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Sedgwick CMS

United States,
Texas

Consumer complaints and reviews about Sedgwick CMS

Ladyd Send email
 
Oct 25, 2018

FMLA rolling back hours withheld

Sedgwick is the worst there refusing to add FMLA hours back used 12 months from date of absences for intermittent claims. They seem to minipulate hours there rude unhelpful and just give you the run around they have ingnored the issue and refuse to correct hours.
tbohpete Send email
 
Oct 19, 2018

Denial of Benefits

Continue the Denial Saga... I have filed more paper work with Sedgwick and was denied again even though it was from an Orthopedic Specialist stating that I am unable to return to work. I was denied because the Dr. did not put a return to work date. I told the lady that I would send more paper work from the Surgeon and the specialist, she told me not to because it just gets confusing. I told the lady I was sick of there run around and their automated phone service and that they should consider Life insurance cause I'm ready to hang myself with the whole process... SHE HUNG UP ON ME. By the end of the day I received a denial and forms for an appeal process. Today I Sent forms from the Surgeon, Radiologist results from MRI but I'm betting that no appeal is forthcoming. I can not return to work until January of 2019!
tbohpete Send email
 
Oct 11, 2018

Denial of Benefits

This is my third round with this company. They are horrible to deal with. You can fax documents everyday and then receive an email that tells you they never received your documents.
I tried to call Monday to verify they received the documents and instead of getting to talk to a representative ...after a 5 minute automated game of push one, push two, push four... it took me to a survey about my experience with my representatives knowledge of my case WTH! Three calls later I'm ready to hang myself! Finally get to talk to someone...she tells me they don'y send an email stating they have received your documents, only notification if they haven't and a date of expiration. That could be a week or more that you sit around and wonder what is going on. Poorest Customer Service ever! How hard would it be to send an email that says "we have received your documentation and it is currently under review"
Yesterday I received an Email verifying my LOA has been approved but STD has not due to inconclusive diagnoses from the Physician. WTH I have a significant tear in my right Rotator Cuff and I am Right Handed. She states I am unable to work due to the inability to move my right shoulder! what evidence do they need? I will be laid up for at least 4 months due to injury, surgery and therapy with NO PAY. Thanks Wal-Mart for contracting this company and SEDGWICK for making your unqualified decisions.
This organization should be investigated and shut down.
renecjammas@gmail.com Send email
 
Oct 7, 2018

Sedgewick

United Healthcare contracts Sedgewick as their vender for Short and Long term disability. United Healthcare sells additional Short Term benefits (larger percentage paid) as part of their employee benefits package. I purchased this additional benefit. When I became sick with Myalgic Encephalomyelitis (ME/CFS) my claim was denied so I took an unpaid leave for 8 weeks and lived off of my savings. The following year I didnt purchase additional Short Term Disability coverage realizing it was never going to be paid. I worked extra hours to replenish the savings I had spent while on an unpaid leave, thanks to Sedgewick. I became very sick again with ME/CFS because of the long hours, sleep deprivation (I worked 2nd shift) and being exposed to mold in my home. I again applied for Short Term Disability. I had just purchased a new home and moved because of the mold. It was my son's Senior year. The stress and head games employed by Sedgewick are CRIMINAL! Constant claims of not having received information from my Doctor, or stating they were unable to contact me or my Doctor. Making last minute requests for information with 12 hour deadlines or the case would be dropped, etc.. The Sedgewick representatives were verbally abusive and rude, so much so It was shocking to me. How could United Healthcare claim they cared about their employees and hire the villainous Sedgewick? As soon as my FMLA was exhausted Sedgewick called and said my job wasn't safe and I needed to return the next day or face termination. I had not been cleared to return to work by my Doctor but that didn't seem to matter to United Healthcare or Sedgewick. Then I received a call from my supervisor advising me that I had been RIF'ed (Reduction In Force). That was in October 2016. As of todays date I am still very sick and now very poor. My son couldn't go to college. My marriage has nearly been destroyed because of the stress and financial strain.
emwd Send email
 
Sep 5, 2018

Yes, No, Maybe So

I opened up a workman's comp claim with Sedgwick back in mid July. At that time they advised me that a short term disability claim would also be filed "in tandem" so that I would be compensated while the Workman's Comp decision was pending. A few weeks go by and I contact Sedgwick again because I had not received any payment. Sedgwick told me that they did not and do not open up a short term disability claim "in tandem" and left me hanging with that. I contacted my workman's comp attorney and he told me to file a sort term disability claim with the state. In early August I contacted the state and opened a claim. They advised me that I would have to wait 25 days to allow for my employer to take responsibility for compensation. Early September I receive a call from Sedgwick that they, in fact, had opened up a short term disability claim for me on behalf of my employer. This whole process took 2 months!!!! I told the claim representative that I had been living off of credit cards for 2 months and asked why they didn't open up the claim do in the first place. Of course Sedgwick had no answer to this.

