

    Please contact us to discuss your denial by Sedgwick. We will need to immediately review the denial letter your received. It is amazing how many AT&T employees are denied benefits by Sedgwick on a daily basis.

    Gregory DellMar 26, 2012  #43

  • Andrea,

    Sedgwick beats to their own drum. The best way to push them along is to consistently send them letters demanding a response. They are like robots and they are forced to respond to letters. They can ignore phone calls.

    Gregory DellMar 26, 2012  #42

  • Mike, I have been off since August 2011 for a mental illness that I have. Sedgwick has been handling my claim however I haven’t been paid since December because of a Denial in my short term. I did file an appeal however was just advised Friday the 23rd of March that a decision was made that they made a final denial. Just last week I was advised by social security that I was approved for disability. Sedgwick made their decision based on their thoughts because they said they were unable to contact my doctors, however they didn’t refer me to any of theirs. I have been with AT&T since 1998 and have already had to step down from a manager to an assistant manager because of my disability. I been having the same letters as in other post of job abandonment.

    Jerry WebbMar 26, 2012  #41

  • Hi there,

    I am an United Healthcare employee who filed a disability claim with Sedgwick that was paid at first (albeit grudgingly), then has been denied as of 11/19. I have been consistently having treatments and surgeries up till the end of January, and was ordered to lay up six weeks after my last surgery. I am since back at work and Segewick sent me a letter stating that they wanted another 45 days in addition to the first 45 from the appeal I filed in order to make the decision. At this point they owe me over $3k. The time is up 4/8 – which is a Sunday. Any way to hurry them along?

    Andrea FontaineMar 26, 2012  #40

  • David,

    Your Sedgwick experience is unfortunately consistent with the stories we hear everyday about Sedgwick claimants. Since you reside in California you should file a complaint with the California Department of Insurance and the US Department of Labor. I cannot understand why AT&T continues to retain Sedgwick unless AT&T’s goal is to force people back to work by relying on Sedgwick to mismanage and unreasonably deny claims?

    Gregory DellMar 25, 2012  #39

  • My AT&T/Sedgwick “relationship” began with an at work slip and fall in January 2007. I began having severe back pain and used my own doctor with receiving referrals to pain management, Orthopedic and Neuro surgeons. Despite having a Sedgwick WC case open, AT&T asked me to pay OOP and stipulating that my PM doctors was my primary treating physician. AT&T did reimburse for the first year, but then it stopped.

    Sedgwick requested that I start going to a doctor in their MPN network. I picked one told my lawyer but never received the appointment, even after making several threats and filing for hearings. A large mass in my back was found during the MRI’s I had and so a biopsy was performed in October 2007. For several weeks after I had intense, unbearable pain which ended up being a large effusion in my right lung. 1000cc of fluid was removed at which time I had immediate relief. Despite all the treating doctor’s extensive notes, I was repeatedly threatened to return to work or I would lose my job. I did return too early and was on light duty for a week before returning to STD for two weeks.

    In July 2008, my lawyer sent me to an AME for my rating which I feel was conservative, but OK. While Sedgwick paid for my pain meds they refused to reimburse me for doctor care that was stipulated in my settlement. So much for lifetime medical.

    Now to the good part. My current manager has well documented issues with disabled techs. On 7/12/11 I had a new WC injury that was opened. I worked a short time after the injury because of my ongoing PM. Finally could no longer work due to severe headaches, back and knee injuries. On 8/2/11 the disability case was open and denied though my PM doctor show me temp total disability. I immediately hired a new lawyer. This time I went to an MPN network doctor, you know the ones AT&T and Sedgwick hand picks. He took me out of work as well. From August to today it’s been the same thing. Because I have two WC cases and the disability case all the paperwork gets filed incorrectly. My lawyer has made hundreds of calls never returned by Sedgwick. Even though mt WC case is approved the disability is denied. No money since day one. All benefits lost. My wife has a life threatening illness that needs prompt care. My MPN has asked for an injection therapy since 10/14. I visit my MPN doctor every month. I’m on company initiated leave that will last only so long. My lawyer applied for california SDI which I was receiving from 8/9/11 until 2/15/12 then Sedgwick WC adjust or called SDI and lied, telling them they would start paying benefits. No pay again. I’m losing my house of 15 years and everything else.

