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Sedgwick CMS

United States,
Texas

Consumer complaints and reviews about Sedgwick CMS

fgg8417 Send email
 
Feb 24, 2017

Denial of claim

Was injured 11/25/2016. Was not due to return to work as I had submitted PTO. Went to my personal physician because I could not stand or walk on rt leg for more then 10 min. Also strained my posterior upper part of back. Was unable to drive but was told by my so called case manager that I had to print off pages of paperwork and take them to my Dr. 47 miles away. When asked why they could not fax these to the Dr. for me was informed that that was not in their job description. My personal physician gave me a slip to be off work from 12/1/16 thru 12/9/16. Received a letter saying it had been approved then the evening before pay day at 4:30 pm my manager was texted that my claim was denied. I had talked with Sedgwick 3 times was told every thing was OK and all set to go. So the week prior to Christmas I did not get paid. Was told I could probably get pto which I did at that time due to Christmas. In all used
40 extra hrs pto. When I didn't get a full pay again I refused to take pto because if I did then Sedgwick did not have to refund me. Not one time did any M.D. employed by Sedgwick contact me. I am the patient. My orthopedic surgeon is very busy treating p[atients who need to be seen he should not have to take his precious time away for any peer to peer review. Why not a peer review with me as I do work in the medical field. What person has the right to dictate to my M.D. that he is not qualified to do his job? This is another way for big companies to take benefits from the little guy and make more money. I have worked for my company 21 years and have never abused sick time. Is this the thanks we get? Sedgwick is a company out to make money off of our money that they deny us. They need to be fined and shut down.
Sjj2600 Send email
 
Feb 23, 2017

Compensation after case was overturned

My claim was denied in 10-2014. I started receiving benefits from short/long term disability, until my case was overturned in May 2016. I was expected to be paid over $70k and when I wasn't, I was thinking it was because Cigna was reimbursed. Cigna is owed over $23k, that I didn't receive that was kept by Sedgwick. I'm still fighting to recover this money. I've reached statutory period under worker's comp, and could be receiving money from Cigna if Sedgwick would've paid them. I've been without income this time since Nov 2016, which is absurd. I requested my ombudsmen to set up a hearing to recover this money, because adjuster never return my calls in regards to this issue.
Irritated Send email
 
Feb 16, 2017

Sedgwick

Injured my left wrist on 12/1/16 followed Amazon's protocol and reported to Amcare who lied and said they didn't have an ice pack to put on my wrist and sent me out the door with two packs of biofreeze, went home and tried to sleep ended up going to ER to obtain xrays diagnosed as a severe sprain, reported to work on 12/5/16 sent home due to a missing signature on my COF now I was operating a PIT vehicle after returning the required paperwork to Amazon to go through the training and obtained my PIT license on 10/19/16, took 2 weeks to see the workers comp Dr who only looked at the xrays I had taken at the ER diagnosed as a sprain again and told to wear a brace and was put on light duty which they never found a job for me to do, 2 weeks later go back for follow up still don't have full mobility of my arm the workers comp Dr releases me to return to work under no restrictions but referred me to a orthopedic hand specialist, 2 weeks later he orders a MRI & Nerve conduction study, on 2/15/17 I go to get the results the orthopedic specialist tells me both tests were normal and that I have arthritis in my wrist, when I asked him why I still didn't have full or even improved mobility of my wrist he I quote "I can't answer that question and I recommend you follow up with your primary care Dr" so I call my PCP and explain what's going on and I'm basically told that whatever the specialist told me was correct but arthritis doesn't just appear in 2 1/2 months and not from an injury such as mine, I go to an urgent care facility where I can be seen and more xrays were taken still no broken bones, but no mention of arthritis causing the immobility in my wrist and was told if it's not better in a few weeks I should start physical therapy, my question is why didn't the orthopedic specialist request that I go through physical therapy.. Oh also I haven't received a dime from Sedgwick since the date of injury.. State law says that if your out due to a work related injury for 14 days its mandatory that you are compensated from the date of injury but not one dime in the 21/2 months I've been dealing with this company.. An attorney will be contacted as I have to pay bills and its illegal for them to have not paid me yet! Sedgwick is the worst workers compensation company I've ever heard of!
Eslater1 Send email
 
