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AT&T offers disability coverage for their employees administered by Sedgwick CMS. Their plan exploits many loopholes in the Federal Law regulating these plans. They will and have terminated benifits for reasons not related at all to the recipients disability or ability to be gainfully employed. Claiments are held under "virtual house arrest" and are not allowed to accomany thier family on even short day trips without obtaining "permission" which is cannnot be obtained in a timely manner if at all. They have and will schedule the claiment for multiple Independant Medical Exams and the doctors in these plans know better than to "bite the hand that feeds them" and do everthing i thier power to find the "claiment" fit to return to work (somewhere else as AT&T has terminated thier employment after one year on disability). This plan is nothing short of a "scam" as AT&T has little intention of prividing the benefits as promised. Sedgwick ruthlessly administers the loophole clauses in Federal Law the plan is designed to exploit and deny benefits to those that are, in fact, genuinely disabled.
Eric Marquardt
Simi Valley, Ca.
The complaint has been investigated and resolved to the customer’s satisfaction.
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i agree completely im alson in a fight with sedwick claims though wal-mart its a struggle i know and my claim has gotten so bad ive had to get a lawyer 9 months and counting so hopfully it will be resolved soon and btw i got fired from wal-mart got injured march 22nd 2007 and 2wks later got the boot for getting injured
signed
disatified worker
I am having the same problem. Sedgwick is refusing to pay on my claim, claiming that they do not have enough information to conclude that I am disabled. They have the information. They are just doing what they can to not pay the claim. You can tell I am disabled by just looking at me. There is no question. Sedgwick is a terrible company.
I agree with you. I am being unfairly denied temp medical benifits by Sedgwick because of their tyrannical practices of exploiting the law to exploit people. I currently work for AT&T and they are a joke along with their bed partners Sedgwick. The more money they save from every claim they deny is more money for the Sedgwick. They want everything done in a way that makes it easy for them to deny justifiable claims. AT&T and Sedgwick are both a joke.
WOW, I am not alone. Sounds like an outside un-biased entity such as the television program 20/20 or similar needs to conduct a serious investigation into Sedgwick & their on going dirty corrupt tactics.
I am going thru the same thing as many I have read about here.
I am not receiving benefits and I am stuck at home & unable to drive
as directed by doctors. It's been 2 1/2 months since my injury and my
good credit is ruined and I am being harassed by bill collectors.My once thriving savings account has dwindled down to nothing.
My family & I have had to do all the leg work & the majority of retrieving medical documentation for sedgwick.Only to be informed by them later that they are in need of the very same documents that I have already submitted many times already. They do not know how to pick up the phone and contact the medical provider. Instead they ask me to get the information myself to expedite the process. That obviously saves them money by retrieving documents for them. On at least one occasion, I faxed a document twice & mailed the very same document also twice. I could go on & on. My claims mgr has become rude and evasive to the point I don't care to ever talk to her again. Frankly, I've seen more courtesy on a tiny sliver of fried bacon. They have been trying to deny my claim stating that having a revoked driver’s license & that does not qualify for benefits. {I HAVE NOT HAD MY LICENSE REVOKED} Their is a complete difference from being ordered by doctors not to drive and having had it revoked. I have gone around and around with them on this issue. I feel sorry for anyone stuck dealing with the corrupt incompetence of Sedgwick CMS.
GOOD LUCK...
Hello all hope you are following this posting still, my name is Elizabeth Smith and I am a union steward with CWA and working on a committee to gather all the employees having issues with Sedgwick and or ATT (especially those who have been fired) to share information for possible future action; please contact esmith66@sbcglobal.net and in subject place sedgwick
Boo hoo hoo, read your disability guide and learn how to work the system you cry babies. Yes you have to get permission to travel but come on, if you are going somewhere that's important, I bet you already knew of the trip and should have told your case manager way ahead of time. The policy says YOU MUST GET PERMISSION to travel overnight or beyond 60 miles FIRST before doing the travel, if you don't, your benefits are terminated. It says that right in the plan book that is mailed to you when you first file your claim. READ IT
It difficult enough to go through all of testing, appointments and physical therapy without having to go through RED TAPE with at&t/sedgewick's mess. (you notice that RED TAPE is in caps...I shall not give at&t/sedgewick that honor)
I've given them the best and healthiest years of my life, including appearing for work with a fever, etc. Realizing that these two companies have my life in their hands is downright frightening.
Yes, we know that travelling is not allowed while on short-term disability benefits. Is it necessary to resort to name-calling? (cry babies) Sounds like someone is having a "juvenile & schoolyard bully" moment, of which is required of pretend sedgewick doctors and some management.
You bet I am fed up with this mess and will contact my CWA office and our attorney. It is ridiculous to think that we would jeopardize our jobs after all of these years. Argh!
I also agree with what you say about Sedgwick. They don't return phone calls ninety percent of the time, they are slow to pay mileage, and they spend more time and money trying not to pay a claim than just doing the right thing. The doctors do not look out for the best interest of their patients, they look out for Sedgwick. The only way to work for a company like that is not to have conscience and be.aware you will burn in hell for the way you have treated people. For the ignoramous that says boo hoo, you obviously have never had an injury or dealt daily with an injury that has ruined your life or dealt with a company cheating you, but your day will come. One word of advice, don't trust Sedgwick and don't trust your doctor. They are not looking out for yor best interest. Only you and a lawyer can do that. Regards, Tennessee
I dealt with Sedgewick for 10 years after getting hurt at Federal Express. Get a Workers Compensation Lawyer and hang in there. If you are hurt or injured prompt your Doctor to help you get your short term or long term benefits. Unless your Dr. tells the Workers Compensation board that you are different now then before you won't win.