    The Sedgwick disability adjuster finally called me for first final denial. I asked for an explanation. They said well now we can approve you but if even one day isn’t approved AT&T says we have to deny the whole thing. I filed and appeal right away. My MPN Ortho and Psychologist as well as my lawyer have faxed each doc dozens of times but they don’t seem to ever have my paperwork. I called my Sedgwick appeals adjuster and refaxed each document. Started at 2pm and finished at 9:20pm. The next day I had her read each doc and they had 15 of the 86 pages missing so I refaxed. Every facet of Sedgwick’s entire system is designed to fail.

    My lawyer had to call AT&T’s defense attorney, something I guess that not done, to get the Sedgwick WC adjuster on the line. I had my procedure approved in 24hrs. Still no pay. A hearing has been filed. Fortunately the law office is a few stories above the court. Only a 30 day wait for hearing. To Sedgwick and AT&T, all laws and employee well being is ignored.

    I guess Sedgwick CMS level of fraudulent activity was too much for AT&T as I received a letter stating that as of 1/1/12 AT&T has a new CMS. Too bad, as that doesn’t help me. I’m stuck with Sedgwick. My lawyers and MPN doctors are dumbfounded by Sedgwick. ERISA means nothing to them. I have eight fellows at work, all with the same issues.

    David AdamsMar 25, 2012  #38

  • I am writing again about AT&T being true creeps just like Sedgwick, only because they can get away with. The AT&T human resource person I spoke to this morning said they pay Sedgwick, so of course Sedgwick works for them not you, the employee. I thought Sedgwick was a neutral 3rd party solely involved in what was medically true or false for me, the employee. I am now told an extension decision will not be made until the 16th of March at the latest. Suddenly my case is complex, they claim. I’d like to see how long AT&T would remain quiet if their source of income was suddenly removed. My CWA union is in bed with AT&T just as much as Sedgwick as they are doing nothing for me.

    M.L. SnodgrassFeb 27, 2012  #37

  • So why can’t someone do something about Sedgwick? I am dealing with them currently. First they got my pay wrong, then it took over 5 weeks to get it right (after many phone calls with the adjuster) it got sorted out. Somehow in the process I gained a case worker from Corvel that handles most of the process with doctor appointments and picking the doctor and everything but I am pretty sure she the doctor and Sedgwick are all working together.

    I have been out for a brain injury and I feel NO better at all. No one is listening to what I have to say, I gave the doctor a list of symptoms he just ignores. He gives me the sobriety test everytime I go in there and doesn’t address the ringing in my ears or the what I guess is vertigo? I can’t do my job as manager of dominos pizza and my employer doesn’t want me to return until I am 100%. The doctor saids he doesn’t know how to treat me and the corvel case worker tells me all the symptoms are from me “getting old” (I am only 36).

    Somewhere someone must have told Sedgwick I am back to work cause they havent paid me in over 4 weeks and they just say “I can no longer help you with benefits”. The Corvel case worker yelled at me when I asked her about it and said its not her problem and the last I heard from my doctor was he wanted me to see someone else for another opinion. So now, because of Sedgwick or someone it looks as though I will lose my apartment because I have no money coming in from anyone at all.

    If we all know Sedgwick is so bad why can’t anyone do something about them? I am sure they are all incompetent and they try to screw injured people purposely.

    KevinFeb 18, 2012  #36

  • Sedgwick took over our medical leave management Jan. 1, 2012 and they are pathetic. They have denied my medical disability which is a benefit from my employer after I had 2 major critical surgeries in November and am not released to work yet by my doctors. They are a scam company who seem to simply deny claims vs. allowing employees to use a benefit we pay for from our paychecks. I am not healed from my wound yet and am in need of my disability pay. I need help.

    PaulaFeb 15, 2012  #35

  • Bill,

    Thanks for sharing your comments about Sedgwick. It is shocking that employers continue to use Sedgwick to handle disability claims. You should see all of the other complaints about Sedgwick on our Facebook page. You need to continue to contact Sedgwick daily until they pay you. You should also notify your employer about the way in which Sedgwick has handled your claim.