Feb 7, 2017

Complete bull

After loss of a loved one I developed complicated grief as well as ptsd, severe depression, and bi polar. My manager at work told me to submit for intermittent leave so I did. My doctor filled out paperwork saying I'd need at least 2 days a week for 6 months. They approved it, but put that my doctor requested ONE EPISODE lasting 30 days/ once every 6 months. After having to pay for another appt with my psychiatrist to fix their screw up, got it changed to 10 episodes per month. Skip forward to a month later. Husband who works for the same company requested leave for support. Paid to see my doctor to fill out his paperwork talking about my issues and that I need emotional support up to 1-2 days a week. Send it in, three times, of course they don't get it. Then about a week later I get a letter saying they received my paperwork and that they approved my request to miss one day a week.. what?? Turns out they filed his case paperwork in my file "because it has my name all over it". My case worker actually started YELLING at me to the point of putting me in tears saying that the paperwork shows HE'S THE ONE with the medical condition. My husband ended up having to take the phone and they said okay fine we'll fix it. They haven't fixed a thing.
jlb3333 Send email
 
Feb 3, 2017

Sedgwick CMS

Was approved for STD 11/16 because of complications from a 9/8 surgery. Surgeon kept extending my RTW and I underwent additional surgery on 12/17. Was approved through 1/17, then surgeon extended again to 2/6. My HR dept. approved the extension, and the ADA/Job Accomodation Specialist approved the extension with the Attending Physicians Statement my doctor's office sent. However, Traci Warnke, my Sedgwick Disability Representative, decided she needed additional medical and said she sent forms to the surgeon's office. Two weeks went by and I heard nothing. I emailed her and was told she was still waiting on medical forms and that I should contact the surgeon and expedite the proceedings. I told her that I was not her administrative assistant, that new medical wasn't even necessary because of other approvals, and that she should contact the surgeons office herself. Today is pay day. I did not receive a check. I complained to my HR dept. and Traci's supervisor and his manager. She finally called, and lied, saying she received the medical today (how convenient), and that it was approved (after telling me for months that it takes at least 2-3 days for approval). She also told me that I had refused to give new medical forms to the doctor. She then said she couldn't guarantee my paycheck today. I told her she needed to do get it to my payroll dept for direct deposit into my account, because she's the one who held this up and this was in clear violation of employment law. Horrible company, inept, rude employees. I will be pursuing legal action against them.
gh1 Send email
 
Feb 2, 2017

WORST EVER !!!!!!!!!

WORST COMPANY EVER! Sedgwick always claims (we didn't recieve the paperwork), that must be the standard answer. So my family is starving and a few days from being homeless. Being a Veteran is no help. They just do not care, it's all about the money!!!!!!!!
csenbach Send email
 
Jan 21, 2017

unable to get authorization for treatment

A week ago, my husband was injured at work. He drives for Advance Auto. While making a delivery, a roter for a high performance car broke through the box and smashed his foot. He has an open fracture of the foot. Went to the emergency room who treated it and said he needed to be seen by a specialist within two days. It is now a WEEK later and we can't even get the claims adjuster to answer our calls....We have called at LEAST 20 times with no response. The foot needs surgery. If he loses part of his foot due to your negligence, there will be a lawsuit to follow.
Chuchi Send email
 
Jan 12, 2017

Claims Adjuster Yarimar Knobler

This claims adjuster, Yarimar Knobler, treats my food poisoning claims poorly and with contempt because I'm homeless.
Katie9091 Send email
 
Jan 11, 2017

Sedgwick disability insurance

The most horrible disability experience ever. They denied my claim and disregarded everything my doctor had recommended, based on their own "review". I had life threatening complications following child birth and had to remain off work past the 6 week recommended time. They denied based on lack of "escalation of care". After records were sent repeatedly by my MD and other professionals showing escalation of care they continued to uphold the denial.
They never returned calls, their process is slow and claim managers are incompetent. They just got back to me on 1/8/17 from a pending claim from 9/29/16. What a useless horrible agency. People are actually ill and they couldn't give a damn. It's all about the money and they work on assuming you're lying
lost money Send email
 
Jan 6, 2017

Short Term Disability

Worst insurance company.

