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Sedgwick CMS

United States,
Texas

Consumer complaints and reviews about Sedgwick CMS

Saloveless Send email
 
Mar 27, 2015

denial of short term disability and FMLA

I have been waiting 48 hrs so far for a Disability claims manager named Robert B.and an FMLA case manager named Jose A. to return my call after being told by multiple customer service staff that my call would be returned within 24hrs. My FMLA claim was denied due to Sedgwick not receiving a Dr.s Certification form in time. The FMLA case mgr was very crass and almost bill collector like while telling me that there is no appeals process for FMLA when it is past the due date. After researching I found that the form that they wanted was e-mailed to my work e-mail...and obviously since I was not at work I was not regularly checking my work e-mail. The funny thing is.....the form was emailed to myself and my Dr. on 3/11. My Dr. filled out and faxed the form on 3/12 and I was able to obtain a copy of it with the original fax time stamp. This is the reason my claim was denied and similarly why my short term disability was denied. ( They needed Dr.s notes from a visit within 2 days of my visit....everyone knows that Dr.s write in chicken scratch and everything is sent to a medical transcriptionist....with a turn around of more than a few days.) I have not yet perused legal council, but after my web search tonight that turned up page after page of disputes and claims against Sedgwick I am really questioning the company that I work for's choice in doing business with this company. God help anyone who ever has to deal with Sedgwick. I recommend an attorney being consulted from the beginning of the claims process all the way through to the end. These guys are the epitome of white collar criminals. They prey on the working class layman and take advantage of any and every bureaucratic mis-step in the complicated process along the duration of your misfortunate and already painful and challenging recovery.
Nursebarbie Send email
 
Mar 4, 2015

Hippa violation

Chris Chavez of Sedgwick disclosed my entire medical information to another employee when she filed her own claim. This was recorded and I also recorded him three more times making overt threats and being a jerk. I told him I don't take orders from a clerk. He refused to let me speak to anyone else or give me any information on who I can file a grievance on. They do not protect your medical information threaten to send investigators to your home and make up crap in your chart. File a complaint with Equal Opportunity at eeoc.gov, the national labor board at NLRB.gov, OSHA at OSHA.gov, and Hippa violation at office for civil rights. Chris Chavez the weasel can be reached at (501)859-8287 or (562)981-0248. Shame on you Sedgwick!
SLMorton Send email
 
Feb 13, 2015

Denial

This company is useless. They denied my claim of being off work 4-6 as advised by Surgeon who performed a Hemmorhoidectomy on me after 10 years of suffering. They stated they normal post op recovery was 2 weeks even though there was documentation that I was in the ER 8 days post op in pain. I could barely walk up to 3 weeks. And only started feeling somewhat better after 10 weeks even though I went back to work at 6 weeks part-time and then full time at 7 weeks. I had plenty of sick time and PTO and still do. It just angers me that they would suggest that I was able to work after 2 weeks.
tada1994 Send email
 
Jan 29, 2015

denied disability

I work for att i was placed out of work in the month of december due to agoraphobia, for those of you who do not know agoraphobia Panic disorder with agoraphobia is an anxiety disorder in which a person has attacks of intense fear and anxiety. There is also a fear of being in places where it is hard to escape, or where help might not be available I cant walk out of my house most days without having a panic attack. My doctor has placed me out of work and sent in the documentation several times, the most recent she also explained that i have type1 uncontrolled diabetes and that the stress can effect my glucose levels the reason that they denied this time was because there wasnt documentation of my glucose levels brought in, are you kidding me? I have called today and requested to speak to a supervisor lets see how long it takes before my call is returned
tlafferty04 Send email
 
Jan 21, 2015

find a doctor

Its been impossible to find a doctor under this insurance. I have had workers compensation insurance since the 80's due to my back being broken and its ridiculous that I have to pay over 300$ a month to see a doctor and fill a prescription every month. These people truly do not care about anyone. Here I am 58 years old and still having to struggle because I have to pay out so much that this so called insurance is supposed to be paying. Does anyone know of a doctor that will accept a claim that is older than 20 years??
birdey12 Send email
 
Jan 12, 2015

denial of benefits

ihave been denied my benefit payment from sedgwick. i am eligible for disability for 26 weeks. they paid the first 12 weeks now refuse to pay the rest. i have not received payment since oct. 2014.my doctor sent in all the paperwork andthat says i cannot do the job i was doing.still denied. i want something done
De1010De Send email
 
