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Total Knee Replacement, Yet Sedgwick Still Denies AT&T Employee’s Disability Claim

The unreasonable Sedgwick Claims Management disability denial of AT&T employees appears to be a daily occurrence. Recently, it seems as if Sedgwick does not feel the need to comply with ERISA regulations.

The latest claims handling technique appears that Sedgwick will decide to deny a claim and then notify an AT&T employee via phone. Sedgwick will then set the claimant for a compulsory medical exam as they claim that the medical records of the claimant don’t support the inability to work. The doctors used by Sedgwick are usually the same doctor they have used for past disability insurance or worker compensation claims.

The paragraph below is a recent message we received from an AT&T employee with a disabling knee condition:

Sedgwick placed me in Administrative Denial status as of March 31, 2012. My total knee replacement surgery was Feb. 21, 2012 with a prior knee surgery October 6, 2011. I am still on Percocet for pain, have swelling, inability to sleep, must use an assisting walking device, can’t sit for any length of time without increased pain. They have me scheduled for an IME with Dr. John L. Kihm, who only does IME work. Of course, he will state I can return to work. How am I to drive 50 miles round trip, sit for 7.5 hours, take pain medication and perform my job function. Ironically, another AT&T employee, who works at the same AT&T center (Pensacola, FL) had total knee replacement and did not have to return to work until three months of recovery had passed. I only got a phone call from Sedgwick about the IME appointment and it was left on voice mail. Nothing certified mail. This is the second time they have done this to me. My mental health is low because of this abuse and it is not helping my recovery. There must be a way to allow me to get well before returning to work.

As disability insurance lawyers that have reviewed hundreds of Sedgwick disability claim denials, we question whether AT&T has instructed Sedgwick to deny the majority of disability claims. By denying disability benefits, Sedgwick essentially strong arms a claimant to return to work in order to save their job and avoid bankruptcy.



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