Surgeon recommended 3 months off work. I went back to work after 2 months but with phys therapy restrictions 3 times a week. They refused to pay those 10 hours a week so I can further my PT and treatment. Refused 10 hours after I came back to work a month early.

A generic nurse reviews clinical notes and denys. A doctor who is a specialist does NOT review (example ortho doctor should review ortho claims for joint replacements).

So the appeal again and fight is on. I am demanding an ortho specialist surgeon do a peer to peer (doc to doc) review. This is nuts.

This is all about money and how much Sedgewick saves your employer by kicking you off your disability even after major surgery. The reports of savings are sent to your employer usually quarterly and then annually.
Mathew13 Send email
 
Jan 3, 2017

Insurance

I just want to say that i have Aetna as my insurance would never dimiss my disability knowing that im sick. Is ashame how we pay for insurance and when your sick they dont want to pay. My insurance Aetna would never dismiss my disability. Is ashame how sedgwick do people is not fair.
Mathew13 Send email
 
Jan 3, 2017

Sedwick

Just want to say that my insurance Atna would not dimiss my disability knowing that i sick. Thats the reason why we have insurance incase of of your sick insurancw oays as we oay as well. Im glad i have Atna cause they would never do what they do to their employees.
Madhanson Send email
 
Dec 28, 2016

No pay the week BEFORE Christmas

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......
Tgrab5501 Send email
 
Nov 19, 2016

Denied STD for treatment

I have worked for my company for going on ten years now. The company just switched to Sedgwick for FMLA and Short-Term Disability Claims. I recently received two assesments from a couple of different residential treatment facilities and was reccomended by both to serve a inpatient treatment program of 30 days, one of the facilities was Hazelden, an obviously well known treatment facility. After doing so i let my work know of my leave and then called Sedgwick and told them i needed to go out on FMLA and Short-Term Disability and they began my leave. A few days into my treatment i checked the status of my claim, and my FMLA was pending and they denied my Short-Term Disability claim. The one time i need to use the resources in my ten years of work for my company i get denied, this is bull. I filed an appeal for my STD benefits, a week has now went by and my claim online says that it is still denied. I have been trying to get a hold of my case manager, but she is out of office for a week. I try to call her supervisor and leave a message and get no call back for 2 days now. So then i go on to call the corporate office and they keep giving me numbers of other people in that same office area. Nobody answers my phone calls and i have an upward of 10 different peoples numbers i have been told to call. So i call corporate back and they tell me they can do nothing else for me. I tell them that this is not right i need to find out what is going on with my claim and 2 different people and a supervisor at corporate proceed to hang up on me multiple times. I am very stressed about what is going on and if all of this does not come together soon i am going to get a lawyer and sue these people. This Sedgwick company needs to be looked at by the attourny general or something, as i read on all these sites i am not the only one being screwed over by them it is very sad to see that this company is still in working.
Cs3 Send email
 
Nov 18, 2016

Bad customer service

Now on ,3rd adjuster. Seen dr got therapy after 3 week delay. When therapist requested more therapy had to wait 2 more weeks. Had 2 interviews 1 with ,2nd adjuster & nurse case mgr/ medical director. Finished 2 round therapy still in pain a lot of pain . Had to go 30 miles to see occupational Md PA who's practice only sees work comp patients.
Waiting on his report . He asked me what I thought was wrong, why it he can move arm. More than I can after multiple times telling him cause of pain I don't. Like why would I intentionally cause poss more damage or pain to self.
Still don't have claim number from them so can't check online.
All I want is to get rid of pain have somewhat normal life back after 4 months
mecreditcard Send email
 