Jan 4, 2015

I hate Sedgwick. They are the devil

I was hit by a vehicle while on my break in the parking lot at work. It was the tech servicing our air conditioning system. He hit me and took off. Yes a hit and run in a company vehicle. So I reported it to a supervisor and I was taken to Concentra Occupational and they did x-rays and I had a strained neck, contusion to the knee and strained upper right arm and shoulder. They did therapy the first day and put me on an elliptical bike the next day. DUMB. The only meds they gave me were muscle relaxers that did nothing to help me so two days later I was in so much pain I went to Kaiser to get a real exam. I had a possible tear in my pcl and rotator cuff as well as disc damage, but I had to be referred to the spine spec. and ortho to be sure. So to speed up my story, about three weeks after my accident I am still in grave pain and now walking with a cane,the chief doctor at Concentra sent me back to work which only lasted about an hour.I haven't been back since. After I met with him he decided to be evil and send me to Concentra's Orhto Spec. where I felt like I was mugged. This dude pulled my shoulder where I had a partial tear in my rotator cuff and yanked on my knee. I was in sheer pain. All I could do was cry. When I left his office I called my adjuster and left her a msg telling what had just happened and then I called my risk management team at my job and told them what happen. Ms. K called my adjust also and had her change my doctors. So then I began going to an Orthopedic Spc for about a year and a half. Every time he requested to do a procedure Sedgwick denied the request. Mind you I never had a full exam by any WC doctors. The exams came from my doctors. My attorneys requested that I have pain management, and it was approved but Sedgwick denied the request stating that the doctor that I was going to see for pain management did the same thing as my Orthopedic MD,which the office manager explained as well as myself that he do the pain management also which my Ortho does not. She denied the request so for two years I did not have the correct dosage of meds for my condition. Finally my attorney took Sedgwick to court and won and the adjust was pissed so when I went to the PM Doctor he took one look at my shoulder and seen that it was hanging lower than the other shoulder and wanted to do and MRI and the adjuster told him that she is only going to pay for medication and my doctors appointments to see him. I have been waiting for seven months to get my reimbursement check when I should have been .I was approved for surgery on my right hand due to impinged nerves and the carpal tunnel is worst on the right that the left and Sedgwicks attorney agreed to allow the surgery to happen and this was back in October on 2014 and I still have not seen anything saying that I having surgery. I had to finally have my doctor do my knee surgery this past November and they will more than likely do my other surgeries and Kaiser will just bill Sedgwack. I was suppose to have my disability payments start right after workers comp stopped but some how the adjust got together with someone in my old Orhto's office and the papers never got filed to the state. I was without a check for four months and that was my sole income. I lost my car and had to fight an eviction and I was also suppose to have my perm disability payments start after the WC payments stopped but my adjuster decided that she wanted to wait six month until I go back to my QME appt before she sends me that money. I am still waiting for my QME appnt. They are also not pleased with my QME doctor because he has also documented the injuries that I have been complaining about that Sedgwick had tried to ignore. He has made sure that they have been entered into the law suit. Sedwick sent me to an Imaging Center to do an MRI on my knee and they must have paid them off because they stated that my knee was fine and this was in June 2014 but my doctor at Kaiser did my surgery November 2014 and found things that did not show up on the MRI that came from the accident. I was an athlete back in the day but I was walking fine before the accident and now I am still walking with a cane. I have L 4/ 5/6 are bulging,bilateral ulna nerve impinged,structural damage on my right shoulder and a tear in my rotator cuff, tear in my left rotator cuff,chondromalcia in my right knee and bone spurs and cartilage damage and peripheral nerve damage. Sedgwack was suppose to make there decision to send me my total disability payments on 12/12/2014 but instead I received a peer review statement from a doctor that I have never seen or heard of. Since the arthroscopic surgery on my knee it feels a little better but I am still not out of the woods. They did three drug test on me "to make sure I was taking my meds" and then they sent me a letter to tell me that they were no longer going to pay for my pain meds. NOT!!! SEDGWICK IS THE DEVIL AND THERE EMPLOYEES ARE TRULY HIS EMPS WORKERS OF INIQUITY.
PTFObOricua Send email
 
Dec 29, 2014

Sedgwick is just stupid!