I too am having issues with Sedgwick and AT&T... I'm with the company for well over 5 years... never called in sick, gone home sick only 4 times in the time I'm there ...work the most overtime out of all the reps and took a leave for stress from the place and have 3 drs backing me on this and I was denied and it is now in appeal status to which I have to have my drs submit more info than they already have done and that could take up to 45 days for that... I'm off well over 30 days now and no pay... and can't use unused vacation time ... Any advice from anyone I'd appreciate it... My drs are behind me 110% ...
Maybe you should learn to play the game like my friend LaKesha (Sasha) Roberts at the Fayetteville AT&T. There is nothing wrong with her, but for the last two years she has been on FMLA and short term disability. She checked herself into the hospital and told them she wanted to kill her self and then followed up with a doctors visit. Now she sits at home and collects a check every two weeks. When she needs to extend she calls the doctor's office or visits them for 10 minutes... get them to fill out the paperwork... and the scam continues. She collects and her doctor collects. Oh and they give her happy pills. Then she brags to us about how she gets paid and do not have to work. We spend our nights drinking and partying at her house. I wish the people at my job was so easy to fool. That girl has not worked in months. She works two are three months out the year, then she goes from FMLA to paid vacation, to short term and is now working on her scam to get long term disability benefits. So instead of whining about Sedgwick you should blame the employees who are pretending they are having problems with stress and suicide thoughts. Friend of AT&T employee
Work for another telco but am dealing with Sedgwick CMS. As to the 1 or 2 folks in every major locale who play the stress disability thing with no cause, they are a detriment to us all, giving us more work to do, albeit of better qualiy, and give us a bad rep. Get rid of them.
I was injured and sent to physical therapy where I was further injured. Was to be seen by a clinic in my town (my choice) that was set up by industry and the local hospital (industrial town) for return to work therapy and was okayed by Sedgwick.
Then I got a new case manager from Sedgwick "who was familiar with complicated cases." She nixed the therapy after a protracted month of non-contact with the provider and me and attempting to run up the clock on my short term disabilty with no services.
I closed the case, went to my family physician, and am doing therapy with my primary insurance, co-pays and equipment that I bought. There is a letter in my personnel file releasing me to work, but Sedgwick CMS won't give up.
They requested a medical history from birth (gave me two weeks) on a closed case. I declined to send it. Now they have scheduled me for an Independent Medical Exam on a closed claim which I will not attend.
Has anyone experienced any blowback from ignoring Sedgwick CMS?
March 16, 2010
I am an employee of AT&T Mobility in the retail sales division. I have worked for AT&T for almost two years. I was one of the store's top earners and trusted with managerial codes. In August of this past year(2009), I fell down the back steps at a rental home I was living at and injured my neck. Initially, I had a sore neck and a headache. I started vomiting the next day at work, I thought it was because I was on Chantix trying to quit smoking. As the days went by the pain became increasingly worse, until it was intolerable. On Sunday, August 9th I drove myself to St. Joseph's Emergency room. As I was driving, I was dry heaving and weaving because of the pain, my right eye was blurry and felt as if it were being ripped from my skull and my head and neck were splitting with pain. When I arrived at St. Joseph's my blood pressure was 161/101. They had me in a neck brace and in a room within 15 minutes. I was sent up for a CAT scan within minutes of arriving in the room. The results of the CAT scan showed blood in my spine and what appeared to be herniation in C5 and C6. I was told that I was to stay out of work and to see my Primary Care Physician immediately. I was prescribed pain medication and sent home.
At the time of my injury I had not yet acquired a PCP. I called my manager the next morning at 7:30 am and told her what happened. Her response was, “Oh you picked a great day for this! The Big Wigs are coming today.”. I was expecting to get better and had a letter for rest. Instead of better things became increasingly worse. The pain increased, I developed numbness in the right side of my face and my right eye, coupled with the pain in my eye, and it became excruciating. I returned to the hospital two more times that week.
My mother came up from Georgia to look after me, and while she was there, she read my Union contract. She told me that my manager was to have already given me the contact information for short term disability and the information I needed to file. So, I tried to contact my manager. After a week of trying to contact my manager, and receiving no response. I contacted my local Union President and told him what was happening. He called my manager and left her a voicemail. I received a text message with a phone number at 4 pm on Saturday, August 15. There was no information with the text message, just a phone number.
On Monday, August 17 I called the number that had been text messaged to me the previous Saturday. It was an Human Resources Disability Department administered by Sedgwick CMS, a third party company that handled disability claims for AT&T. I filed my claim by following the voice prompt instructions, at that time I was given a claim number. The following day, August 18, 2009 I spoke with “my” disability case worker, Keith Adams. I was at that time told to fax my hospital records to him. My mother took me to Mission Hospital's Records Department and paid $25 for 50 pages of documentation on a CD. At that time my mother and I went to Kinko to fax the documentation. We were told that it would cost $75 and that they could not fax from a CD, that I had to go home and print out the 50 pages and bring them back.
I went home and searched the Internet for e-fax options. I found an e-fax company that would fax 100 pages per month for $10 per month, and that the faxes could be uploaded from the computer. I subscribed to that and faxed the information, after receiving email confirmation, I called Sedgwick and confirmed receipt of fax, my case worker, Keith Adams was not in. The next day I placed a call to Keith Adams, he was not in his office and I left him a message. I then spoke with a Customer Service agent to confirm receipt of the fax yet again and the agent confirmed the receipt of fax.
During this time, I had called my management on August 10, 11, 12, 13, 14, 15, 17, 19, and 21. On August 25, I met with the Mission Trauma clinic at 8:30 am and then to my new PCP at MAHEC at 10:10 and reviewed the information from the hospital and trauma clinic.
On August 28, I went back to Mission to obtain the records from my appointment at the Trauma Clinic and then to MAHEC for the records of my appointment with them and faxed them to Keith Adams at Sedgwick. Again, Keith was not in and I left him a message after confirmation of fax with an agent.