Oct 25, 2016

Denial, claim and my 19 years career terminated

I broke my back, AT WORK! Its been three and a half years of living hell, unbelievable pain, surgeries, hospital stays, physical therapy, spinal replacement, no income and denied disability pay, then...termination of employment after 19 years...Sedgwick has ruin whats left of my life, taken everything from me that I have worked a lifetime to earn. This company needs to be brought to justice and so many of us vindicated for there mistreatment.
Lilybyrd Send email
 
Oct 21, 2016

Unhumanly treatment

Sedgwick is a joke. The few months, i've been dealing with this adjuster who unreal and laugh at everything. Her day will come. God is real. I pray she meet her real like eperience soon as she laugh at clients tragedy. She have denied me for no reason. She said i missed a call. Then she said she never reveived my medical form. It's been month. I'm going to sue the vendor who failed to respond and act on a claim. People are low life. We had many tragedies in America to have so many corrupt, greedy, takers. I ask them for my missed one work day. Still today she haven't reveived anything. She never enclosed her investigation on her part. Never mention nothing. Everybody day will come. It falls on your children so watch how yall robbing people Connie Carter, Matthew and his Supervisor. They ignore the signs u're just wasting energy. I pray daily for God to deal with all 3. The whole building. It's sickening the crimes they commiting. I have no choice but to sue. I ask to work with someone else due to the difficulty of working with this adjuster. Hell is hot. Laugh now yall u will cry later. Do your job. They will harrass you instead of meeting you in the middle. I've sent enough. Now they want me to sign a HIV test, a mental test, a drug test and etc. This is outrageous. The CEO in this corporation rich now and jipping people off now but wait til judgement day. You guys have insulted me day 1. This is a joke and no investigation will ever be done but to harrass you on duplicate papers u constantly send in. A disgrace. Hell hot
pgorczycki Send email
 
Oct 11, 2016

I was hit by a rent a center driver totalled OUT my car it's over two months and im still waiting for my car to be replaced!!

THIS KID TOTALLED OUT MY CAR. AND WHY THEY DON'T RETURN PHONE CALLS IT'S OVER TWO MONTHS NOW. TRYING TO GET A SUPPER VISOR TO SPEAK WITH. YOUR THINKING I'M GOING AWAY NICE TRY. NOT!!! IF ANYTHING I WILL HIRE A LAWYER FOR MORE THAN JUST REPLACING A CAR. BUT I DON'T WANT TO DO THAT. BUT IF YOU BACK ME INTO A CORNER THAT'S WHAT'S GOING TO HAPPEN PLEASE HANDLE MY CLAIM SO I DON'T HAVE TOO!!! PLEASE???
Tramyne Send email
 
Oct 3, 2016

Sedgwick claim has taken the money from my personal injury claim and my disability from the United States Navy

I am a disabled veteran, in 2013 I was active duty in the United States Navy. I was hit by a 18 wheel truck on my way to work at Norfolk Naval Base on May 9 2013. Dues to the injuries from the accident I was medically discharged from the Navy on March 17th 2015. On April 19th 2016 I and my attorney's at Rutter Mills law firm had a settlement agreement with Maersk Trucking company, the response party/ owner of the truck. There was a multi-million dollars settlement on that date. After, Sedgwick claims with my attorney's took the settlement check and deposited it in an Wells Fargo account and cut me a check for a significantly smaller amount which I did not agree to. They also claimed to had paid bills that had already been paid by Tri-care. Now this company has people following me around, breaking into my house and car, hacking my phone, stealing and altering my personal documents. Doing any and everything to steal my money and not get found out. The United States Justice department needs to know what has been happening, because I'm not the only person they have done this to. Also there are discrepancies concerning the driver of the truck that hit me. The guy that hit me is not the person who should have been driving the truck!
agevorgian Send email
 
