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Sedgwick CMS

United States,
Texas

Consumer complaints and reviews about Sedgwick CMS

pkubath Send email
 
Nov 10, 2015

Delay in 1st appealed claim with Sedgwick

I have been dealing with Sedgwick, regarding short term disability. During this time I was mentally unable to function, due to extreme anxiety every day, major depression, and something that did not come to mind at that time, was my inability to process information and not being able to remember things, or communicate in an effective manner. I am rather new, a little over 2 yrs in San Diego County, I haven't adjusted completely, financially, mentally, or emotionally. The event of ADHD has greatly been uncontrolled since working at Time Warner Cable, almost 1 year, this job has lead me to be on a 2nd medication in addition to the antidepressant I have been on for more than a year, and now I need more therapy. I struggle with ADHD, part of the symptoms are anxiety and panic disorder and major depression, irritability, inattentiveness, and impulses that can't always be controlled, especially under stress; also bringing on bipolar reactions.
These symptoms are not Time Warner's best interest to have me interacting with customers if I can't consistently perform in a professional manner; furthermore to be a effective team member and to comply with the stringent metrics required to excel at the job of a Customer Service Agent in a high volume call center, also to be to work on time.
In addition, I travel 70 freeway miles to and from work each day, which is an added anxiety and depression to get to work, and more wear and tear on my car which is costing me more to repair, which gives me panic that the car will break down. Furthermore, even if accommodations are made, which is probably to work part-time which; it would not pay off for the distance to travel.
I have already been denied once by Sedgwick, in the mean time, the State of CA SDI has been paying out benefits. After reading the complaints against Sedgwick for Bad Faith Practices. I have jumped through the all the hoops and had my provider jump through the hoops. My appealed claim with Sedgwick is pending after being off work for only 34 days, they tell me that a determination would be on Dec 18.
Letmokbegreat Send email
 
Oct 29, 2015

Sedgwick Injury Claim Denied

I was shopping in Frys Food Store on 67th ave Indian School Rd and I slipped on something wet in the aisle and sprained the muscles in my right leg from top to bottom. I had to be on crutches and wear a leg brace for a month. When it happened I reported it to the manager and she said she was sorry and that she would have somebody clean it up. Katherine Brady at Sedgwick gave me the run around for 3 weeks then called me yesterday 10 28 2015 to say my claim was DENIED because the manager didnt report it and an employee just had cleaned the area 10 minutes prior to me being in that spot. She also admitted to seeing me slip and apologized and said there was nothing she could do then got nasty with me for asking questions. I wonder if I could appeal this decision??

Lahobe83@gmail.com
Imagemakercm Send email
 
Oct 26, 2015

Denial

I have read the above and all of the cases are exactly like mine. I have a chronic illness, stage 4 kidney disease(state 5 is dialysis) and Sedgwick says I can work in a Walmart warehouse. They even paid a doctor to call my doctors to go against what each other said. They have followed my case for 24 years and he's never met me. Pitiful that Walmart didn't represent me as a long term associate of 20 years! Sedgwick should be investigated for fraud. I paid my benefits and only got one check. They started lying and stressed me and cheated me out of my job in my daughters senior year of high school! I DO NOT have respect for them and definitely not for my sad greedy company that let me down!
lilwof Send email
 
Sep 21, 2015

AUTO INSURANCE CLAIM

On August 5, 2015, I arrived at NTB aka Tire Kingdom to check the air pressure in my tires. While sitting waiting for an attendant to service my needs a hearing impaired employee of NTB smashed into the passenger side of my vehicl with another customers car. After 3 weeks of having air blown into my ears from the store manager and assistant manager, my patience was finally exhausted and I called the Corporate Office. I received a phone call from Sedgwick by the end of the day......hooray!!!!!. I will fast forward to 9/8 which is the date I spoke to Joey Florestal, a claims examiner for Sedgwick. On this day he stated the check was in the mail. Perfect was my response. With this news I decided to make an appointment to get my car repaired. My vehicle has been in the shop since 9/16 and issue number 1 is I don't have a check to pay for the repair. Issue number 2 is Enterprise Car Rental is threatening to charge my credit card because Joey Florestal nor his supervisor will respond to my numerous email or telephone messages.What a way to run a business. I am overwhelmed with disgust regarding the lack of professionalism, and attention to this matter. As I am writing this complaint Enterprise Car Rental and Wilburn Auto Body are calling me to find out if I have received a response from Sedgwick....wow. So I have to be harassed because of NTB's lack of concern or due diligence.
Matty Bumpo Send email
 