I returned to MAHEC on Thursday, September 3 for a follow up, on September 9, I went to my first Physical Therapy Appointment with Care Partners West. On Thursday September 10 I returned to the Trauma Clinic were I was ordered to cease PT and was scheduled for an MRI because my symptoms were becoming worse. On Saturday, September 12 I went to Mission Hospital for an MRI.
I called Sedgwick on Thursday, September 17 because I had yet to hear anything back about my disability. I again could not reach my case manager, Keith Adams. So, I called back the next day, Friday, September 18 and was informed that I had been denied disability because Sedgwick had made an appointment to speak with my PCP and she did not take the call and they had to refer my case to their doctor whom determined I was not disabled. At this time I had yet to get back the results of my MRI.
On Friday, September 18, I called my PCP and asked her if she did not take the call, as I was denied because of it, only to find out that not only did she take the call, but she informed them(Sedgwick), that she was not comfortable with the form of the questions and that she would gladly, at that moment, draft a letter stating the facts of my condition as they knew them and that at this time I was unable to return to work pending the results of my MRI. Sedgwick declined saying they had enough information, and thanked her for her time. I immediately called my local Union President, Curtis Shew, and informed him of the situation. I told him that I would be in PT at 10:30am on Monday, September 21 and that since I would be in town I needed to speak with him. Curtis told me to call him after PT and that we would meet around 12:30 on Monday and I was to bring all of my documentation that I had sent to Sedgwick. The documentation included the 50 pages of hospital records, the Trauma Clinic notes, the notes from my PCP, and the PT evaluation. I sat in my car for two hours waiting for Curtis to call, he never did. I, to this day, still have heard nothing back from him.
Upon returning home I got on the Internet and found out whom my district representative was and called my District Union Representative. I spoke with her assistant, Francine. I called my District Union President, Betty Witte two times a day for five days in a row only to receive apologies from her assistant, Francine. On Monday, September 28, Francine finally told me that Betty Witte instructed her to have me email all of the information that I had for Curtis, and that she would take care of it. To this day, I have heard nothing from Betty Witte.
On September 23, I went to the office of Dr. Ralph Loomis at Carolina Spine and Neurosurgery to go over the results of my MRI with his PA Laurie Stoker. I then on small instruction from a Sedgwick agent, applied for an appeal. After 46 days I was reinstated on the basis of the information gleaned from my MRI.
I continued PT for 2 ½ weeks, at which point the symptoms had gotten so bad that I contacted Dr. Loomis personally and scheduled an appointment for surgery. I had my surgery on November 12, 2009. I did not have a herniation, I had shattered vertebra. I had to have a scope put down my spine to look for fragments, a discectomy, a cadaver bone implant and a titanium plate and four screws. I had spinal stinosis, and nerve impingement. I was discharged the next day and was forbidden to leave my house for any reason for one week due to risk of infection. I was told I was not to walk stairs, uneven pavement, or even lift a gallon of milk, as a gallon of milk weighs 7 pounds and my restriction was 5 pounds.
I received a letter from Sedgwick at this time stating that I had until January 18 to provide further documentation if I was to still be unable to return to work.
On December 8, almost one month post-op, I returned to Dr. Loomis' office and had an x-ray done and met with PA Laurie Stoker again to address what the next course of treatment would be. I was to start PT again on December 17 and was told that I was not to return to work until I completed physical therapy.
On January 12, 2010 I received a voicemail stating that my case worker, Keith Adams had spoken to my doctor and that he said I could return to work with accommodations and that I was to return to work within 24 hours. I returned the call and per usual, Keith was not in. I spoke with an agent that told me that Keith did not speak with my doctor, but according to the notes from my visit on December 8, 2009 I was able to return to work with accommodations I the proceeded to ask the agent what those accommodations were, and she told me she did not know. I asked her if my doctor had stated my accommodations they should have them on their file. She said they did not have them. I then asked her how, if they did not know what my accommodations were, how did my store manager know, and how would they have had the time to acquire them. She could not answer, I also pointed out to her that I had an official document signed by Keith Adams which stated that I was approved until January 18 and that was the date in which I provided my Neurosurgeon and PT staff, and that they were having a team meeting the next day and were to provide me the notes and recommendations by the due date of the 18th and that I wouldn't be able to get them any sooner. She said, well it says here you have 24 hours, I was denied the next day.
On January 15, 2010 I received my denial letter. The letter stated that I was denied my disability benefits because Keith Adams spoke with Dr. Loomis on January 7, 2010 and that Dr. Loomis clarified that repetitive motion restrictions would still allow me to do keyboarding and sit and type at a computer and that these restrictions were presented and accepted on January 8, 2010.
Now, ask yourself... does that sound the same as what was left on my voicemail, or what was told to me by the agent of Sedgwick. No, it doesn't. I brought the denial letter to my Neurosurgeon's office, the research was done and none of what was contained in my denial letter, office notes of December 8, or the message left on my voicemail were factual in any way. The entire letter, the entire reason for my disability denial were again completely and utterly fabricated.
Sedgwick CMS, employed by AT&T has innumerable lawsuits pending against them for the exact same type of fraud that this company has committed against me.
I am enclosing links to websites that list pending lawsuits, similar employee stories, and information regarding this company and the companies that employ them just for these types of tactics so that they do not have to pay benefits to their employees that not only depend on them, but have earned them.
Also, I want you to see how the CWA Union in North Carolina has completely disregarded the needs of a due paying member, in good standing, and left me to fend for myself without representation against this giant.
At this time, I am facing losing my position because this company has lied and has said I have not done what I am supposed to do and have not corresponded with them since before January 13. Which, is entirely untrue. They have also disregarded direct orders from my Neurosurgeon and my Doctor of Physical Therapy, and denied my disability. I have also had no support from my management, by way of email documentation or direction, except when I have sent an email asking for help, and then the response what short and vague at best.
