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Sedgwick CMS

United States,
Texas

Consumer complaints and reviews about Sedgwick CMS

rhickman84 Send email
 
Jul 27, 2017

Liability Claim (AT&T)

I have never dealt with a company this bad. AT&T buried an internet line that they said was needed to install out WIFI. During the installation they damaged our fence beyond repair and sent us to talk to Sedgwick. This happened back in March, 2017. All photos and paperwork were submitted, per company policies. It is now July and nothing has been resolved. On top of that they stopped responding to your calls and emails saying it was still in the works. But when we do talk with someone they say this should have been resolved within 30 days. Well that has yet to happen. We are in the process of getting out attorney involved at this point. We did not ask for AT&T to damage our fence and we did not ask Sedgwick to treat us like this.
natty123 Send email
 
Jul 26, 2017

Long /short term disability

Sedgewick took a very long time to issue any payments to me, they are not approving my extension for therapy. Ms. Jamie Burns and her Supervisor Monica King is not responding to any of my emails and voicemail. I still have outstanding bills that weren't paid
and i don't know how they are assigned to you but not answering you. They sent me to their doctor and was proven to be 100 % disabled, they not complying to my doctors request and i'm still in pain. They are the worst disability company ever. we pay some much for insurance and when you become sick or injured they give you hell to at least get your money, pay your bills and receive any type of treatment.
Missjohn Send email
 
Jul 12, 2017

claim denial

I had ankle surgery two months ago, everything was all good until the sixth week. That's when sedgwick denied the last two weeks of my claim stating that a surgery of that nature allows a recovery time of 45 days . Really? Says who? My doctor/surgeon said that it will take up to two months which is why he allotted that time. So now its like my doctor has to defend his degree, because a doctor at sedgwick doesn't agree with him. smh. This is crazy. And the "specialist" told me that her cousin had the same surgery and he was only out for two weeks and he drives a fork lift.. Lady I still has stitches and a boot. There is no way the fork lift cousin was driving a forklift with a boot.
Fordgal1965 Send email
 
Jul 10, 2017

Denied my claim

I was having major back pain going down my legs I was scheduled for back surgery disc fusion and they denied my claim. I was told by work I couldn't be at work because I was in too much pain and I was told by my doctor not to work because I was in too much pain. For some reason they felt that I could work and denied my claim after several reviews. They are horrible!
Rizzo Send email
 
Jul 6, 2017

SLE LUPUS

I was diagnosed with Lupus at 10.... I was approved for FMLA for the time I was out of work but denied for being paid. Now I need to know how to go about finding an attorney to sue Sedgwick and my Doctor who sent a letter admitting he didn't have the skill set to treat me for lupus. I used my credit cards to stay a float during the time I wasn't being paid. I have gone through depression and anxiety these past 3 months. This is not a aliment I can make up....this is my life for the rest of my life. I am at my wits end. My adjuster didn't even have the guts to call me, I had to track him down! They are a bunch of cowards!
vrival Send email
 
Jul 5, 2017

Benefits denial

I began my disability leave on January 20, 2017. Everything was going ok when I was on the disability until I received a call in May. The adjustor Veronica indicated to me that she needed paperwork from another provide that I had not been to. Since I was not sure why she was asking for this info I did not understand why she was calling me. I had submitted all requested paperwork to my doctor and was not sure how to proceed. She advised me that if I did not provide the documentation that I would not be paid. I asked her what action I was to take –she advised that there was no action on my part that she needed paperwork from my provider. I contacted my provider and asked them to respond to any paperwork. This phone call was very escalated, Veronica did not provide info that I was asking for, I feel this was either Veronica did not understand what was provided or did not know how to explain the process to me. We ended the call with her very upset and not explaining why she was asking for provider info from someone that I have never seen.

Benefits were denied. I was no longer collecting a benefits check. I had no money, could not pay basic bills.

This continued until I was forced back to work by the system. I contacted Sedgwick again and they said that my doctors office sent them something for me to sign. Well that is just silly, why would my doctor send them something for Sedgwick to secure my signature. Not to mention Sedgwick already had my authorization for medical records. Why wouldn’t Sedgwick simply fax over my signed document that indicated I released records?

This being said – I am now being denied my claim – I worked with a supervisor Megan Crosby – however felt she let the ball drop as its July and I still have no payment of the benefits that should have been paid to me. Megan kept telling me that she was working on it and that she should be able to get what was needed as she is a supervisor and understand the process a little more. At this point I am struggling to pay late fees and bills and reorganize my life because Sedgwick received paperwork that indicated they needed my signature??? I just don’t understand how this could happen… It feels like I am being punished for being on disability. This is causing undo stress in my life, I feel like I am being treated differently due to be being sick and on short term disability.