I was working for family dollar and on truck day (April 17, 2014) she overloads a cart with chemical boxes and oops, it falls over resulting in ME getting hit by SEVERAL heavy chemical boxes ( left side shoulder and neck). I am instantly in excrusiating pain, told the manager and assistant to make the report and send me to ER, manager said no and if I left I would be fired. My manager even tried forcing me to take pain pills she gave me, which I just flushed. After several days of pain and being denied even 1 day off, ( April 26, 2014) I finally went to the ER. The DR noticed I couldn't lift my arm above my head or extend it very high. My neck refused to turn the way it's supposed to either and said he thought things were torn keeping me off work until I was cleared by a PCP and Mri's were done. I reported it myself to sedgwick and they did their "investigation" while sending me to their DR (May 5,2014) and he told me the same thing the ER doctor did! "I think you might have possible tears, def contusions and sprains, you will not be able to go back to work until we get MRI's and can get this taken care of. I'm keeping you off work for a month so you can get the MRI's you need and proper rest until then." May 5, 2014 my claim was DENIED, yes, the same day I saw the DR. 1st Sedgwick claimed I did not report it in time, and 2nd, they later claim that according to their investigation, it never happened. I hired a lawyer and they investigated and found out otherwise! I was threatened from the beginning so I figured I was gonna get screwed by liars, so I took it upon myself to have a saved messages from the assistant manager, which is also the daughter in law of the manager, on a voice recorder stating it was sorry that her Mother in law didn't report the incident, in which she was present to also, and I also have saved text messages from her stating the same thing. My lawyer sent me for MRI and suprise, suprise, I have a torn Labrum in my shoulder and my C5 in my neck is torn. They did an appeal to sedgwick and while waiting for response sent me to see shoulder and neck specialist. Ortho surgeon suggested surgery since months of PT were not at all helpful. My neck was said to be able to heal with proper rest and medications to losen up the muscles that were too tight since surgery would not be possible at the time because of the muscles being the way they were. Novemeber 10 2014 my insurance appeal was overturned by Sedgwick and they requested medical records to send to their medical review board to get opinion and find out if I do or do not indeed need surgery. I lost out on over 6 months of work but they were only paying me from May 5 - June 13 2014. WTF right? As of today after waiting over a month and a half I was told today "we can not cover any of your medical claims since it was a pre-existing injury so if you feel the need to seek medical attention you can do it on your own." Really idiot? I called my lawyer and we will just all out sue their ass! This is BS! I have never had a shoulder or neck injury before and oh its just so convient that they all of a sudden pull this shit! They are ridiculous so PEEPS, beware of this scam company!
Gregory Takemura Send email
 
Dec 16, 2014

Denied all requests for work comp claim

My mother has been under work comp for almost 4 years. She was kept from having any benefits for almost 2 years. Her first check was almost 2 years later also. At 75 she fell backwards on a concrete floor hitting the back of her head against the leg of a table. Her employer took her not to ER but a doctor on some side street. Kept her from having work comp.

When Sedgwick took over the claim they hired an attorney to fight the case. My mother was waitressing for years and was an athlete in her own right. She ended up in a wheelchair and with major depression. Sedgwick has denied all requests...Physical therapy, neurological, home health care, aqua therapy, psychologist, psychiatrist, natural path, acupuncture, wheelchair, walker, back brace and even mileage. We have had to take everything to hearing due to being denied all requests. In cases where my mother has had 3 physicians referring my mother to have services, they have denied all claims. It takes 6 months here in Hawaii to have a claim heard then after a hearing, my mother is currently still waiting for an answer from the state work comp offices and its been 4 months.

Sedgwick is claiming that all of my mothers problems is age related and pre-existing.
starr Send email
 
Nov 11, 2014

DENIED LAST WEEK OF DISABILTY

I was out on disabilty and was approved for 8 weeks and they denied my last week even though i had an unrelated surgery that
week ,which increased my stress and back pain. I recieved a letter from them stating they approved the addittional week for state
but not my company pay...which is the bulk of the payment. when i callled distressed about this the rep said it was an error and that
i was approved for both state and my company pay and made a cmt that i had called a couple days b4 and was told the same thing.
than i find out they wrong and i had to appeal my final week. I faxed in all my info and waited about two weeks and called a rep
yesterday who told me the final appeal decision would be determined on 11-15-14.. I was elated.. than I got a call that afternoon from
the appeals rep who said the appeal decision would be made by dec 15.14.. I told her I had just been told this morning that i would be made by nov 15.. and her reply was oh she probablhy meant dec 15.. This company can say anything they want to you and not be
held acccountable.
LivingSimply Send email
 