Aug 16, 2015

Sedgwick CMS

I have been through hell and back with Sedgwick and unfortunately I live in a state that in 2004, Governor "I'll Be back".......yes, the Terminator, sold out to the insurers and passed a law granting them amnesty against bad faith actions.....ergo, Cailfornia is a damn nightmare........my injury started in 2009 with my first rotator cuff surgery to my left arm and when it was time to do my right shoulder rotator cuff a year later, Sedgwick said no........my lawyer fought and I had right shoulder rotator cuff surgery in 2011.

That surgery failed within 6 weeks during therapy when I felt a pop and a great deal of pain that would not go away.....big head tendon ripped off the medical bolts used to re-attach it during surgery.....Sedgwick says no. We wind up going to court and I have a 2nd rotator cuff surgery in 2013 and ir also doesn't turn out so good.......during therapy in the 10th or 11th week, my shoulder gives out,,,,,,,.MRI shows more tears and a torn labrum.......Surgery requested and turned down again.

We go to court and the insurers prevail by using some paid IME to agree with them but I found another surgeon that diagnoses my shoulder differently than what was previously requested. Sedgwick of course says no again but my new surgeon contacts the denying doctor and points out some hard facts that the other physician couldn't refute. Since my surgery was asking for something different than rotator cuff repair, it was approved and while I had my 3rd surgery, my new surgeon repaired my torn rotator cuff anyway since he was already inside my shoulder for other reasons, i.e., loose steel sutures from prior surgeries that didn't hold up.

Sedgwick is immune in California from any bad faith accusations because of SB899. There's hope ahead.......Romano v. Kroger/Sedgwick CMS is in the the California Courts right now.......that could be the start of something good.......I hope so.

Matthew Brennan
559-977-6944 (PST)
Nanny123 Send email
 
Jul 31, 2015

We all should find lawyer and file suit against sedwick

look with all the complaints about sedwick after I was denied again for a nerve block out of work waiting since March 2016! Thou getting paid peanuts , big deal, you would think a lawyer would want to file a class act suit against this company? They need to be exposed due to them being feudal an on people's health...enough , is their a lawyer willing to help us fight back and bring them out in the light
RNDuke Send email
 
Jul 27, 2015

HIPPA VIOLATION

I picked up a prescription from the Walgreens in Durham NC and was given another patient's prescription which contained the PHI. Some unknown person was given my prescription with PHI and my Home Address and Phone Number. I called the claim office and "Joseph" told me "well what do you want; $25.00? Really, this is a Civil Rights Violation of a Federal Law called HIPPA Sedgwick and Walgreens. I plan to file a complaint with the Secretary of Health and go to the Media in the Research Triangle Area with well over a Million People and disclose this violation and the location of this Walgreens.
PaulaAdkins Send email
 
Jul 19, 2015

FMLA and short term disabilty

My husband has worked for Walmart 11 years. He is one of those employees that should be valued but when he was struck with a mysterious pain in his mid-section and unable to work, stand or tolerate the extreme pain he finally used his vast personal, sick leave and vacation time to cover the EMPLOYMENT gap. When all his accrued time was exhausted (Dec. 31, 2014-March 31st 2015) he requested the use of his Short term disability. At that time we were told that they would have to back it up to the first day of leave...we would have to pay back all the money paid to date from his EARNED leave benefits. With the mountain of medical bills that was impossible...In April he had his 11th anniversary and we used his vacation time to help with the lack of money. Sedgwick informed us that they would not start his short term disability after he spend his earned leave benefits because that was considered DOUBLE DIPPING. So here we are without any money coming in and he is still officially employed by Walmart. Somehow I think this is a breach of insurance benefits, FMLA and the fact that he has dutifully paid into his Short term disability and now is paying his medical benefits each pay period out of ZERO PAY.