I have sent this letter to Mr. Randall Stevenson, CEO of AT&T Mobility, I have also contacted my State Representative Heath Shuler, The North Carolina Insurance Division, The U.S. Department of Labor, CWA Local President, CWA District President, and the CWA National Office. I received no response from Mr. Stevenson, no response from my CWA Local or District representatives, the CWA National Offices said they could not help me because they had no “Mobility” representatives in their National offices and that the only thing I could do was to hand write a letter to the CWA National President Larry Cohen and mail it to him. I was told by my State Representative, the NC Insurance Division, and the U.S. Department of Labor they could not help me, if it wasn't Social Security I would have to get a lawyer and take Sedgwick CMS/AT&T to court. In my city, Asheville North Carolina, there is one lawyer that will handle this type of law and she charges $200 per hour, because according to a dozen or more local lawyers, there is no money in it.
http://www.gesupplydiscrimination.com/files/htm1/ATT%20Freedom%20Fighter%20News.htm
http://www.gesupplydiscrimination.com/weblog/ATT_Sedgwick%20Spanking.pdf
http://gesupplyrexeldiscrimination.blogspot.com/
http://sedgwickcms.blogspot.com/
With a little research of your own, I think this is a worthy story... I know it is of utmost importance to me. The last pay I received was on January 19, for $125 after Union dues, insurance, and taxes. I pleaded my case with my case manager's supervisor, Maritza Diaz. I sent her my medical information, the denial letter, the discrepancies, and a letter from my surgeon and stated that I should be reinstated due to the complete fabrication from her subordinate, and that I should not have to file an appeal and wait 45 more days because my case worker blatantly lied. Not only did I not get a response, I found out recently that I am no longer an “active” employee. Which, I may find out means I no longer have a job.
Apply immediately for your Social Security Disability. You have paid into it since you started working at I'm sure a young age.
Sedgwick CMS has alot of red tape to go thru before you can use them. I honestly had to tell them 15 days prior to my surgery to have them open a case. I could have died in this time. But you have to follow protocols with this company. They Do not care about you... you are only a SSN number to them.
I honestly don't know what to do at this point. I am in serious pain. I had a tumor removed from inside the spinal cord. They cut the tumor out; the doctors told me if I had not cut it out shortly... 1) it would cause me to be paralyzed shortly by pressing on nerves... and would cause permanent nerve damage. 2) It was pushing against the largest artery in the human body. If it ruptured it or cause a blood clot I would be dead in literally seconds.
Everything was going fine until Sedgwick CMS tried to force me back to work 3 weeks after the surgery. It literally took me three months to learn to walk again without using a cane must less a walker. I was in a wheel chair the first month nearly.
This surgery really took a lot out of me. My doctors fought hard to keep me on at home so I could rehab. That only lasted 2.5 months and Sedgwick CMS forced my doctors orders and saying he could go back to work on light duty. So I was on light duty for 4 months.
So now its 7.5 Months after the surgery and I have chronic back pain. I can do a lot more than a few months ago. I cut myself down to 1-2 pain pills a day; which would be all I would need to cope with the pain. My supervisor insisted for me to be back on light duty if I took any pain medication. Sedgwick CMS denied everything my doctor has wrote for me being on light duty.
I am scared to death to take any pain medication for my chronic pain because I don't want them to pop a urine test and find me guilty of using prescription drugs for my back pain. I am an outside worker working on the outside plant. The DOT is strict on us about the drug policy. And because of this; AT&T uses this as a way to press people with random urine tests. I have known employees get tested twice a week and three times in a 3 month period here recently.
Another thing; AT&T has a numbering program; where if you don't make their numbers which is close to impossible to make at times; you get wrote up. If so many write ups are in affect you have a possibility of getting fired or they will make your life at work hell.
Right now I am on full duty. My doctors has done everything in their power to extend my light duty. I talked to the Union Reps and they say now my only options are two months home without pay and If I am no longer better I would have to go two years without pay. And there is a lot of red tape in order to set this up. Funny thing is... the union doesn't with to help with this situation. I have been thru more stuff as an employee than pretty much any of the employees I work with.
Anyone has any lawyers; advice; anything to lead me in the right direction please point them this way.
I cant work in this pain.. it's way too great. I don't wish to quit but I honestly right now feel I have no better resolution.
kingsword2008@gmail.com
I feel your pain. I am an AT&T employee & currently in a very bad position because of back pain & Sedgwick denying my claim. They guaranteed I didn't get approved right up front by not sending me a "welcome packet" with the paperwork for my doctor even after I made several calls to them asking for it. Finally the day before the deadline of the new date with an extension they sent it. I took it to my dr that same day but by then we had reached the deadline. They know as much info as they want there is no way for him to see other patients & get my detailed paperwork filled out & sent in. He went ahead & sent it in even though it was past the deadline. They followed up by sending him additional forms to fill out while declining my claim anyway even though they dropped the ball on their side. I appealed & the same thing pretty much. I was told at the start of the process a caseworker would be assigned to me & would be in touch soon. I have been in this claim process for nearly 6 months & still have not ever spoken to a caseworker nor any other person who has ever called me from Sedgwick regarding the case. I am a single mother with no financial support whatsoever so needless to say after 6 months I have gone through my entire savings as well as had to withdraw all of my 401K of course paying huge penalties out of it for taking it out early. So now I am pennyless single other that is about to be homeless with a 6 year old because of this nonsense., When I end up splitting a vein long way they will maybe see that the chronic back pain & depression I "claim" to have is very real and my child is the one that will suffer the most. It absolutely infuriates me for these big companies to treat people this way. They have no idea what I have at stake because they want to get out of paying out claims. I have had scoliosis since I was a child, degenerative disc since my 20's, & arthritis is my tailbone & SI joint that I was recently diagnosed with at 45. A lifetime of chronic pain has destroyed my quality of life so I suppose depression was inevitable. By the way my appeal was also denied saying I did not submit documentation when my dr & I together have sent in my last 20 years of medical records. I even sent them older x-rays & dr notes with details of my back condition. There is nothing else to send them but they denied it anyway so my depression is over the top at this point thanks to them. They are destroying the quality of life of an innocent 6-year-old with their games trying to avoid payment. As for AT&T, they should stop offering benefits to employees that they don't actually intend on giving to anyone. Just sounds good in their job description. Someone needs to be held accountable for this nonsense cause as I can see in reading complaints we are among many that were not treated fairly by Sedgwick guaranteeing that their process will keep anyone from getting their docs sent by the deadline & the refusal of any caseworker to ever call you about your case. These people are destroying the already difficult lives of people that they are supposed to be there to help. Unless you have lived with back pain you can't begin to understand the effect it has on your life. I sure hope you found a resolution as well as some pain relief. Sorry for the long rant but as I sit right outside my WFH office trying to find the strength to log in and start taking calls today or lose my job completely my mind is in complete chaos as to how hard-working people pay and pay and pay for benefits but then can't use them when they need them & I just can't wrap my mind around it.