Sep 16, 2016

crash hp pc 2000 laptop

I had problem with my email it was not opening.I contacted 866... # of At&t,and ended asia. The lady who answer my call refused to tell me what country she is . She stated I will fix the email problem .she was on the phone for half hour and got control over my lap top.She was not sure what she was doing. After 45 min. My laptop screen turn blue,I asked her what is going on she said i push wrong key. I canot fix it.she said I will make appt. With your At&Y TECH. ANY WAY tech arrived spent one hour,and finf out my hard drive was crashed by overseas uneducated person. I called At&t after seven times transfer called, they sent report to SEDGWICk co. The claim department supposetly did investigation? I denied my claim. Interesting . Sedwick rep. Stated " I contacted overseas and spoke with the lady who try to fix your email. He didn't kow what country it was, or the person id #. What a liar, I am sure he never contact anybody.I know this company very well they deny all claims. At&t washed there hand and pass the problem. Very sad that rich people get richer by ripping middle class . This is abuse, and we can not tollerate this action.
mtspencer Send email
 
Jul 21, 2016

Hard to Reach Case Manager - Second Opinion

Hello, My name is Monae Spencer. I work at Amazon in Whitestown, Indiana. I fractured my arm on 9/15/2016. I have been to physical therapy and work conditioning. My doctor now wants to do surgery but I would like a second opinion. When I completed physical therapy the doctor said I had reach maximum improvement and my worker's comp case was closed. A few days later, I called back the doctor due to nerve pain. The doctor had test done and it said I had carpal tunnel. He then ordered working conditioning therapy on June 22nd. It was during that visit the doctor told me, my mom and the worker's comp nurse that if work conditioning did not work then, he would sign off and say what my maximum improvement level was. Well today the doctor said I needed surgery. I am concerned because this is not the first or second time that I can not reach my Worker's Comp Adjuster and no else at Sedwick is able to answer my questions. That is not fair to myself or other clients that you may have. Your customer service is terrible. I still can not lift my left arm above my shoulders and I can not reach my computer to type. Right now, I'm typing with one hand. I barley can lift 5 pounds. During my working conditioning, the therapist kept having to lower the weight amount and adjust my routine because of the pain. I have pain in my elbow and all the way down to my fingers. Then I also have pain in the elbow and shoulder when I try to lift or move my left arm. It even hurts when I walk long distances due to how my arm sways. It also hurts when I drive due to the car vibrations. Driving from home to work puts me at a pain level of 5. I am concerned that no one is taking my pain level and limitations serious and I can never reach my case manager. Also my employer never set up my work station ergonomically as my doctor ordered. So, that leaves me in constant pain trying to work. Lastly, given the fact that my doctor said work conditioning would be the end and that he would determine my MMI I would like a second opinion to know for sure. Cause it sounds like with surgery I will have to start all over again with therapy. Also the doctor ordered that I return to full time work on 6/28 however, I did not get that information. He said he sent it to my case management nurse but no one informed me so I continued to work 5 hours a day per my doctor's statement on June 22nd, which was the last time I saw the doctor until today. I did speak with Leah Cruther who was very helpful and would look into getting me paid. So, here again is another concern, I'm not receiving communication on information the doctor is sending to Sedwick or my nurse. And this also adds to me wanting to get a second opinion and I feel I should not have to pay for it given the fact that it seems like I am the only one concerned about my recovery. No one cares that I can't lift or hold more than 5 pounds in my left arm. No one cares that I can lift my arm up to do everything I need to do at work. No one cares that I have chronic pain and that walking, driving, sleeping, moving and lifting my arm causes pain. And this is just work. No one cares that I can't wash my own hair, put my groceries or dishes in cabinets cause I can't reach them due to pain.
SedgwickVictim Send email
 