The question is...WHO READS THIS AND WHO WILL RESPOND TO THIS LEGAL QUESTION?
ggierach Send email
 
Jun 2, 2015

Sedgwick Complaint to Insurance Commision

Office of the Commissioner of Insurance
125 South Webster Street
Madison, WI 53703-3474


Dear Sir or Madam:

I would like to lodge a formal complaint with your office regarding the tactics of Sedgwick Claims Management Inc. My employer is Wal-Mart Stores Inc. store #XXXX, WI. I have short-term disability insurance through my employer handled by Sedgwick.

Sedgwick has made it extremely difficult to process claims. When I have medical records sent to Sedgwick, they claim they never received them. Then I receive a computer generated letters denying benefits or threatening to deny benefits. They have sent me 9 letters stating they haven’t received medical information from various claims since August 1, 2013 until May 27, 2015. I had to repeatedly ask the medical clinic and the hospital to re-send information to Sedgwick.

I have a current claim # XXXXXXXXXXXX that I started April 14, 2015. Sedgwick has closed and terminated my claim and denied benefits from May 7 until now. It is the same situation where they claim they never received medical information. I have checked with the medical records department at Froedtert St. Joseph’s Hospital in West Bend WI. and the West Bend Health Center and they have sent medical information to Sedgwick. I have been on FMLA medical leave from Wal-Mart since April 14, 2015. I have a Diabetic ulcer on my foot. I am having prosthetic Diabetic shoes made at Hanger Clinic. I cannot wear regular shoes because of a deformity in my left foot caused by Charconeuroarthropathy.

I would like to have my short-term disability reinstated.

Sincerely,
G

Email ggierach2000@yahoo.com
DrSSRodrigues Send email
 
May 24, 2015

Texas worker compensation fraudulent policies

I'm a medical doctor who was kicked out of the Texas WC system because I treated injured workers like human being. due to lies and cheating within the entire system.

Did you know that most if not all injuries to the body will naturally heal in time?
Did you know that if you place a huge medical system at beginning of an injury it is just about profiting off of what nature will do anyway?
Did you know that bone, joints do not cause much pain at all?
Did you know that muscles are the only organ system that produces pain signals?
Did you know that we have always had highly effective treatments of the pain that comes from muscles?
Did you know that WC systems choose, by law and policy, not to treat your muscles but your skeleton? ===>which is not even science based but profit based. Yes you are being deceived. (I was too)
Did you know ?? maybe 20% of those who are injured will not get better until the treatments focus around and into the muscles with kneading and deep stimulation? ===> which is not happening.

Did you know that pain is being mis-defined, misrepresented, mis-located, and mistreated by the medical associations who took an oath to uphold these truths?