    Gregory DellFeb 14, 2012  #34

  • To say Sedgwick is incompetent would be a gross understatement. In my mind, they are criminally negligent. I filed a short term disability claim through my employer – United Healthcare. One month and five days later, still no check. My landlord wants me to move out because I’m late on the rent and Sedgwick keeps telling me the check is “in the mail.” From day one the claim has been a nightmare, made all the more difficult by Sedgwick’s incompetence and soul killing indifference.

    BillFeb 14, 2012  #33

  • I work for Greyhound Lines who recently switched to Sedgwick. I have been placed out of work by Concentra, the company that Greyhound uses for workman’s comp. So far I have not received a letter or any other notification from Sedgwick or my employer. I only know that they have my case because the last claims company sent me a letter. I have spoken to the Rep. handling my case about three times. But I have a relationship with her voicemail that tells you she will return your call in one business day but then she takes a week to call you back. She then tells me she is still trying to verify the information that I gave her. They have not approved the tests that the doctor has ordered or approved a check and I definitely haven’t received any money. The Rep. also told me that she is waiting on my company to verify my statement. Wasn’t it my company who filed with them? Because I sure didn’t choose this company! I have followed all of the rules, when you see your child hungry or going without then you start to go crazy. My desirous certainly don’t want to hear that I’m having problems getting my money from workman’s comp claim services Sedgwick CMS.

    Kofi DixonFeb 13, 2012  #32

  • An AT&T employee recently shared her experience about dealing with Sedgwick for a short term disability claim. This story is a routine situation for people that are forced to deal with Sedgwick for the handling of their disability insurance claim. Read it here: Sedgwick continues to deny disability benefits to AT&T employee.

    Gregory DellFeb 10, 2012  #31

  • Deb,

    The situation you describe is the typical games we see played by Sedgwick on a daily basis. I am still trying to figure out if Sedgwick does things intentionally to make life miserable for claimants or are they just really so disorganized that they have very little idea what they are doing. Sedgwick’s claims handlers seem to be some of the most inexperienced claims people that we deal with on a daily basis.

    Gregory DellFeb 9, 2012  #30

  • I broke my foot on December 23rd and to this day I have not been able to get an answer from the CMS at Sedgwick as to whether or not they are going to cover the claim. My doctor put me off work due to the location of the fracture trying to keep me from having surgery. I call and leave messages on the CMS’s voicemail and she doesn’t return them. At one point I had to call her supervisor and threaten an attorney because it had been 10 days. She claims she has not received the medical records from the hospital. Also she stated she needed me to sign a form which she delayed two weeks post injury in sending me, then sent it to my old address which is not the address on my claim or the one the company has on file for me. She then tells me she will email it to me which she does and the attachment is blank, then next attachment I can not get open and and finally when I do there are no forms to sign as she mentioned only a letter. She then resends it to my correct address without enough postage. I feel like it is not my responsibility to have to pay for it since I don’t have the income from the company that is causing all this plus they didn’t even pay me for my holiday pay (Christmas and New Year’s) which I normally get paid for.

    DebFeb 6, 2012  #29

  • Marie,

    Sedgwick has been out of control lately. Either they are extremely disorganized, overwhelmed with claims, or hire incompetent employees to manage claims. You need to persistent and call them or write them everyday until you get a response. If you have been denied, then you must file an appeal in a timely manner. If you would like legal assistance, please contact us.

    Gregory DellFeb 6, 2012  #28

  • My husband works for one of the big three automakers. He was diagnosed with a sleeping disorder which enables him from handling heavy machinery, and also diagnosed with sarcoidosis. He filed a claim with Sedgwick over two months ago, and has submitted all test results, doctor notes, chart notes, and also proof of physical therapy. No matter what he does they continue to deny paying him!

    They repeatedly tell him either “we have not received it”, and ignore his Doctors’ phone calls. He is not well, and should not be burdened with this! His union is not doing much for him either. I am beside myself with anger and frustration, as I am having chronic health issues.

    What can be done to stop this company from doing this to hard working individuals, who have paid into a system that if in the event of illness or injury, they can still live? How many denials can be appealed? Is there a statute of limitations? If so, what is it?. I have followed the chain of command, however, since the union is not assisting at all, should I resort to taking legal action? Our utilities are due for disconnection, and our automobile is in jeopardy of repossession. Please advise.