My point it that Sedgwick is just a TPA (Third Party). They administer the disability plan that is given to them by AT&T. Sedgwick doesn’t make up the rules. AND to top it all off, before all these rules and processes and policies are given to them, AT&T management AND all the affected Unions has to agree to the plan first. If the employee has a problem, say with the travel policy, they need to chat it up with their union rep and when the next plan discussion comes up, change it. Don't blame the TPA for your lack of information or even ignorance to the way corporate America works. AGAIN…READ THE DISABILITY GUIDELINE BOOK and BE INFORMED!
Sorry bud you need to find out what you are talking about. There are no employers that say FM.employee yeah F them good especially a good employee are you out of this earth. Sedwick tries to impress to be the best world wide. My manager has said file charges against them so I got an attorney. My claim is strictly against Sedgwick.
the problem with that company is that they do not follow thier own guide. I have read the full att idsc guide last printed and revised on may of 2009. I have been out for 6 months and have delt with 4 case manager and 2 of thier supervisors that have no clue what I am refering to when I covered the information with in that ducument. I have also spoken to the liason for att and sedgewick and was advised per her that they are aware and should be following it. In all that company is doing what all insurance companies do. deny your claim give you stress and attempt every dirty trick in the book. If you call bs on them they act stupid and deny your claim.
I heavly suggest to anyone that is on disability to get a copy of the guideliness and make sure that all conversations between you and them are on speaker and being recorded on your side. For legal reason you do not need thier permission to record a conversation if it being done for personal reasons in most states. Those tapes though can be requested as legal documents in court though. Also do not I repeat do not give them any information on your medical case since you are not a doctor and can not self diagnose nor can any of it be used to approve your claim only deny it. The case manager will attempt to gain a bunch of medical info from you just tell them to contact your doctor for that. I say this since you may be heavly medicated and not be aware of anything you say. In fact i suggest not even talking to those idiots unless you have to.
I am currently employed by AT&T and was injured when I fell at work on July 12, 2008, I filled out an incident report with security and the emergency response team was never called to check me so I had to call my husband to come to the job to wrap my leg. I could not leave because I would get points but could not walk so one of my co-workers got a chair and rolled me to my desk and the end of my shift she had to roll me to the front door so that my husband could pick me up and put me in the car. I went to emergency room doctor when put me on crutches and advise that I had some limits that would prohibit me from working without accommodations which they could not meet. I never got a company of the incident report that I filled out because no one had and my old manager went out on leave and when she returned she was told that her service was no longer needed. I have been seeing a specialist for my injury but began to have back spasms that hits so hard that my lower part of my body has no control. I had one of my attacks when I was stepping out of my house when the pain hit and came down on my leg and ended up in the hospital for a week and back on crutches. My leg swell so big that I could not wear any pants because they could not go pass my calf in order to pull them up. I had to wear a boot on my leg for a period of time and my leg still swells to the point that I cannot walk on it & have to go to work approximately 30 minutes early so that I could give myself enough time to walk across the parking lot because I have to take breaks in between. While on crutches, I was told that Sedgwick said that there was not enough medical information to support me being out of work so I had to return to work while on the crutches. I did go back in fear of losing my job and I went back and while back at work. One day I went to the bathroom at work and the floor was wet and my crutch slip from under me and I fell again and filled out another report that would allow me to see the doctor again which is the same doctor but had to open up another workman’s comp claim that meant go to the same doctor for two separate appointments which had to be on different days per the guidelines.
On February 04, 2010 I was diagnosed Scabies is an itchy, highly contagious skin condition caused by an infestation by the itch mite Sarcoptes scabiei and my doctor said that I could not go to work like that because I could pass to other employees. I was also having problems from a surgery on my arm which had left my upper arm numb and not it was not impacting the whole arm and which would go limp on me from time to time. My family doctor referred me back to my surgeon and a neurologist for review and resolution. My surgeon said that I need a MRI of the shoulder and my neurologist was in agreeance. My neurologist performed a nerve test and made a diagnose of nerve damage but my claim was denied. I had to file an appeal and still waiting for a determination.
On May 6, 2010, I had to go back to the neurologist because my arm is so limp most of the time that while at work I am having to log out when I cannot use my arm and was sent an email by my new manager that really cut deep because she did not try asking questions to what was causing me to have such poor adherence and availability but let me know that it was not acceptable and would not be tolerated. My neuorolisgt said that I have Reflex sympathetic dystrophy (RSD). Reflex sympathetic dystrophy (RSD): A condition characterized by diffuse pain, swelling and limitation of movement that follows an injury such as a fracture in an arm or leg, The symptoms are way out of proportion to the injury and may linger long after the injury has healed. RSDS is also referred to as "the shoulder-hand syndrome, " "causalgia, " and "Sudeck's atrophy." I am again out of work and spoke with “my” disability case worker, Keith Adams so that he could inform me that there is not enough medical information that would support me being out of work and that I would have to file another appeal when the 1st appeal has not been approved and still waiting on the decision. He informed me that this claim again has been denied for the same reason for the last claim. I am to out done with the issues that surrounds this company and all of the other problems that has to be dealt with in reference disability. My doctor advise that I have to go to physical therapy for a month to try and get my arm working and some of the feeling back in the arm.