Oct 1, 2014

Wrongful termination of benefits

I had previously had knee surgery in which I paid for on 9/11/12 and returned to work on 11/11/12. On 3/9/13 I fell down an oil coated stairwell while working at Con Agra Foods and re inured my surgically repaired knee. At that time I went out on workmans comp. I remained on workmans comp until 7/9/13. Sedgwick sent a nurse out on an appointment and with me. Long story short. Up until this point, the fall, (in which it did), re injured my knee. When the nurse shows up, it's my fault. At this point I am totally confused. Sedgwick cancelled my workmans comp checks immediately. I go on to further investigate. Spoke with a manager at the department of labor and he has informed me that after further review of my file I was due to receive 60 more days of payment. I contacted Sedgwick and was told that my claims representatives name was Donna C. It has been weeks and I have yet to receive a call. I have even went so far as to contact her via fax. I am still unable to return to work due to the condition of my knee. When I fell and re injured my knee I hadn't even finished paying for my first surgery and physical therapy. I now need a full knee replacement at 40 years old. It is really a shame that you have to obtain legal action for simple things especially when it was owed to you in the first place. I mean I can't even get a call back. I have been reading and investigating on my own about this company and I am amazed at all the complaints against Sedgwick. I don't understand how companies have even decided to choose or keep them as an insurance provider.
allgood Send email
 
Jun 29, 2014

Denied FMLA Extention/got Fired

I was out on FMLA and had 2 operations the last one I got MRSA, I was told I almost died. They took me back in for surgery and cleaned out the infection. I was on bed t and IV,s at home for 6 weeks. But I still has pain so and MRI and Myelagrahm were don't and they say I needed another back surgery. The doctor sent all the note and info to Sedgwick and while I was waiting for a decision I was fired from my job at Labcorp. Now I have no job and no insurance. I am still in pain and on medication for it. This whole thing has given me a nerves breakdown and I'm on medication for anixity and depression. I think Sedgwick should have changed by short term disability to long term disability, but I feel my employer was I cahoots w/ them. They never allow FMLA extensions to employees over 50 years old form what I have found out. I was to suite both Sedgwick and Labatory Corp. of America, but cant find a lawyer to help me
kypwerkz Send email
 
Jun 28, 2014

refused clains

These people are legal criminals that is messing up family lives. My doctor took me out of work indefinitely and they went against his decision as usual. What kind of company will trust these people with their employees lives? Baker Hughes is just as rotten as sedgewick. left with no income and no job. How can these examiners sell their soul to the devil like that. somewhere down the line they will have to reap that and it will come with a great increase. all of them!!!
Betrayed Send email
 
May 6, 2014

Update:Sedgwick CMS Botched FMLA, Caused Delays in Process, Then Denied Claim over the Delay, Cost Me My JOB.

Just an update to the main complaint below. The week after my termination, I returned to the clinic that had sent my THREE faxes to Sedgwick over the course of two claim processes between Jan and Mar. I wanted the dates of transmission and copies of these faxes. The very first fax sent, as mentioned below, was sent well within the deadline (on day 6 of a 15 day window, bank statement shows the fax fee charged to my card that day.), but according to what the clinic told me when I came back having to RESEND it, due to Sedgwick refusing to accept it, the first fax was not even in the right form. Sedgwick had started the process with the wrong form. These were the very words of the clinic. The week after termination, knowing what was done to me was dishonest and immoral trickery, I went to clinic to get the copies and dates. The clinic had copies and dates for TWO of them. Guess which one has now mysteriously disappeared from the clinic? NO RECORD OF IT WHATSOEVER, NOT EVEN IN THE FAX LOG! My bank statement proves that it happened, and WHEN it happened... somebody made it disappear.
Betrayed Send email
 
Apr 25, 2014

Sedgwick CMS Botched FMLA, Caused Delays in Process, Then Denied Claim over the Delay, Cost Me My JOB.

These racketeers just got me fired from my job. I'm sorry but the story is a bit long.

I was just fired last week (April 18, “Good” Friday) from an AT&T Mobility call center in Tulsa, OK, where I’ve worked for 16 months as a Customer Care Rep. In Dec 2013/ Jan 2014 there were multiple ‘bugs’ going around in my work area. After about two weeks of dealing with an uncontrollable cough that progressively interfered more and more with my ability to handle calls, I woke up on Jan 01 in a cold sweat, dryheaving, thinking I had a stomach virus.