    MarieFeb 5, 2012  #27

  • Steve,

    It is scary how often we hear the same story from disability claimants about Sedgwick.

    Gregory DellFeb 2, 2012  #26

  • I went out on disability Oct. 1 2011, on Oct. 31 I went back to work for 1 day and then went back out on disability. I have been out till 1-1-2012 when I resigned my position. I was told that for Oct. 1-31 I will be denied because I didn’t go to an MD, I went to nurse practitioner who I normally see. Then I was denied in Dec. for the time since Nov. 1. This time I did see a MD. When Sedgwick called to tell me this they did not have half of the doctor’s notes, they did not know I was on a sleeping pill for 3 months, they did not know that I was on 3 depression medicines at 6 different strengths, then they said now it’s also because I didn’t go to a psychiatrist. I explained I had an appointment for Jan. and it takes that long to get in. I really feel that no matter what, Sedgwick only knows one word: DENY. I was called today 2-2-2012 and told that my appeal was approved for 9 days, 11-1-2011 to 11-9-2011 but the rest of the time was denied. When they called my doctor, he offered to send them the doctor notes they were missing but they were not interested. I think Sedgewick is a joke.

    SteveFeb 2, 2012  #25

  • Using Sh*twick now, I was injured in a tractor trailer accident, neck and back, on 10/27. Days after the accident sent in writing my injuries, Sh*twick forgot to tell Dr. about my back, then when they did they only discussed my lumbar and neck. It took 3 months to get approval of X-Ray mid-back, now it shows a fracture to go along with herniations in neck and back. Who can hold Sh*twick responsible for malpractice?

    DFeb 1, 2012  #24

  • My claim was denied on the basis that I waited too long to receive medical attention. So on the one side, even though I had reported the incident to my employer and wanted to wait and see if my injury would heal and not create a recordable for my employer I was then told by “saidslick” I took too long and thought it was not caused by the initial injury. In other words they think I’m lying even though I kept in verbal contact at all times with my employer. What this will create for employers in the future is more unnecessary recordables than usual. I’m just lucky my injury was not more extreme but I will never take the chance again if I am injured in the slightest way.

    Mark PeppardJan 29, 2012  #23

  • Rick,

    We currently represent several AT&T employees that have had the same experience as you. It seems that Sedgwick has a business model of unreasonably denying disability claims and forcing disabled people to return to work. Sedgwick is probably the most difficult and unreasonable third party administrator of any disability administrator we deal with. Every day we are contacted by people around the country that have been denied by Sedgwick. You have rights and you should fight them if you can.

    Gregory DellJan 29, 2012  #22

  • I have worked for the phone company in FL for 39 years. It was called Southern Bell, then Bell South and now it is A.T.&T. Every time I have had to go in for some kind of surgery I have filed short term disability and have not been paid for several weeks at a time because of the decision makers at Sedgwick. Their people say that my doctors do not follow guidelines to their standards and Sedgwick refuses to pay me for the time it takes to heal. Most recent is open heart surgery with 3 way bypass with removal of veins in both legs on top of being the carrier of 6 stints at this time. Two of which were installed three days before my open heart.

    At this time I am required to return to work Jan. 30, 2012, after only 30 days recovery and discharge from ICU Cardiac Surgery, or not get paid. The Dr. has already given me instruction not to return to work until March 12,2012. I have to return in order to get paid because I am still trying to catch up from 14 months ago in which an accident caused me to break eight ribs on my left side and could not return when Sedgwick told me to, and did not get paid.

    Rick HughesJan 29, 2012  #21

  • Hello people who will read this. My mom has been dealing with Sedgesh*t. They cannot get their act together, and they are screwing with her. My mom has had to call the doctor and Sedgesh*t repeatedly, being the messenger. It personally ticks me the h*ll off. She is supposed to be let off of work for 8 weeks instructed by the doctor (I was there). They say she cannot be let off that long because she has had to have multiple surgeries regarding the same problem. She has been dealing with it for 2 years now and it was just a stress fracture and in my eyes it might as well have gotten worse with all the stress they are putting on her and my family. Screw Sedgesh*t.