Lesson:

If you have a workman's compensation claim open, demand that they also open up a short term disability case OR file immediately with the state to push their hand.

Don't let weeks go by, keep calling, and keep asking questions.
Mibbles Send email
 
Sep 1, 2018

Damaged property

Like so many others, my experience with this company has been to say the least exasperating. A delivery driver contracted by Home Depot backed his truck into a rock and cement structure in my driveway. I called Home Depot and after about four transfers finally got someone who would talk to me. Well from Home Depot to the trucking company and then to Sedgwick, absolutely no one would own up to the damage. Exactly three months later, more emails and phone calls than I care to list, I have still not gotten an answer. Sedgwick is the third party insurance company for Home Depot so Home Depot doesn’t give a crap. As far as Sedgwick, I have never dealt with anyone as incompetent and rude as the joker handling my complaint. Sent him photos and all the information he asked for. We aren’t talking a boatload of money here but my property was damaged and someone needs to be held accountable. I think they think I will go away but that won’t happen. I’m not going to pay for an attorney but I’m sure a local news station would be interested. It is a poor excuse for an insurance company and should be called to task for what they have done to so many many people. I’m not giving up and I hope no one else does either.
Busymom348 Send email
 
Aug 28, 2018

Sedgwick always seems to deny

I have been hurt since July 2016 Sedgwick does nothing but deny everything without looking at solid evidence on injuries.
I have noticed over the past two years that workers comp is a joke seems to me that the insurance company the lawyers and the judges all get paid pretty well while we the injured workers get worse.. how do these people get away with everything they do? Wasnt workers compensation developed to help the worker get better?

I've been to 6 IME's and only 1 doctor gave me a thorough exam plus took my MRI & EMG reports because Sedgwick did not provide them with the evidence to show my injuries what a joke!!! Why am I trying to still prove my injuries when they have all already been established!
I am so done with this entire system and I need to move on with my life
Busymom348 Send email
 
Aug 24, 2018

The worst!!!

Does anyone know of a class action suit against them? I want in for they have destroyed my life!
Frankikox Send email
 
Jul 28, 2018

Denied STD

Be aware of this company, they are evil. They are not to help you at all, all the want is deny people’s claim. They manipulate evidence to deny claims. I was in short term disability for panic attacks, depression and anxiety since Dic 2018 and they approved me until May 2018. Based on my doctor’s diagnosis I was able to return to work on July 2018. They denied my extension and made me go to a different doctor in order to appeal my claim which I did. During the consultation with the new doctor I was ask if I do alcohol or drugs. I told the doctor I drink occasionally during the week ends but not daily, and that A few times Inused medical marijuana to decrese panic attacks. They send a report to me a my company stating than I am a drug abuser. They did not include in their report that I was taking medicine for my mental condition, but they misrepresent me as a alcoholic and drug addict. I am so mad about this false accusation because it is affecting my image just for heck of deniel people. I am a clean person without any records of drug abuse, or alcholic abuse. It is heartbreaking to read false reports of you, and worst that it sharing that to your employer. By the wasy I am back to work, still under doctor’s medication but this company is doing nothing to help me. DO NOT TRUST THIs COMPANY.
Babyangel Send email
 
Jul 6, 2018

Approved claims then denied them 6 months later

I had several claims they approved and then 6 months later they went back and denied all of the claims saying I know owe $12k of overpayment.

The claims consisted of giving birth to my kids and then another one that I couldn’t see with my eye and see a computer screen but they are saying that’s not reason to miss work even though I physically couldn’t see.

How can this company violate personal rights and approve claims and then over 6 months later deny those claims
PtinSiSi Send email
 
Jul 6, 2018

Hand Injury

Injured my hand at work and briefly had no issues prior with and specific fingers, going numb, tingling and other injuries that happen quiet frequently with the type of work I do.

I am shortening this would be easy to go on a rant on this unconscionable company and specific employees.