If my benefits allow for 26 weeks on STD and I was already approved on STD – treatment was progressing but why two months before I go back to work are my benefits cancelled, for a signature?
skizix9530 Send email
 
May 24, 2017

Corrupt Sedgewick!

Honestly the worst company I have ever dealt with. They treat you like the plague for having to file a claim. I was injured by another employee on March 6, 2017 and it has been a nightmare dealing with Sedgwick. No contact from my claim rep, management that is completely clueless when you finally get in touch with someone, they are heartless and try to make you at fault so they do not have to payout any claims. They completely screwed a close friend out of his settlement for an on the job injury that has literally taken 10 years of his life and pretty much ended his career as a firefighter, he lost everything because of this company, his home, his cars, his retirement and is still under medical supervision for this injury and they say he's 100%. They don't listen to your doctors advice instead they send you to one of their paid off "quacks" to give you clean bill of health which is why we get re-injured.

I am disgusted and I too am looking at a major lawsuit against this totally corrupt company and would love to join a class action suit with anyone who has had the displeasure of dealing with these illegal morons. They should not be allowed to do this type of work anymore with the thousands of complaints and lawsuits that have been filed against this company, when will the State L&I people start stepping up and investigating these claims and this company? Why are they all so corrupt? Who will help us?


I am totally distraught, broke and at my wits end with this company can anyone suggest help?????
sswanner Send email
 
May 11, 2017

Auto Accident

My auto was hit by someone that was renting a car which is being handled by Sedgwick. My insurance said I have to go through Sedqwick. The accident happened October 2016 and getting anyone to call you back from Sedgwick is a joke. I have a claim number everything. I get story after story after story from them. Like it is a really big claim $3,000. Does anyone know of someone else I can contact to get some attention? Thanks
catino Send email
 
Apr 22, 2017

Employer Disability vs. Disability Insurance

The below comments are based on years of experience in the insurance industry - I work for a large employer in the benefits department.

There are many complaints on this site regarding people who are upset that a disability (i.e. not work-related) claim was denied by Sedgwick even after paying said premiums. It will be beneficial for you to understand the differences between Employer-Provided Disability Plan and actual Disability Insurance. Your employer is not required to provide short and/or long term disability coverage for employees... they actually offer it as a benefit. You do not pay for this. The Employer-Provided coverage terms are generally very strict with only certain injuries/illnesses covered for a very specific time frame (this coverage may only be available to certain positions within the company and not available for all employees). If your claim is being denied by Sedgwick, it is because the situation you are facing is not considered a covered disability by YOUR employer. This is a huge expense to companies and is a true benefit... not all employees have a right to this coverage regardless of how long you work for your company. Usually lower level positions are not included.

The Disability Insurance which you are paying for will fall under your own insurance, generally the same as your health coverage. This will be handled by another company... it is not handled by Sedgwick as they are not an insurance company. Instead they are a third party administrator hired by your employer to process claims based on the plan set forth by your employer.

Hopefully this information will help you. Dealing with any type of injury or illness can be very stressful and your recovery is the most important. Keeping a positive relationship with your assigned examiner will always result in a more enjoyable experience and likely better outcomes for you.
Harry P Send email
 
Apr 10, 2017

NO communication from Sedwick

Got Rear Ended while working my job. Back shoulder and neck injuries from the collision. Sedwick CMS is the Insurance Company. My EMPLOYER PAYS Sedwick to bust my nutz??? Been treating for 6 months and NOW my case has been "transferred from Stephanie N in Maine to a Dominic in NH. Haven't seen my Physical Therapist for 3 weeks now (Dr has written MORE P/T for me), and it's BEING IGNORED BY THIS GUY DOMINIC who works for Sedwick CMS. ....The P/T office has been calling him 3 times a day for the PAST 2 WEEKS, and NO response from "Dominic" INCLUDING any Faxes sent to his "Office" Thank God I retained Legal Counsel a while ago. SEDWICK is playing games here and my Attorney will be in contact with them. BTW... I am a retired Workers' Comp SIU Field Investigator, so I KNOW how all this goes...
Harry P Send email
 
Apr 10, 2017

NO COMMUNICATION

Got into a Rear End Collision while working. SEDGWICK is the W/Comp Ins company. Case was given to a Stephanie N in Maine, which got "transferred" to a "Dominic" in NH. My Dr has written more P/T for me, BUT it seems "Dominic" isn't returning ANY calls by the Physical Therapists OR me... I'm 6 MONTHS into P/T for injuries sustained and aggravated back issues from the collision.... LUCKILY.......I've been represented by Legal Counsel since the accident. My Employer PAYS Sedgwick CMS for their "Services" to string me along. NOT ONCE HAVE THEY EVER GOTTEN IN TOUCH WITH ME.
BabblinBrooke Send email
 