    AlyJan 27, 2012  #20

  • Who gets paid on a Monday? No one. Monday are holidays, banks are closed. I worked for AA and have been out with a full knee replacement back in 2010 to present as I am still having problems with the knee and also corporal tunnel injury to both left and and right arm. I need to pay my bills on time. Spoke to rep. at Sedgwick about checks arriving on Mondays that have been prepared on Thursdays and mailed out of their office on either Fridays or Saturdays and gets to me on either Mondays or Tuesdays. For the last two Mondays, Jan. 2 was celebrated for New Year’s Day, Monday Jan. 16 Martin Luther King’s Day, so no check until the Wednesday if I am lucky.

    Rep. tells me check is a courtesy to be mailed out before the actual pay day. When SRS was handling the insurance I was religiously paid on Thursdays and never late. Rep. tells me check was hand made, which was a lie. All I want is my check that I am entitled to through workers comp.

    What the rep. at Sedgwick is telling me is to go to hell in a very diplomatic way and will pay you as we see fit. There has to be a mandatory law forcing these insurance companies who have to pay people who are sick or on disability to handle these people who have been hurt on the job with a lot of courtesy because one day they may be on the other side of the fence and not to find everything negative in the book to handle them with. People don’t go to work to get hurt or killed on the job.

    AlexanderJan 17, 2012  #19

  • Shelley,

    Sedgwick’s conduct you describe is not unusual. You need to appeal their denial immediately.

    Gregory DellJan 16, 2012  #18

  • I work for AA in Memphis, TN. I was out of work for two months this past summer (2011) with a back injury. Now I didn’t file it under workman’s comp. because I could not give an actual date, flight, time and bag that caused the injury. It has been a gradual 23 years of repetitive motion. And when working at the gate, it is impossible to use proper bag lifting technique because we only have 25 mins to turn a flight, and when you have 50 people and 30 carry-on bags, you just can’t do it… and NO manager can do it either. Anyway, I re-injured my back within the first two weeks of coming back to work. My last day was the 14 Nov. and I have waited and waited and waited for Sedgwick to send me to a doctor. I had to allow them access to all my previous medical records (MRI, chiropractor and ortho assessments). So I recieved a call from my GM yesterday 13 Jan. 2012 and he advised me that they denied the claim… Well, NO ONE from Sedgwick has called me to tell me, but they tell my boss…. What kind of crap is that? And then to make me wait 12 freakin’ weeks?

    Shelley CarterJan 14, 2012  #17

  • Sonia,

    We represent clients nationwide. Please contact us via our free consultation form or telephone to discuss your claims.

    Gregory DellJan 10, 2012  #16

  • Dear Gentlepersons,

    Do you represent clients in California? I have two, possibly three, claims against SCMS and Kroger and I need help. Please contact me to discuss details.

    Sonia E. Harden Lemke

    Sonia E. Harden LemkeJan 9, 2012  #15

  • I have been looking at the internet to find out about Sedgwick because my brother, who injured his back after working at California State Polytechnic University in Pomona California for over 30 years, has had claims denied contiuially by Sedgwick!

    He just had back surgery no more than 3-4 weeks ago and they denied his claims for pain medications. They are a nightmare to work with. They have him jumping through hoops going from doctor to doctor and still not getting what he needs. Although the doctors are prescribing the pain medication Sedgwick adjustors are denying the claims. He has not had a penny in his pocket for over 3 years. My disabled mother who is in total kidney failure with heart trouble is trying to help him financially and it is placing a strain on her finances.

    Our family didn’t get it? Until now looking at your web site and other web sites who have had the same thing happen to them. I e-mailed 2 senators to place my complaints regarding Sedgwick and others in the governmental arena to try to shed light into what this company is doing to our injured workers. Asking them for help! I don’t know how these poor disabiled people are surviving?

    Sandra CrowellJan 4, 2012  #14

  • Michael,

    You are in the typical strong arm technique used by Sedgwick. If you can’t work then you cannot return. You may be able to return one day and then leave again and file another claim. Sedgwick AT&T usually requires two appeals.