Go to HR explain what is occurring -they send me to occupational Dr. and orthopedic put me on a few hours a week restricted duty I get very little pay.
But Drs. Concur my injury is from my eork, Sedgewick than sends me like 40 miles to there "Specialist" who spent like4 minutes looking at my hands and than sending me for tests with needles.

Conclusion all that numb tingling and trigger finger is "not from my work, i am not active enough!"
If I wasn't so mad I would roll on the floor laughing the hand that doesn't hurt he said has carpel tunnel the one that does and the other specialist diagnosed with carpel tunnel doesn't

That the injured on I use all day writing , mousing, using the keyboard and scrolling all day long and timed so have to be fast.

There "specialist a liar with no conscious"
I wonder if I would have walked in as a private patient what they diagnosis would be????

Sedgewick is a unconscionable company it should be in a class action suit, all their drivel about empathy for the injured makes me sick.

They are horrible the whole lot of them!
Dvnprt018 Send email
 
Jul 5, 2018

denied disability

I've been off work for 3 surgeries sedgewick which has denied my short-term disability MetLife is designed my long term disability according to Sedgwick I should have got off the operating table and some went straight back to my job they didn't even have to take out the IVs Sedgwick didn't think I should have been off the job for anyting
Rozzie Spitzley Send email
 
Jun 6, 2018

Workers comp

Sedgwick denies comp claim for everything under the sun. They refuse to process claims, lose un purpose mileage forms.

Sedgwick is ordering and denying patients care for no reason.Get rid of Sedgewick.

Class action required/ class action against Sedgwick.
Lawabiding Send email
 
Jun 3, 2018

RUDE EMPLOYEES DENIAL

Update 5/ 31/18 FILED A COMPLAINT WITH THE BBB; AG; AND INSURANCE COMMISSION FOR ILLINOIS

Those of you who have been victims of this horrible company Sears Birmingham location practicing negligently and willfully destroying your car should file a complaint with the Consumer Division of the State of Illinois Attorney General against their insurance company SEDGWICK Claims Management Services Hoffman Estates, IL who is aware of this and does nothing about it. Ask for Jenna Jones Corporate Manager (901) 415-7896. Mrs. Jones was notified how badly her employees act when filing a legitimate claim. I was treated horrible by the claims adjuster and his superior. THUG mentality!

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

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

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

Whoever is reading this look at all of the other reviews, especially, the one where a woman and her family got into an accident after Sears worked on their car. Is it coincidental, or does Sears have malicious and unqualified employees working for them? And when you file a legitimate complaint their insurance company listed herein above, like all or most, try and wiggle their way out and use inexcusable reasons as to why they're not liable. Thus, this is why they need to be investigated. The Insurance company is their for these type of matters. And the owner of Sears as disingenuous as he is knows this is going on at this location and does not lift a finger to resolve the issues.
thwilliams5 Send email
 
May 5, 2018

Horrible, slow and unprofessional

Be very careful with them. They will send out over payments intentionally and will not notify you until after the fact. Even though you notify and keep them updated of changes, they will keep sending payments and then say oh, we will take it from your settlement. They don't return calls or emails to the employee nor the attorney representing the employee. Then you call and ask for the leave specialist that has been sending you letters the entire time and they say, they have no idea who that person is. I hope this class action lawsuit goes through. They truly bring out the ugly side of a person, and will cause you to lose your cool. I have an attorney for my case, however I am willing to be part of a class action lawsuit.
Cat young Send email
 
May 5, 2018

Std

I've been out of work since 2/25/2018, my rep at sedgewick is a very rude unknowledgable unprofessional idiot. My job is customer service which requires me to answer the phone all day and handle bills, typing and dealing with customers info.on February 24th my mouth swelled up as I began vomitting at my desk while helping a customer.needless to say I called sedgewick at almost end of shift.my employer failed to let me know until last minute that we had the option available.So far I have been to the E.R 15 times in 2 months,I have been on meds to treat my condition the entire time. I have provided them all reports and then call them to be sure I have everything turned in they ask me for.however even after saying yes they deny it.The director of nursing from the hospital even contacted John Johnson my rep and told him the severe condition and that there is no possible way I can preform my job u till after the surgery. All calls are recorded and she contacted me to discuss everything she explained to him.He of course continues to find ways to deny me.and lies to me saying he didn't receive things and even admitted he screwed up reading my report because he has no clue about medical info.not only am I going to lose my job because of the idiot but never received any pay as of yet. I was finally able to have surgery yesterday on my birthday and have to heal , 6 extractions and 29 stitches,however his response is always oh I'm sorry I misread your reports and clinical studies. I am disgusted at AT&T for even having them for their company.so please feel free to include me in any fight against them,I would be more then happy to assist.oh last but not least,they expect everyone to have the packet they send you filled out by doctors but they never send the packet so they use that as grounds as well and they get really angry when you prove them wrong.
nikesz14 Send email
 
