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Sedgwick CMS

United States,
Texas

Consumer complaints and reviews about Sedgwick CMS

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.
Kharmaiscoming Send email
 
Mar 8, 2012

Denial of Disablity

No one said the anti -christ was just one person. Why not one company and all who work there? You would think the DEA would have the intelligence to realize that since Sedgwick became popular with SIP's as their TPA, the pain medication epidemic has grown way out of proportion. Their trick is to hook all these injured workers, so they choose door #1 ( life time medical complete with gag order) instead of door #2 (cash settlement and you get to quit your job complete with gag order). Need to find a lawyer who can't be bought by them and file a class action against Sedgwick. They count on workers fighting their employers, while they slither in the background.
Jenn Schafer Send email
 
Mar 7, 2012

Rude and unprofessional

My car was hit in the front right passenger corner on January 4th of this year, by a gentleman that drove a 7-11 company car. My car was undriveable. A police report was filed and the gentleman resumed full liability for the accident. Unfortunately, the car was insured by Sedgwick CMS. On January 4th, approximately 10am I filed the claim to my insurance company, Progressive. I was informed by my agent that since I only have liability on my car, that I was unable to obtain a rental car until Sedgwick was contacted and a claim was filed. I am 24 years old and in the state of New Jersey, most rental companies will not rent a car to you unless you are 25 or older. This was a huge problem seeing as I had no transportation. Anyway, both my insurance agent and I tried time and time again to contact this company and for reasons unknown, they were elusive. I could not get through to a person, all I could get were machines. After a week of trying, I finally had enough. I mailed and faxed a letter to their main office stating: if they were not going to give me the time of day, I was simply going to contact an attorney. I suppose that sparked some interest and I received a call the very next day. The call was from a man named Nabeel Nasir and he was extremely rude. I was treated like the accident was my fault and I was being bothersome. When in reality, they were assuming responsibility. The only up-side was that Nabeel was able to get me a rental car within a day of speaking to him. I obtained the rental from Enterprise on January 19th. I was told I needed insurance on my rental, again since I only have liability insurance. The gentleman at Enterprise was very accomodating and assured me that Sedgwick should be able to cover the insurance fee. He then tried to contact Nabeel... to no avail. I had no choice but to take his advice and take their rental insurance. I was not directed otherwise by Sedgwick, so I did not see it as a problem. About 2 days go by and I am contacted by Nabeel stating that my car was totaled and that he will contact me the next day with further instructions. No call and no answer when I tried to call until the following week on the 25th. I was told on the 25th by Enterprise that Sedgwick called them and told them they will only pay for one more day on my rental. I was beyond livid at this point. I received no information on my totaled car until I called Nabeel about 6 times in a row that same day. I asked to speak to his supervisor and I was not put on hold, I was hung up on. I never got a call back and could not get a hold of Nabeel for the rest of that day. The next day I took my car back to Enterprise, not wanting to use any money out of pocket. The gentleman at Enterprise explained that he was unable to contact Nabeel or anyone from Sedgwick and unless he could I was going to be charged the $160 for rental insurance. After waiting an hour in Enterprise calling Sedgwick, we finally got him on the line and asked for the reimbursement. He informed us that Sedgwick does not pay for rental insurance and would not explain further. We finally spoke to his supervisor to which she explained they will not pay for insurance, however they will lend me the rental until I had received my payout for the totaled car... but they still WOULD NOT pay the rental insurance. Thankfully, the gentleman at Enterprise had a heart and told me I did not have to pay for the insurance.

Overall, I felt I was ignored and treated very poorly by Sedgwick CMS, even though the accident WAS NOT MY FAULT. I hope no one ever has to deal with them again.
Mannequin Send email
 
Mar 7, 2012

Rude and unprofessional

Dear Sedgwick victim in TX
I wish I had read these stories when I was first injured on Feb 08, 2012. I received a letter this week stating they were denying my claim due to lack of medical proof. What???
I told my daddy who is 80 yo that I am in battle with Satan.
This company has lied, avoided, accused, been condescending, rude and unprofessional, to say the least.
i pray you are doing well after your horrific hassles from cealing with Sedgwick ( Sedgwitches!)
Best regards - from another victim.
Elu Send email
 
Feb 23, 2012

Denial of Disablity

I feel the same but I realize they only care about their money, they don't care at all about us...they will do anything even illegal stuff ...so be aware
SC%% Send email
 
Feb 23, 2012

Denial of Disablity

Thank you WW** and Joarel for letting me know I am not alone. My doctors request for an extension has also been denied...over the holidays. The approval has been given by California State Disability, but Sedwick CMS has denied the extension. At what point will AT&T and Sedwick CMS realize that we are off of work because we have to be, not because we want to be. I want to be at work, work gives me a purpose. I've been robbed of my motherhood, wifehood, and soon will probably be robbed of my employment status because of this disease I have. All that myself and my Dr is asking for is additional time for this new biologic to work because I am unable to perform my job. More than anything, I wish these people would understand what it is like to walk a day in my shoes. I couldn't ever wish this disease on anyone...knowing what my kids have had to see me go through. All I want is my life back...and now they want to take away my job? This is one of the only things that gives me purpose.
WW** Send email
 
Feb 23, 2012

Denial of Disablity

I recently had back surgery(lumbar fusion), recovery was extremely painful and long. After my doctor provided valid info that due to the trauma I would need approx 2 more months to recover fully, as well as physical therapy, Sedgewick CMS denied my extention of my claim. My employer ATT then uses the time I was off from work to build a case for termination. This is clearly a case of 2 major corp in bed together and together both manipulate and lie to find ways to terminate long term employees from their payroll. Unless hard working middle class American take back our country and shutdown these big corp we are DOOMED. We will soon resemble Mexico-millions of their citizens leaving to escape the 1% that control 99% of their citizens. Both of my parents are retired teachers, the closer I get to retirement the more pressure big companies like ATT, Sedgwick CMS find ways get rid of older employess. I know other major corp have turned over their disablility, workers comp. etc.. to Sedgwick --GM Corp, Well Fargo and list gets bigger everytime Sedgwick low-balls a bid and forces smaller Disabality/Worker comp companies out of business. It time to do whatever is necessary to shutdown all Big Corp before this country is in another depression that we will never recover from.
Joarel Send email
 
Feb 23, 2012

Denial of Disablity

Thank you for speaking out WW**. I am going through the same thing as you, only I am in California and was just denied an extension over the holidays no less...

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