    Gregory DellDec 28, 2011  #13

  • I am in a typical “Catch 22” with my employer AT&T. I have appealed my short term disability denied claim and Sedgwick now has until January 19, 2012 to make their final decision. However, I am out of FMLA time so AT&T has mandated my return to work or I have abandoned my job. How can I utilize what is contractually at my disposal, the appeal process, and AT&T present employment reprisals at the same time? So, in the meantime I return work while claiming I am unable to? That is ridiculous! As of 10 a.m. today I am considered unemployed by a company I have worked very hard for since October, 1999.

    Michael L. SnodgrassDec 28, 2011  #12

  • Alan,

    Sedgwick should not be ignoring your attorney. You should discuss with your attorney filing a complaint with your State of Department of Insurance.

    Gregory DellDec 13, 2011  #11

  • At what point does someone do something about Sedgwick CMS? They are really being difficult at the wrong time. I just recently had back surgery and shouldn’t be going through what I am with them. I can’t call my claim adjuster because I have a lawyer. But they disregard their phone calls as well. Is there any way that I can make this a government issue, expose them and bring justice to myself and the thousands of others that have the same or much worse cases? Seriously, how am I supposed to make it to my therapy sessions and doctors appointments without financial means?

    Alan SmithDec 12, 2011  #10

  • Kim,

    You have a few different issues going on.

    1) You need to contact your doctor and clarify your restrictions and limitations. If you are unable to work, then you need to discuss this with your doctor and have your doctor clarify your limitations.

    2) You may need to speak with a car accident attorney regardless of what Sedgwick does. Sedgwick may try to offset any auto accident recovery you obtain.

    3) If you are injured at work, then you would have a worker’s compensation claim, which would once again offset any of your disability insurance benefits obtained.

    Gregory DellDec 5, 2011  #9

  • I work for 3M. I was in a car accident, not my fault, with broken ribs and several other bruises. My paperwork didn’t have enough information and I was out of the guidelines for missing work because of my broken ribs. My doctor sends me back to work for light duty, with restrictions on bending, twisting, and reaching above my head, my paperwork is faxed to Sedgewick, and later that afternoon I get a phone call from Lisa notifying me that their doctor talked to my doctor and my restrictions have been lifted. Evidently, with that one phone call I am now pain free and can do what I haven’t been able to do with one month of physical therapy. All I have is an email to my employer about a verbal consultation with my doctor that I was not a part of. Either my doctor is spineless or Sedgewick can preform miracles. If I am injured further at work because of my “lifted restrictions” who will be responsible? We didn’t want to get a lawyer because of the accident but may need one now because of Sedgewick.

    Kim RobertsDec 4, 2011  #8

  • First time I tried to claim, they used every paperwork not filled out by doctor, paperwork not submitted etc. etc. excuse. Doctor said can not work, employer agreed, but Sedgwick says not enough. Employer has me collect unemployment until I can come back to work (Frito-Lay). I was without income for four months and collected unemployment the last two.

    Second time I have a serious condition that prevents me from performing my job. Doctor puts me off work and Sedgwick for over a month now keeps finding faults with my paperwork and closes 3 cases in a month that I had to keep refiling for. No matter what you send them it’s not done to their satisfaction or not enough.

    I think I am going to need an attorney.

    Paperworked OutNov 28, 2011  #7

  • Pam,

    As you are aware, Sedgwick can be a very difficult company to deal with. Please contact us privately to discuss how we may be able to assist your husband.

    Gregory DellOct 12, 2011  #6

  • Husband works for 3M. They realized husband is disabled at this time and shouldn’t be at work but Sedgwick don’t care, they are insisting he return to work with out doctor’s release, even though the functionality test says not able to return to work ’till after treatment, which he just started. Looking into an attorney now. Tired of harassing phone calls every other day.

    Pam WolfeOct 11, 2011  #5

  • I have had 2 claims with Sedgwick. The first one was OK, I guess. Not the best, but I do feel that they pay off doctors. My impairment rating was fixed, I’m sure of it, seeing that I went to another doctor and he said that my impairment should have been WAY higher. But the 2nd one is the one I’m having the most trouble with. I basically injured the same thing. My surgery failed from the first claim and they don’t want to pay for it. The only thing is, if I dont have this surgery I will lose my hand. I’m seriously about to get an attorney on this one… if I can afford it. It’s just a never ending battle with this company. I’m really disappointed that my employer would hire such a crappy company!