Apr 29, 2018

Sedgwick denied every one

Horrible company -- they lie and mislead you and you can lose your job or home because of your medical issue and dealing with these IDIOTS -- I have seen my doctor for over 15 yrs and have back issues -- I pulled my back and couldnt move and my doctor had me out for 3 weeks from work - I filed short term disability and all the paper work and doctor visits to get this done for NOTHING -- they declined me as USUAL like others here - they take all your medical history and submit to a 3rd party doctor so they say who you have NEVER spoke to and they know nothing about you and review your doctors findings and oppose those -- This comany is A RIP OFF -- I will NEVER work for any company who deals with sedgwick -- LETS ALL FILE A CLASS ACTION LAWSUIT because millions of peoples lives will be ruined financially because of the ASSHoles--
nikesz14 Send email
 
Apr 29, 2018

Sedgwick

Horrible company -- they lie and mislead you and you can lose your job or home because of your medical issue and dealing with these IDIOTS -- I have seen my doctor for over 15 yrs and have back issues -- I pulled my back and couldnt move and my doctor had me out for 3 weeks from work - I filed short term disability and all the paper work and doctor visits to get this done for NOTHING -- they declined me as USUAL like others here - they take all your medical history and submit to a 3rd party doctor so they say who you have NEVER spoke to and they know nothing about you and review your doctors findings and oppose those -- This comany is A RIP OFF -- I will NEVER work for any company who deals with sedgwick -- LETS ALL FILE A CLASS ACTION LAWSUIT because millions of peoples lives will be ruined financially because of the ASSHoles--
simmonco Send email
 
Apr 27, 2018

Sedgwick Claim Denials

Good evening all I was reading through your post and I see that I am not the only one who's had their claim denied by the monster company named Sedgwick. My sister is currently dealing with them for her workmans comp claim denials, but what my sister and I are trying to do is to get at least 44 people who are willing to share there stories to start a class action lawsuit. If you are interested are just want more information please feel free to email me at courtneyrichard1@gmail.com
Thanks for your cooperation
Bnic92 Send email
 
Apr 17, 2018

Denial of Maternity Leave after having taken my approved leave

I was hospitalized on Dec 20th 2017 when my water broke at 26 weeks. I got my leave approved. I had my son 2 months early on Jan 14th. Had my tubes removed March 5th and wanted to start back working on the 26th. Well because of this company I was unable to start back until April 17th and I just got an email earlier this evening that they have denied my whole leave. They claim they are missing papers from my doctor, but they faxed all papers to Sedgwick multiple times just to ensure they got them. Now I am fearing I will get fired due to Sedgwick screwing things up by losing papers my doctor sent back. How can they approve a leave and then deny the entire leave right before I am about to return to work?
SheriC Send email
 
Apr 5, 2018

Sedgwick

I’m not sure what good it will do for me to complain here other than make me feel better, but Sedgwick is a horrible monster of a company. i’ve had two knees replaced within 8 weeks of each other, doing my best to heal and get back to work as a nurse. For the second time now during my short term disability leave, they have denied my benefits because they said they didn’t receive the documents they wanted from my doctor. I watched my doctor’s staff fax everything on March 27 while in their office! A week later, they email my denial letter. Their communication is deplorable!
When I called, they said they had gotten a “fax error”, but never bothered to let me know. So now I don’t know when or if I’ll get a paycheck again, and I’m still not ready to work yet.
I guess most of us have no choice in using this company, but I hope to see massive lawsuits against them!
ahartelt49 Send email
 
Mar 28, 2018

not approving time out

Sedgwick are monster They have fought against us for the past 3 months for my husband thyroid cancer. They have made my husband 3 recovery longer and my horrible experience ever. My husband has kidney damage and serve nausea from dr prescribing him calcium. Sedgwick refuse with doctor's paperwork to pay my husband. They destroy peoples lives and pay. most horrible company I WILL report them to every organization on how they practice there work and treat people. They talk about not receiving paper. we they have received the paper work. They delayed the approval on purpose and cause people not to get paid..
Shamoni09 Send email
 