Next day I went to an Urgent Care clinic near my home, was swabbed, tested, diagnosed with bronchitis, given a heavy antibiotic (Zpack, which made me worse for 48 hrs before getting better), a pill Rx, and albuterol inhaler. I missed 4 work days. Jan 3 was an off day, no penalty, but the absence added 4 attendance points to my then SIX. Termination level is 8, so the claim was do-or-die. I returned to work on Jan 6, found that two others on my team were also out with bronchitis, one hospitalized, and I put in my FMLA request. I gave them my cell number and my personal email address, and requested updates to be sent there, because I knew my “work email,” which can only be accessed when I’m clocked in and taking calls, with every second being monitored, was VERY difficult to keep up with, especially when still not quite back to normal yet. I didn’t want even a chance of missing an update. (Hold THAT thought for a minute.) I called the clinic where I’d been diagnosed, emailed them the form I was sent, gave them my Visa info to charge me for sending the fax. They faxed it in on Jan 12, six days after my return to work.

Two days later, unbeknownst to me, a reply was sent to the very email address I did NOT want to have to rely on, with nothing sent to my personal email, which as I said, was the one I expected it to be sent to. And of course I was late finding it too. That was the very reason I wanted it kept OUT of that inbox in the first place, so it could be done more methodically, in an email acct I could access on my own time. Nothing had come to my personal email. The reply I found late said “Documentation that would meet (our) requirements WAS NOT received within the allotted time period.” This email also contained an FMLA physician form. It seemed to look a little different. I notified the clinic of the problem, and at that time they informed me that the form I had sent them originally was NOT even an FMLA form, but an AT&T Worker’s Comp form… (Sedgwick had sent me the wrong form the first time)… but they told me that they had put my info into it anyway and sent it on to prevent a delay. They agreed to send another, in the proper format (WHICH I NOW HAD), at no charge due to the extenuating circumstance. However, the rules of the clinic dictated that only the doctor who examined me could legally fill out this form, and that doctor worked in another town two weeks out of every month. So I had to wait for the doc to return to town before it could be done. I called the FMLA office, informed them of the situation, and they told me that the deadline had passed, but that the deadline for any ADDITIONAL info to be sent in was going to fall on the day after the doctor’s return to the clinic in my town. It was skin-of-the-teeth timing, but barely safe, or so I thought. (Even so, IT WAS OUT OF MY CONTROL.) The doc’s first day back in town, I was there, with the right form, and the info was faxed in FOR THE SECOND TIME as I watched, all because Sedgwick had started the process by throwing me a curveball I had to deal with and a mess to clean up. My claim was final denied, and the excuse given was “lack of a sufficient reason for the untimely submission,” even though the delay was their fault, a result of their sending me the wrong form to start with. Add to that the delay caused by their sending my reply to the very email I requested they NOT use (due to the KNOWN difficulties in keeping on top of it), plus the delay of the doctor being out of town, which my conversation with them had led me to believe had been taken into consideration.

My final FMLA denial had one single sentence at the bottom, in lighter font (set up to be overlooked), mentioning something called an IDSC claim, which I had never heard of before (FMLA is more a household term). This was another ATT acronym (don’t get me started on “Acro-nese,” a language born of neccessity due to being so rushed that we don’t have time to use real words) for “integrated disability service center,” and since I am not a “disabled” person, never been on disability, don’t fall into any “protected class,” I dismissed it as not pertinent; and despite all the hands-on help available for literally everything (else) done in that call center, even filing insurance or 401k, I was blind to the fact that this secondary claim could help even ME, until a manager clued me in and advised me to file IDSC claim ASAP. I did, that very morning. Proper form was sent this time. I saw what the doctor wrote. No way this one will fail, right? (THIS IS MY THIRD TIME TO SEND THESE PEOPLE DOCUMENTATION, the same info in three different formats now.) THAT claim gets denied, due a time window that had already passed before I filed it. The FMLA denial’s single sentence in the footer about this IDSC claim also said that IDSC had to be filed within ten days of FMLA denial, a date which had passed before my IDSC claim was started. But Sedgwick didn’t inform me that it was a wasted effort (and a wasted faxing fee) until the denial of that claim.