    M. I. RobAug 22, 2011  #4

  • i was at at green mountain coffee roasters and was injured feb of 2011 as of yet i have recieved nothing. doctors havent been paid for visits or my surgery. i have hired an attorney because being decent and honest with Sedwick proved to be a costly mistake. Thanks for this blog. more people need to find out about the way things are handled. We all are not a bunch of “bumber chasers”. we are just people trying to be treated fair.

    AprilAug 17, 2011  #3

  • I have been on short term dissability with Qualcom sedwick CMS and they have not paid me in 1 month. This is my only income and they dont even care. It is there faught because of there new system they say. There manager Ms Jenny Marathow dosnt even return calls if she exist at all. They say its payroll Qualcom’s problem and payroll Qualcom says its CMS issue. I don’t know what to do. I requested to speak to a higher Dept and CMS says they dont know who that is, stating they dont have a complaint dept WOW I cant believe that no one is running the Office. I feel Qualcom benefits dept should get involved to watch over ther employees so they want be abused like this. After this treatment who would ever want to work for Qualcom because of the treatment from a CMS. I was a good employee for 3 years and I am dissabled now trying to recover from foot surgery and this is the treatment i get.

    Karl ReddJun 6, 2011  #2

  • Sedgwick, or better know as Sedgthug, is out for the best interest of the employer, not you. If you work for a self insured company such as Frito Lay, like I do, expect to be screwed. My claim was actually a workman’s comp. claim and Sedgthugs worked closely with Frito Lay to find doctors that they could pay to claim that it was a non work injury ($2,000.00 to one doctor). Guy did a brief (and I do mean brief) exam, asked a couple of questions and sent me on my way. Disgusting little company out to screw over the hard working Americans. Way to go Sedgthugs!

    JaneMay 6, 2011  #1


Do you handle ERISA Sedgwick appeals?

If your disability income claim has been denied by Sedgwick and your disability income policy has been offered through your employer, then federal ERISA law requires you to file an appeal with Sedgwick. Our law firm has handled thousands of ERISA appeals against Sedgwick and we will prepare a very strong appeal on your behalf.

Do you help with Sedgwick applications?

The application for disability benefits with Sedgwick is the foundation of your claim. One mistake can result in your claim for disability insurance benefits being denied by Sedgwick. Our lawyers will guide you through the entire application process and make sure you are in the best possible position to have your claim approved by Sedgwick. We welcome you to contact our attorneys to discuss important information about applying for disability benefits with Sedgwick.

Do you file Sedgwick lawsuits?

If Sedgwick has denied all of your ERISA disability appeals, then you have the right to file a lawsuit in federal court against Sedgwick. An ERISA disability lawsuit is different than any other type of lawsuit and you should hire a attorney that has handled thousands of disability denial lawsuits against Sedgwick. Our disability insurance lawyers know what to expect with the challenges filing a federal lawsuit against Sedgwick.

Can you help with a Sedgwick disability Insurance denial?

We have helped thousands of individuals collect long term disability benefits from Sedgwick and we know the unreasonable denial tactics used by Sedgwick to deny disability insurance benefits. Our experienced attorneys know the many options available to get your disability benefits paid by Sedgwick.

Do you manage Sedgwick monthly claims?

Monthly disability insurance claim management is a unique service we offer. Our goal is to make sure your Sedgwick disability benefits continue for as long as you need them. Many claimants either don't trust or experience aggravation dealing with Sedgwick. Disability Insurance Attorneys Dell & Schaefer manages every aspect of your claim for disability income benefits from (Sedgwick. Sedgwick only interacts with our law firm. Contact Disability Insurance Attorneys Dell & Schaefer to learn how we can manage your disability claim.

Can you negotiate a Sedgwick lump sum buyout?

Lump sum buyouts and disability buyouts are occasionally offered by Sedgwick. Our disability lawyers have established relationships with the people at Sedgwick that make the decisions on disability buyouts. We have negotiated hundreds of lump settlements with Sedgwick. Our goal is to get you the highest buyout possible.

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.

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