As of today, I am still in a lot of pain sometimes my back locks up and I cannot move my husband has to take care of me 24 hours a day or my kids have to be with me because I cannot take a case and be by myself. It is so bad for me that I can now seeing a physiatrist counselor because I do not know how to deal with this anymore. No one should have to go through this when the claims are validated by a doctor.
There is another employee on my site that bumped her knee under the desk and has been out of work for 3 years with AT&T with no problems as for me I have to be a work in consist pain and no relief until I can get off and take my meds because cannot take at work because of the effect it has on me. I am on muscle relaxers, pain killers, and Cymbalta.
i have a complaint and i think the way that sedgwick case managers and supervisors handle things is a bunch of bs first of all they talk anyway to you and tell a bunch of lies lets be serious here if your on short term or long term disability you must really have a reason i was cut off from short term disability becaause my disability specialist claims she tried to contact my dr about my return to work date she stated that she tried to call them on six different occasions only for them not to return her call she then told another lie that she tried to contact me at a number where they told her that i did no longer live there thats not true i only have a cell phone so since she said that she could not get in touch with me or my dr never called her back she closed my case now i have to appeal this is f up its a shame how they play with peoples income im so upset right now now i can see how people walk into offices and blow some one dam brains out segwick cms disabilitty specialist in chicago ill are full of [censor] especiaaly melissa mcc ullough and her boss kevin something needs to be done about the way they at sedgwick keep on [censor] on people and f up peoples lives anybody out there listening
This is unreal! Sedgwick needs to be investigated. My husband had a major heart attack in June, and has been told by his care provided that he can return to work Sept 22nd. We just received information that after a careful and thorough review of out request for further payment of short term disability benefits has been determined that our claim does not qualify for payment.
My husband is doing what the doctor tells him to do. We called Sedgwick to find out why, we were told that the doctor office did not turn in the paper work that needed to be turned in. When we called the doctor's office to find out why, we were told that they had faxed in all the paperwork requested and they even have the tranmittal report to show that they did indeed fax what was requested.
Sharon Flectcher with Sedgwick is unable to return a phone call for some reasons. my husband has called and left messages for her 5-7 times, and NOT once has she returned a call.
This is bs, with this kind of treatment, how is it possible for this company to continue. I don't get it. My husband is doing what the doctor has told him to do. When he wass working, the man missed 3 days of work in 5 years(he has been with the 10 yrs)last time he had his review. He wants to go back, but the doctor said Sept 22nd.
What is a person supposed to do? We are not receiving a check now and the bills are still coming in. We have always paid our bills and live a simple life not beyond our means, and now are unable to pay for anything and the food pantry is empty.
As another post mentioned, I do see how people go crazy and go into companys shooting everyone in sight. If Sedgwick is one the news one day, we will know why. This is not right!
Sedgwick CMS would have been better named Sedgwick POS or FTP (Fk The Patient.) One thing that I think hasn't been mentioned yet is that AT&T won't honor the doctor's restrictions unless you get that initial approval. How cheap and sleazy is that? I work outside and my doctor says that all I can do is sit. They deny my claim because I can supposedly sit, and if I can sit I can do SOMETHING. The orthopedic clinic named after my state is also a snow job. (My PCP unwittingly referred me there, and I unwittingly allowed it. I thought two orthos would better than one.) Their doctor saw me for 30 minutes (if that) and wanted to tell me nothing was wrong with me. He looked at the MRI and had to admit that there was something wrong. Once I found out what they were going to tell Sedgwick, I called in and told them that clinic was full of crap and that I'm going for a second opinion. I have an appointment with another orthopedist at a clinic named after a university in this area. (This will actually be the second visit to this doctor, hence the comment about two orthos earlier.)Not only that, I had told my supervisor that I had been reinjured on the job (an aggravation from a previous injury on the job a long time ago which I've been having periodic trouble with ever since) but I feel I did not receive proper attention from my supervisor, who pays lip service to concern for my health. I've long since figured out that the only time this one cares about my health is when it keeps me from doing my job. Sadly, that's more than I can say for Sedgwick FTP.
I want to get better and return to work without having to think about my previous injuries, but my target at the moment is getting that initial approval. The key to the barn must be hidden somewhere on this 5000 acre farm...
I am representing an individual in an ERISA disability dispute with Sedgwick. We just received a very favorable discovery order in Tebo v. PNC, Sedgwick which is aimed at internal Sedgwick claims documents. Is anybody aware of ex-Sedgwick employees who are blowing the whistle?
gthompson@gthompsonlegal.com
www.insuranceclaim-attorney.com
Please please please contact your state's workers compensation agency and ask to file a formal complaint against this company. It is the only way to take your claim away from this company. In Ohio it is an SI-81 I believe. Take action. Take control.
Please please please lodge a complaint to your state's workers comp about this company. In my case, they are my ex-employer's self insured company and I send in a SI-28. The only way my employer can have their self insured status taken away, and that means out of the mismanaged hands of Sedgwick, is for many people to lodge many LEGIT complaints. So, take the time to fill out just one more form and take action. And if they are not self insured, then call your BWC CSS and find out how you can take care of it and if you have a lawyer, contact them as well. Take control of your situation and don't give up. I sure as.. well you know what.. won't.
Did guys tried to file a complain in any government agencies about this? I am worried because I have pending case with sedgwick.