Both claims were denied despite what I still perceive as a great effort on my part in getting them all the documentation they needed, not to mention having to make up for their initial error. I was told that there was no avenue of appeal either, even though Sedgwick’s error indirectly caused the very delay that they used to deny me. Unbelievable convoluted mess to say the least. I feel this whole thing was set up for failure. Gaming, scheming, intentionally making things difficult… I’m not sure really HOW to best describe this fiasco. Honestly I’m still in a mild state of shock I suppose.

Now it is March, and I am basically a dead man working, two attendance points over termination level, despite EVERYTHING I did, just waiting for the hammer to fall. I approach managers, asking what is going to happen to me, over the course of several weeks, while I’m still working there, with 10.25 attendance points hanging over my head. The stress was unbearable. (I’m still not back to sleeping or eating normally.) Several had told me during March that since prior to the January illness, I had only gotten one “first written notice” for attendance (step 2 of a 4 step process, with step 4 being termination), it was likely that I would be retained and placed on “final written notice” rather than terminated.

It wasn’t until April 18 (the day after my wife, a CWA Local 6012 Union Steward there, had just returned from a mass CWA protest rally at ATT Headquarters in Dallas), that I was expedited out the door after a brief meeting, at the beginning of the day, before logging into the phones (which I never touched again). Union Steward present at the termination questioned the AM about skipping the “final written notice” step of the disciplinary process, and the reply was “uh… some policy changes are taking place in the back, don’t have all the details yet…” The Steward didn’t buy it, but I was still terminated. The Union has filed my grievance, but I have no idea what it will come to.

Now I don’t have a job, and all I did was get sick, with bronchitis I picked up at work, exacerbated by taking calls and talking all day, and missed an email that I did my best to make sure would not go into the “vortex,” or work email. This just does not seem morally right. No. It's just plan evil.
seether007 Send email
 
Apr 17, 2014

Sedgewick is corrupt and crooked,

Go here for a petition for the government to take action

https://petitions.whitehouse.gov/petition/class-action-lawsuit-against-sedgewick/fdczb5ld
CB5811 Send email
 
Jan 30, 2014

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?
Bigdan1975 Send email
 
Apr 5, 2013

Denied then fired

I was working as a U-Verse prem tech. I started with AT&T on May 30, 2008. I work at AT&T. Well, I use too. That is until I tripped over a fence and fell at work on June 15 2011. Now, they are suing me and saying that I committed fraud and the fall never happened. It did happen. I sustained a fracture to my spine and 2 herniated discs in my back. I have looked it up and AT&T and Sedgwick CMS have over 1000's of these type claims denied for the workers and then they fire them. Not only in Ohio this is nation wide and NO ONE IS DOING ANYTHING ABOUT IT!!! The injured employees just have to suffer and deal with it. I have had to borrow over 16,000 dollars to fight these people and every time they try to get me for something else. Now, they are wanting not only to sue me in civil court for 400,000 dollars they are wanting me to do jail time. They want to pursue this as a criminal case as well. Please help me and the 1000's of others that are being mistreated understand how AT&T and Sedgwick CMS can do this to their employees? This is by far not right. Do you know of anybody that has emailed you about anything like this? Help me find them so we can have a fighting chance against these big companies. Thank you! my email is bigdaddydan1975@yahoo.com
BAIHLAH Send email
 
Feb 21, 2013

SEDGEWICK CLAIMS MANAGEMENT

I WAS DIAGNOSED WITH A RARE IMMUNE DEFICIENCY.
M.D. ORDERED ME OFF WORK INDEFINATELY.
SEGWICK REFUSED TO PAY ME MY SICK PAY
BAIHLAH Send email
 
Jan 9, 2013

CLASS ACTION LAWSUIT AGAINST SEDGWICK CMS

I WANT TO FILE A CLASS ACTION SUIT WITH ALL THE OTHER PEOPLE THAT SEDGWICK DENIED SICK PAY TO
BAIHLAH Send email
 
Jan 9, 2013

DENIAL OF MY SICK PAY

I WAS DIAGNOSED WITH A RARE IMMUNE DEFICIENCY.
M.D. ORDERED ME OFF WORK INDEFINATELY.
SEGWICK REFUSED TO PAY ME MY SICK PAY
daddyfatstacks65 Send email
 