The definition of pain is wrongly used, difficult to conceive, write down on paper or transferred to another person.
Pain can easily be misinterpreted and improperly treated.
Pain is like an itch; very personal, private, invisible to technology, invisible to others and impossible to prove in a court of law.
Pain can easily be denied, refuted, disavowed, marginalized and disrespected.
Pain is not some static entity that a physician can use to discover the correct therapy. And yet, physicians continue to use this static concept to advise patients to undergo therapies that end up doing them harm.
Pain cannot be seen for certainty on a scan, MRI, or an X-ray, but physicians use these methods to locate pain.
Pain can only be pinpointed with certainty by human touch. Still, we confusion the location of pain with science and technology.
All “pain” has a pathologically significant cause that should be uncovered to be effectively addressed or treated.
All “pain” that can NOT be readily found on scan, X-ray or other equipment used in modern technology must be in the muscles and connective tissues.
The “pain” in muscles and connective tissues can not be removed, rearranged, repaired or fixed in the operating room. So no conventional medicine conceived surgery for the pain in the muscles!!
The “pain” in muscles and connective tissues usually does not respond very well to pain medications or other conventional medicine options.
The “pain” in muscles and connective tissues is called Myofascial (MF) Pain. This type of “pain” is so small that it can not be seen under the microscope. We now can see changes under the electron microscope but we are not using this in the office.
This invisible type of pain that is in muscle requires therapy or it will start to transform or degrade itself and compound pain signals.
This invisible pain type will continue to degrade and sequentially interfere with the aliment of the skeleton, stress skeletal components, alter blood flow and corrupt nerve impulses.
This invisible type of pain can spreading into adjacent tissues and “metastasize” into distant parts of the body.
This invisible pain will stress your adrenals and nervous system leading to neuroses and metabolic diseases.
This invisible pain, if left undertreated or no treatment at all will devolve the muscle cells and lead to many problems we think are primary, but are due to delays in recognizing and delays in treatments; Degenerative Joint Diseases, vertebral disc imaging abnormalities, Radiologic joint space abnormalities, CRPS, RSD, TN, TOS, CTS, IBS, Migraines, pelvic pain syndromes, psychosocial, weakness, imbalance, vertigo, falls, disability and PTSD.
Do you know the #1 reason why our society has a problem with long-term pain problems, narcotic abuses, and suicides?
Do you know the #1 reason why hip, shoulder, back and knee surgeries fail?


Did you know that modern physicians have negated innate Mother Nature healing?
Did you know that it is Mother Nature that heals all all wounds?
Did you know that all injuries, auto accidents, trauma, fractures dislocation, torn ligament, smashed spinal disc or knee meniscus are automatically healed by nature? All we need to do is assist the person until nature heal those would.
Did you know that the concept of a shoulder tear is illogical? Nature does not allow these types of wounds to go unhealed. The will heal or be inconsequential in 8-12 weeks.
Did you know that there are historically known treatment optison for all types of pain problems?
Did you know that these known treatment options are not included in many conventional medicine treatment options?

Medicare has allow advisors, scientist, physicians and policymakers to write into laws the means to practice medicine that is fraught with poor or tragic consequences. I call this malpractice.

Did you know Medicare has placed limits or will not cover many of these options?
Did you know that Medicare has banned one of the most important of these therapies?

Here is the list of therapeutic options that, in reality, are safe, non-toxic, holistic, restorative and potentially curative:

The Holistic Healing Recipe-Self Care: In many advanced ancient cultures, wellness and proactive care was a standard concept. Keeping balanced, harmonious, tending to your body’s “whispering” requests for self-care early. Daily self-care, along with a wholesome diet, herbs, extra vitamins and Magnesium supplements, exercise, stretching, yoga, heating with pads, hot tubs, hot springs, mineral springs, Epsom soaking, massage, scraping, acupoint or acupressure treatments, strain-counter strain, unwinding, chiropractic spinal adjustments, traction and, most importantly, sleep hygiene.
http://en.wikipedia.org/wiki/List_of_forms_of_alternative_medicine

The Holistic Healing Recipe-Assisted Care (minimally invasive): In cases where you may get behind and need the assistance of more intensive therapy, you can progress to acupuncture, modern or myofascial acupuncture, dry needling, GunnIMS, and wet needling, and Travell’s TrP injections.
http://en.wikipedia.org/wiki/Myofascial_trigger_point
Michael Hunt Send email
 
May 20, 2015

WORKER'S COMP DOCTOR

I have heard and read numerous complaints regarding Sedgwick. I even went so far as to read the Romano vs. Kroger decision in California just to get an impression of this TPA. I am not an attorney and I will not provide legal advice. As a licensed healthcare provider in Illinois at AarrowHealthCare.com, I have dealt with numerous work related injuries over the years and have seen resistance to providing compensation for Worker's Compensation not only from this insurer, but others as well.

It makes no sense for the work comp carrier for the employer, not authorizing the treatment recommended by medical specialists.