Mar 27, 2017

ARE Sedgwick

On 11/15/16 I fell carrying ice and milk into my home. I hit my head so hard I lost consciousness for awhile. I hurt my left ankle and right knee. My head but the ground twice. Once in the top and it bounced and I hit again on the right front. When I lost consciousness, I saw white before I was knocked out. Per my Drs. the white was due to my brain hitting the bones of my skull. I went to ER, notified my supervisor and was out on STD due to a severe concussion and TBI. I don't remember thanksgiving or Christmas of 2016. I couldn't talk right and had a horrendous headache for 6 weeks. Dealing with Sedgwick was nightmare!!! Every time I was due a paycheck it was always something they needed. My Drs has me out from 12/06/16-05/31/16. I had to return to work because Sedgwick nurses reviewed my case notes from my neurologist, pcp, ent, knew surgeon, and a cardiologist and denied and closed my claim!! I am currently in appeals process. How can a nurse overuse doctors!!? I hate them! I haven't been paid since 02/16/17. I returned to work on 3/20/17 on a modified schedule of 4 hours. I don't even know if I can do that. I have short term memory loss. Sedgwick is supposed to pay me the other 20 hours for the next 6 months. I don't know what to do?
sdraheim Send email
 
Mar 26, 2017

no call back from adjusters

my adjuster out of chigago tj stevens will not return phone calls from me or my surgeons office .fellow employee has same proplem with same adjuster.NOT ACCEPTABLE !!
TJpeeps Send email
 
Mar 16, 2017

Sedgwick

My name is Turrie Peoples, and on 1 March 2017 my vehicle was damaged by a cart carousel (the entire bulky metal car return) was blown into the side of my vehicle in the parking lot of a Kmart. I filed a claim with Kmart and their third party insurance which is Sedgwick, and proceeded to have nothing but problem after problem with this company. First I tried contacting them for a week to no avail, but I did file a claim with my insurance company so that I wouldn't be without a vehicle. My vehicle has been in the shop for over a week now, and a supplemental estimate has been done because more damage was assessed by the collision shop. Even though my insurance has made sure I have been taken care of; I have exhausted all my coverage, and still don't have my vehicle back. For over a week we have contacting Sedgwick to see where they are in the claims process, and finally after a week we received a call saying that they may not pay for the damages because they have to investigate whether or not Kmart is required to bolt down the cart carousels to the ground. So it would all be on my insurance. Meanwhile, we will have to come out of pocket for a rental, because we have exhausted all the rental coverage on the insurance. This is insane. Sedgwick has been a bunch of pompous individuals who care nothing about a person's welfare. Them refusing to pay a claim is just another way corporate America has us hard-working individuals in a choke-hold. Dealing with Sedgwick is like dealing with the death dealer, you pretty much know the answer to that one. All I have gotten is the old "Cabookie Dick Dance' from this company, next step lawyering up.


Sincerely over the whole insurance process

TJpeeps
Hawkman98 Send email
 
Mar 7, 2017

Sedgwick

Like many others who have been denied benefits because of Sedgwick's arrogance, I too have been denied benefits by Sedgwick. This is business as usual for Sedgwick. I too suffered a work related injury only to be denied my legal rights to have my injury addressed in a responsible manner, again by Sedgwick. Sedgwick's intent is twofold: (1) to discredit the individuals account as to how they got injured and (2) to exonerate Sedgwick and the employer of any responsibility and accountability, both of which Sedgwick and the employer have none. This does not bother me in the least because I expected that irresponsible behavior from Sedgwick. I served as a Navy Corpsman 3 times in Iraq and once in Afghanistan. I had a $250,000.00 bounty on my head. I have NO fear of Sedgwick. For Sedgwick to deny me my rights is merely Sedgwick setting themselves up for failure. I have hired an attorney who has an unbelievable success rate in dealing with low life scum such as Sedgwick. Anyone who is affected by Sedgwick should find comfort in knowing we, my attorney and I, are in the process of filing a class action lawsuit against Sedgwick. Additionally I will be exposing them through the media such as tv. Sedgwick's ongoing history of their inept ability to acknowledge their responsibilities via incompetent case workers is going to be their downfall. Sedgwick really should take notice of the words of Sir Walter Scott, "oh what a tangled web we weave, when first we practice to deceive." I am very excited about Sedgwick being served notice of the lawsuit coming their way. I strongly encourage anyone affected by Sedgwick do the same. You have EVERY RIGHT to stand up against scum like Sedgwick. The only common denominator with Sedgwick and the lawsuits they face, is Sedgwick themselves.
Hawkman98 Send email
 
Mar 7, 2017

Sedgwick

Everyone on this complaint board should find comfort knowing I am in the process of filing a class action lawsuit against Sedgwick
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

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