Dec 19, 2012

unprofessionalism, rudeness, bad faith bargaining, and tampering with evidence

Matt Trissler .lied to me about video evidence in this claim. he became very upset when I found out myself that he was lying and I confronted him on the situation saying that I need to stop calling his superiors and complaining and I need to stop asking questions that I have no business asking. furthermore he tried to negotiate with me on the claim settlement in bad faith offering me first 250 dollars then calling me on the next day and offered me 500 dollars when my total expenses were well way over the 5000 dollar mark. he would not accept or deny any liability or responsibility is claim, instead stating that the 250 dollars and the 500 dollars were a customer service gesture because they felt bad about my situation.
that he didn't have to accept or deny responsibility or liability and that he didn't need to pay any of my doctor bills. And as for mister Paparockie me of being a scam artist and trying to hustle them out of money. he also said that I better get a lawyer because he wasn't going to approve any claims that I had pending. these outbursts and tactics go against the rules regulations and policies of the Department of Insurance and also violate case law for the state of Kentucky. my claim has yet to be settled but I assure you that I have taken this to the higher CEOs and have reported these people .
Carmen Send email
 
Oct 11, 2012

Denial of Disablity

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 Sedwick CMS, 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. 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 I’m seeking legal representation.
DivaMamaGrizzly Send email
 
Jul 31, 2012

Denial of Disability and Injuries

Dear Mr. North:

I posted some comments on your UTube interview. Your company treats injures workers like dirt. I got hurt at work and from the beginning of this odyssey it has be a total nightmare. Your company policy appears to be deny every claim no matter what the medical evidence and screw the injured worker as much as possible. One harassment tactic after the other to try to get them to quit their job and bullying by the claims adjuster of the injured worker, the doctors and no provision for medical treatment unless the injured party has a lawyer that will put pressure on SCMS to perform.

Since getting hurt a work there has been countless delays in my medical treatment, my QMEs, diagnostics, and misconduct on the part of Kroger, my employer who did not advise me of my rights of predesignation until Jan 2012. I was hired in April 2007, not once did they comply with California State Law until I wrote David Dillon to tell him what was going on in the trenches in the stores. Since then I have suffered a 25% permanent disability, plus a permanent damage to my gastro intestinal system caused by the pain medications my WC doctor gave me and all this was reported several time to Andrew Gemmer the adjuster who did nothing to provide me with medical care, nor a QME or any disability benefits for this problem, the asthma caused by my modified work, the rear end collision I suffered on 24 August 2011.

Countless times I have followed the ‘rules’ and requested a QME panel from DIR-WC and got the panel, made the appointments and at the last minute one time with one hour’s notice, yesterday with less than 24 hours notice that my QME for which I have waited over 18 months has been rescheduled by SCMS/Defense Attys with not so much as a ‘by your leave’ or notice to me! I was called by the doctor’s office and they told me the next available appointment would be 2 Oct 2012!

At my own expense I had a colonoscopy and endoscopy which diagnosed IBS and Gastritis. Neither of these conditions were present when I had the same procedures in 2008. The only difference is that I had been prescribed: Naproxen, SOMA, Limbrel, Gabapentin, and Tramadol for the arm pain from my original injury of bilateral epicondylitis. Then on 24 Aug 2011 while directly enroute from my WC doctor I was hit from behind at a stop light in Pleasant Hill, CA. I have also had to pay for this injury out of pocket and I was subsequently informed by a competent WC attorney that this accident was part of my WC claim.
User929998 Send email
 
Apr 11, 2012

Denial of Disablity

I have just been denied a maternity disability claim for chronic headaches and vomiting. i've been to THREE specialists -- my ob/gyn, a neurologist and an endocrinologist. my ob/gyn submitted and certified me as unable to work due to the migraines several weeks ago.

Diagnosis is migraines and hypothyroid. however, i cannot be medicated due to the pregnancy and sedgewick is denying me because there's no evidene of a "treatment plan." I told them i can't take medication because i'm pregnant!!! how come three doctors who have treated me and know my situation get trumped by some nurse/doctor reviewer at the insurance company? because it's their job to deny claims. I've contacted a legal referral service, and i'm wondering if i have a case. in the meantime, my ob/gyn is going to hopefully write another letter to sedgewick stating i cannot work because of the migraines and my further treatment plan will be to go to acupuncture since i can't be medicated. what the hell are these people looking for? and they are taking their time getting the paperwork together and didn't even start until i was out of work for a week. they're horrible.

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