In my opinion, the majority of these impediments to receiving care are to the people who do the most work and receive the least in compensation. The majority of us possess ethnic names that applaud our lineage, as is the nature of this country. We willingly infuse strength and lifeblood into this local community. As a whole, we are better and stronger because of these efforts. I am incensed by the discriminatory efforts to deny health care to any injured worker. “One doesn’t ask of one who suffers: What is your country of origin and What is your Religion? One merely says you suffer, this is enough for me. You belong to me and I shall help you.” Dr. Louis Pasteur.

If you require medical assistance do to a work related injury in Illinois, please contact us and we will attempt to assist you and refer you to a specialist as needed. Dr. Walter
Michael Hunt Send email
 
May 20, 2015

FIND A DOCTOR IN ILLINOIS

I have heard and read numerous complaints regarding Sedgwick. I even went so far as to read the Romano vs. Kroger decision in California just to get an impression of this TPA. I am not an attorney and I will not provide legal advice. As a licensed healthcare provider in Illinois at AarrowHealthCare.com, I have dealt with numerous work related injuries over the years and have seen resistance to providing compensation for Worker's Compensation not only from this insurer, but others as well.

It makes no sense for the work comp carrier for the employer, not authorizing the treatment recommended by medical specialists.

In my opinion, the majority of these impediments to receiving care are to the people who do the most work and receive the least in compensation. The majority of us possess ethnic names that applaud our lineage, as is the nature of this country. We willingly infuse strength and lifeblood into this local community. As a whole, we are better and stronger because of these efforts. I am incensed by the discriminatory efforts to deny health care to any injured worker. “One doesn’t ask of one who suffers: What is your country of origin and What is your Religion? One merely says you suffer, this is enough for me. You belong to me and I shall help you.” Dr. Louis Pasteur.

If you require medical assistance do to a work related injury in Illinois, please contact us and we will attempt to assist you and refer you to a specialist as needed. Dr. Walter
BatshitCrazyJerzyGurl Send email
 
May 16, 2015

FMLA/STD benefits Denied

My husband is a Desert Storm combat vet, and last Oct, his PTSD started giving him problems. Dr. F at the VA signed the first note so that my husband could take time off in January-used his vacation time. Then Dr. F got sick and retired, but the VA played games. Sedgwick is demanding paperwork, so husband gets Dr. K, who says nothing's wrong & sends him back to work!. So we get Dr. McD, who signed him out until July this year, but Sedgwick just notified us that his claim was denied. We have been surviving on NOTHING, and now he's forced back to work. Need to find a lawyer...but Sedgwick must be working with Walmart to force people back to work before they're ready....
barbara gardiner Send email
 
May 1, 2015

sedgwick

Everyone was telling me I had to get a job. My lawyer and vocational job hunter. I went on inter view. A week later to come in and do all of my paper work. After 3 hours on the computer I was played for it. I did not get the job. 2 days later Sedgwick stopped my weekly pay check from workman's comp. Now I have 0 money because it has been 8 weeks since this happened I am going for a second option to see if I need more sergery on my broken shoulder . When will I start getting my checks again.? And how can I get them back from Sedgwick. I will do what ever it takes before I loose my car and condo. Thank-you.
barbara gardiner Send email
 
Apr 30, 2015

sedgwick lawyer rappaport

Sedgwick stopped my workman's comp. Checks. I need them.only money coming in. Help me get them back.
72058
barbara gardiner Send email
 
Apr 30, 2015

sedgwick. rapaport is the lawyer

I was told by lawyer and vocational helper I needed to get a job fast. Went for an interview. I was there 3 hours and did not get the job. 2days later sedgwich stopped my weekly workman's comp checks. It has been 8 weeks. Doctor told me and Sedgwick no work for 8 more weeks. I now have 5 dollars to my name. How can I get my WC checks?
Saloveless Send email
 
Mar 27, 2015

denial of short term disability and FMLA

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

Hippa violation

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

Denial

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

denied disability

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

find a doctor

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

denial of benefits

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

I hate Sedgwick. They are the devil

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

Sedgwick is just stupid!

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

Denied all requests for work comp claim

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

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

Sedgwick is claiming that all of my mothers problems is age related and pre-existing.

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