As of 1 Jan 2011, AT&T will be RID of Sedgwick CMS. This does not come as a surprise; however, what happened to the numerous and numerous amount of claims wrongfully denied. AT&T was aware of the unethical tactics of Sedgwick CMS; therefore, a little too late for so so many people. AT&T, this will not clear you from those unethical denials created by the company YOU hired.
I have a complaint with the 3 government agencies that are pending against at&t and sedgwick cms.
awesome insurance-claim-attorney my new examiner whispered things to me and my 2 previous examiners were long-time employees who were both ordered to do wrong on my case to not be homeless i returned to work early and now am sick again due to old work injury surgeries needed due to consistent accidents. Now no one will pay me benefits and sedgwick has been in breach of contract and fiduciary duties since 1/17/11. Class-Action possible? So many similiar severlely disabled persons our trustee is not caring for as required. Stimme law said it well I will email you thanmk you
I would strongly you to read the Diana Jordan v Sedgwick case, which was in Connecticut, in particular the September 8, 2008 court record. The case was settled - Ms. Jordan obviously won, but it was sealed as part of the agreement. Sedgwick did not want this publicly revealed. I am also a person who was victimized by this ruthless group. An attorney I contacted strongly suggested for me to go to findlaw.com in order to locate an attorney who would work with me. The legal remedy is the only way to go. Also, Independent Medical Examiners for Sedgwick can be held accountable. Don't ever believe their "final" decision is final.
I have worked for EBay for the last 6 years. I am a excellent employee, who is dedicated to my job. With that said, I filed a STD claim with Sedgewick 12/11/11 because my feet were swelling and I had pain all over my body that progressively got worse. I literally had to call sedgewick daily. They played the oh we didn’t get the paperwork you sent us, oh we never got the doctor’s paperwork, etc. I would have to call my doctor’s and ask them to fax again, then call sedgewick back frequently. Then they would tell me oh it take 7-10 business days to review. They approved some of my time, but they were always behind, causing me to have to call into work every night. In March the doctor’s finally figured out that I had fibromyalgia. Since the pain was so severe I had stopped moving around and stayed in bed a good portion of days which then led to diabetes. I became severely depressed and anxious. My therapist said I needed to destress and my regular doctor and rhuematologist said it would take time to get the meds right. Sedgewick approved my time until 4/1/12, however they then required me to see a 3rd party therapist and refused to pay me until they decided. I saw the 3rd party therapist even though my family doctor and my therapist said I can’t work yet. I called sedgewick. Heather my caseworker told me that she sent her recommendation to her supervisor which was to deny my claim. I asked why and she said because the therapist said I could work. I had an anxiety attack which is pretty normal after talking to Sedgewick. If I am constantly in pain, can’t sit or stand for long periods of time, have physical therapy 3 times a week, have massive anxiety attacks, and have crying spells, how am I supposed to go to work? The denial leads to no back pay or future pay, no job, and no medical insurance. How am I gonna get my medications, see doctors, and get treatment? Sedgewick doesn’t care. They told me I should have thought about that before I filed my claim. Now I am even more depressed and anxious. How can they get away with this? Something needs to be done.
🐵Cooper I can tell you must be a Sedgwick employee no one would write such favor of a claims management in length. Sedgwick and every other TPA are monster that's there JOB to still the life right out of someone. I have this case manager who has drug my case out for 33 months plain old lazy/denying/foxing/ she is bad at it. Here is good example she has tried 2 x She has hire 2 IME's one from Cancer Institute and one from a major medical center both IME's have stated not at MMI the 2nd IME states pt. needs 3 surgeries before reviewing MMI again. So this case manager who as I stated hired the 2 IME's has now had the case nurse make another appt. to have a doctor at Nextcare to give another MMI. This doctor hasn't seen me since 4/2020 and she thinks he is going to give me a MMI when all he did in 4/2020 was write a OOW slip. So please don't say that Sedgwick is a company that is in business to give every injured employee a fair shake and its the system, or your employer. Your wrong my manager at work ask me if I was going to file suit against Sedgwick for wrongful handling of my case.
If you have a legitimate injury and are following the guidelines of your company and the state laws that apply, you will be paid. It's really that simple. Sedgwick isn't the big bad insurance company. Sedgwick is the third party administrator. All of the companies that use Sedgwick pay them to handle claims and THEIR money.
Most claims have reasons to be compensable and reasons to be denied. There are a lot of cases where it could go either way and it's your company that makes the final decision. In that case, the adjusters hands are tied.
A few points to note:
1. It is YOUR responsibility to provide your medical documents and work status notes to your adjuster AND your employer. It is never the adjuster's job to have to call every single medical facility for each of their 175+ claimants. They would never have time to do anything else if that were the case.
2. If your physician says its ok for you to return to work on light duties and your employer is willing to accommodate those restrictions, you will not be paid lost time benefits if you refuse. If your doctor says its ok and your employer is willing to work with you while you recover, YOU are the one being non compliant.
3. Your adjuster is not going to "look at you and see you are disabled". They actually make decisions based on the medical notes that have been sent to them.
4. Just because you have an injury or illness, it does not mean it is work related. I repeat: JUST BECAUSE YOU HAVE AN INJURY OR ILLNESS, IT DOES NOT MEAN IT IS WORK RELATED. For example, an employee is walking in the hallway at work and felt pain in their knee. They were not pushing, pulling or carrying anything work related. There was no trip, slip or fall. There were no defects to the floor or their shoes. Being at work did not put this employee at a greater risk for injury. Walking is walking. The location doesn't matter and the knee pain would have occurred no matter where they were walking.
5. If your claim is determined to be not compensable it is because with the information provided there is a legal reason to deny it. When you got hired you probably signed a whole bunch of papers without reading them. One of them were the guidelines for reporting injuries. If you feel the decision was made in error then PLEASE send your adjuster documents to support overturning the compensability decision.