Jul 3, 2016

Sedgwick CMS

I was injured in an automobile accident, I was rear-ended by a woman on a cell phone. For over 9 months I did my own treatments and unpaid time off for MD visits, but I kept getting worse. Finally, Mid December 2015, he takes me off work for 4 months thinking that I needed to stay home to heal. MRI shows Lumbar, bi-lateral sciatica, Sacral, and cervical bulging discs etc....lots of pain. Currently on Dilaudid, Baclofen, Diazipam, and a few others. The neurologist I went to see put me out till August 2016. I was doing better after a specialized Physical Therapist did some Deep Tissue Miofacial Release, but my MD wanted me to get a lumbar epidural to relieve the rest of my pain. I was denied my Short Term Disability Early June 2016 due to a peer-to-peer review. I immediately filed an appeal and requested my file in writing.I was in "limbo" for several weeks. Not entirely denied but receiving no pay. Due to the meds and pain it took me a while to find the law in California that states only Doctors licensed in California can diagnose a patient in California. A technicality they didn't know, or hoped I wouldn't know. They have kicked me back to case management and I received my back pay. However, I'm only approved thru mid July. I have permission to go back to the Physical Therapist that got me feeling the best I've felt since this all started. The epidural had made me worse then I was before. I'm praying the Physical Therapist makes it possible for me to go back to work. I really can't fight these people anymore. They've caused me so much anxiety and heartache. I can't get better, the stress is making healing impossible. The first few months they required medical documentation every 2 weeks, then every 30 days....they like to make deadlines on Sunday that are nearly impossible to meet. My MD told me at the beginning of June I should start wrapping my head around the idea that I may be permanently disabled. The kicker is pain is "subjective".....they want "objective" medical proof of my disability. Chronic pain, Migraines, back issues that range from c1 all the way to my Sacrum, unable to bend, sit for long periods, walk for long distances or even sleeping at night are nearly impossible. All of the meds have caused my cognitive reasoning to abandon ship...I read their notes, so demeaning. Somebody needs to put a stop to this practice....you can't get better this way.
sensei Send email
 
Mar 17, 2016

Violation of HIPPA/

I have on request to Sedgewick for my medical records over the coarse of 25-1/2 yrs , long before they took case management from W.V. I received 4,0000 pgs then sent a computer disc, with those records.
The records also include records/w/names, address, SSN's and diagnosis of other clients.
I reached out to their chief of security to resolve the violation in HIPPA law and thought we had gotten all those confidential files returned and assured it would not happen again.
Then I received a new Disc.
I had it transcribed to paper at my cost and then filed by a private party who does this type of service, at my cost.
Since that party is very finial with the medical field I was questioned as to why I would have records and Information of a personal and legal manner in my possession. I got the feeling I was under suspicion of illegal acts.
Mt E--mails on my case are being returned to me as undeliverable. My E-mails are blocked and Phone calls to my case manager ignored.
Advise please.
P.s. Because of this manner and treatment my lifetime award for payment/services are either ignored or denied though doctors have given proper requests.
Nina1045 Send email
 
Mar 1, 2016

Denies

I had a Sears repair done on my washing machine, the repair person did over 3000.00 in damages to my property, I filed a claim , and was denied before I sent my pictures in to them. I called many times to a Adam, which is suppose to be a supervisor,, very rude and hinged up on me many times. This is in the Lexington ky office.
Ashast Send email
 
Feb 25, 2016

Sedgwick Insured Trnt A Center hit my parked car

I was at work and a Rent A Center delivery driver backed into my 2013 Mazda. The driver left a note stating a claim had been filed along with a claim number. This was January 29th 2016. Since that time, I have been calling repeatedly. A few times I talked to someone but many times, I have been hung up on.. call transferred.. talked to rudely! After weeks of the claim adjuster avoiding me, I received an email wanting me to sign a document to release all liability yet my car is not fixed because there has been no check issued or no car rental paid for. What ever state you are in, you can contact Department of Insurance to file a complaint, I just did. There's class action lawsuits where everyone het to tell their story to someone who can do something about it. I, personal, am seeking satisfaction through small claims court for my property damage that's almost $2500 .Make sure to record all calls and get everything in writing!

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