Mar 26, 2018

STD denial and rude repa

So I went out on std leave due to some severe work related issues. I was approved for the first 30 days but denied for 5weeks but the approved for fmla after a previous denial. This is confusing because the same ex has been from day 1 so I did the appeal for the 5 weeks almost a month ago which a claim doctor had to speak with my dr which was ok since my documents was ok for almost all of my leave(not explanation for denial). Let me add I’ve never taking leave in my life from any job so this process is new reached out to my claims manager. To make sure I was doing everything correct to assure the appeal be approved . I was contacted by my appeal manager Tyra and she tells me to stop calling because that will make my decision process longer she was short and rude and hasn’t returned any of my calls since in 21 days . And I know for sure a decision for appeal was noted on my account per another claim rep who wasn’t sure why my pending case had been addressed at this punt I’m at a loss of 3816.71 in wages and luckily my documents were enough to secure my job otherwise I’ll lose everything I own. I will be resigning due to the way the claim is handled and will not work with any company that uses sedgewick . This company claims reps are heartless, nasty ,short ,rude and unprofessional !!!!
rhague Send email
 
Mar 24, 2018

Insurance with CPS

You are the worst insurance representatives I have encountered. You will be hearing from my attorney soon.
pctopper Send email
 
Mar 12, 2018

Lazy and rude

In the beginning of the process I was asked when I think my return to date (to work) would be. I answered, well I won't know until I see my doctor in two weeks--and simply because applying for disability happens 1 month prior to the actual surgery date, my prep-appointment that goes into detail has not yet happened. The rep told me it was fine that I didn't know the exact date, and to just estimate the recovery period, if I needed more weeks, the extension request would be very simple and easy to do. So because I never had foot surgery before, I estimated 5 weeks was what I was needed (being hopeful as always that I recover sooner than the average person).

4 weeks into my post-surgery, seeing that I wasn't healing quickly for week 5 and still had pain & trouble getting around (foot tends to swell up when too much pressure or activity happens), I asked my doctor again about recovery period and he said his minimal weeks for recovery is 6 weeks.

He put in a note for the 1 week extension so that I can get the full 6 weeks of short term disability, and this is when my assigned rep (different from the previous lady setting up my account) turned rude, cold, and insensitive.

I did everything she asked me to do. Send in a new form, backed up with my doctor's actual medical notes. She called me days later after the form and documents were faxed saying the form was wrong, and that she basically didn't like what the doctor wrote for his objective findings...which he put that my recovery range should be from 6-8 weeks long in lieu of the one week extension request. Instead of calling the doctor's office herself, I basically called my doctor's office every single day about how they responded to the form, apologized a lot to them for continual outreach, and to top it off...once I spoke to the rep again (Liz), she accused me and probably my doctor that my foot recovery in general should have been only 16 days long vs. several weeks. At this point I wanted to cry because foot recovery really is NO JOKE (I was still taking painkillers).

Mind you on day 16 of my foot recovery, I was freshly placed in a cast by day 14, sleeping with nerve firings at night (very painful), tripping in the bathroom because my foot even when I was moving my body, I was still taking my subscribed pain killers, and how was I suppose to go back to work at all? On top of that I am a mother of 2 boys under the age of 7, and I'm the other provider for the family as we are dual income. My place of work is on a large campus, even with handicap parking I still have to walk very far to the building and then once inside, there is still a long distance before I get to my actual seat.

All in all, I told her what am I suppose to do timecard wise for that week pending on their response. I was afraid that if I take LWOP, I won't have enough to pay for bills, I don't have that much vacation time, and so I said, maybe I can take LWOP for 2 days and go back to work on the 3rd day. She then told me if I was trying to go back to work before week 6 (what I had requested), I would need my doctor to grant me permission...but in the meantime she gave my application request to her supervisor.

WELL, to make the story short, I decided I will take LWOP for the 6th week and wait for sedgwick to process my extension claim. I really need the extra week to recover so that I'm strong enough to deal with work, my children's needs, and the house.

People are very insensitive. I hope Liz understands one day how it feels to recover with so much pain, and the service that she and her employer paid for, is ripping her to shreds and treating her doctor's orders like its some scam.

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