6. Believe it or not, If you are entitled benefits, your adjuster wants to issue them. They do care. You have to keep in mind that about 75% of claims are bogus. People take advantage of the system and those people make it harder for the people with legitimate injuries.
7. Most group health providers will not pay for claims until work comp issues a denial letter. If you received a denial letter pretty quickly, your adjuster may have actually been trying to make it easier for you to submit bills to them. If later its discovered it should be work comp, then work comp reimburses you and your group health provider. Either way, it's an attempt to spare your credit and prevent bills from going into collections. This is not always the case, but it is a possible reason why.
Instead of spending so much time complaining about Sedgwick, you should be researching your state's disability or workers' compensation act and get very familiar with it. Also get familiar with your company's policies. Always always always send your adjuster your medical notes and work status notes. Adjusters are not physicians but they make decisions solely based on the medical notes or lack thereof. If you aren't happy with your company's policy, try and change it. Complaining online doesn't accomplish anything. The same goes for the state laws. When it comes to your adjuster, cooperation will produce much better results than fighting, yelling and name calling. If a customer walked into your workplace and started screaming irrationally about how stupid and incompetent you are, I'd bet you wouldn't have a ton of motivation to go above and beyond.
It seems like you only hear the bad side of things. For every person who has had a bad experience, 10 had a good experience. I have seen adjusters fight really hard for their claimants. I know someone who had a claim for a man who worked in a factory for over 20 years. The company policy stated that physicals were required every year. This employee neglected to do so. He was diagnosed with a very advanced form of lung cancer from working and inhaling chemicals. The employee did not comply with the annual physicals that would have found the cancer sooner and he is going to die because of it. For technical reasons and statute of limitations, his claim was denied. The adjuster fought with the employer and convinced the company to pay for his medical fees anyway. He has 5 kids and a wife and he is going to die for his mistake. He was a loyal employee for over two decades and he was so nice and grateful on the phone even though he only has a few months left that his adjuster decided a death sentence was punishment enough and that his wife and kids didn't need to have 100k in debt. The employer has been willingly paid for all treatment just because the adjuster fought for it
Sedgwick is a racket, they are hired by all the big corporations to deny benefits to their employees. Its actually a brilliant move by the corporation, because there is no blood on their hands if the employee sues and wins. No bad press either cause "technically" the corporation is not denying benefits Sedgwick is. That is the exact reason Sedgwick is not publicly traded, their secret would get out with the bad press. It's a win for Sedgwick because they can hire a bunch of GED owning employees to over ride a MD, for no other reason than " It's not enough information". They also know that these GED employees are not qualified to work anywhere else and will work for a salary based on 37 hours per week, but will actually put up with working double that for the same pay. These corporations also pay bonuses to Sedgwick for getting the employee back to work early or just denying the employee benefits altogether. They know that a % of employees won't fight or aren't educated enough to know how to fight Sedgwick. If you have the unfortunate circumstance of being injured and have to deal with Sedgwick, make sure you write down and confirm every correspondence with them no matter by phone, fax, or mail. The second you feel your rights are being violated contact a good attorney. It's amazing how quick your approval letter from Sedgwick comes after a demand letter is sent from a lawyer. It's only a matter of time before we see them on 20/20 or 60min till then good luck.
THIS IS WHAT WORKERS GET IN A RIGHT TO WORK STATE, UNDERSTAND THE STATE YOU LIVE IN IS "NOT"ON YOU SIDE I LIVE IN TENNESSEE AND YOU GET INJURED HERE YOUR FIRED FROM YOUR JOB I WENT THREW THIS BUT I CAME FROM ANOTHER STATE CONNECTICUT WERE WE HAVE UNIONS AND THEY CAN'T DO THIS TO YOU UP THERE SO STAND UP AND SAY YES TO UNIONS.AND THE HELL WITH RIGHT TO WORK WHICH IS TITLE WRONG THAT HOW STUPID THEY ARE.
While working for AT&T I developed chronic migraines and after using all my FMLA was forced to file for STD to keep from getting fired due to absences. My migraines were so severe that they often lasted for 10 to 12 days at a time and I was in and out of emergency rooms regularly until even morphine wouldn't help so I stopped bothering to go. In a three-month period, I had exactly 3 headache free days and frankly stopped caring much whether I lived or died. Sedgwick denied my disability claim (of course) citing as their reason that in the stacks of medical records I submitted documenting everything I went through, there were no test results "proving" that I was actually having migraines. Apparently Sedgwick had hired the ONLY "board-certified neurologist" on earth who doesn't know that THERE IS NO TEST TO PROVE MIGRAINES. Not only did AT&T fire me, but after telling me not to worry since I could apply for rehire in 6 months anyway, they then turned around and decided that I was permanently ineligible for rehire and that was the company policy all along. Typical AT&T--they lied to shut me up until the deadline had passed to file a complaint with the EEOC. And the Union? Sure, I was a member. THEY WOULDN'T EVEN RETURN MY CALLS. A shady company with shady insurance negotiating with a useless union.
Work Comps Harms and Kills Workers. it harms some families generation after generation... NO MORE ...TIME TO reboot the system. What's being done to many workers is criminal...Yet the ones doing the harm, hide behind State Med Tort Laws that protect the abusers. While the injured workers suffer and get driven insane in many case. Some even to the point of suecide/homicide...we have divorces/domestic violence...ect...that are the bad ill ripple effects of this broken comp system that no one, in power, wants to fix. For many are profitizing off the misery of the poor working class who are being harmed by this after years of employment. Employees used up and tossed out after years of labor... Not fair nor just for all... INEQUALITY and back door austerity measures being imposed, all based on a bias gut instinct and not medical facts being made in favor of the corps bottom lines and not in the interest of the injured workers. We need folks to admit it's broken, so that we can fix it so that it helps, and not harms, those it is pretending to be their for. http://moelaw.com/blog/how-a-workers-compensation-adjusters-intentional-delays-killed-a-man/
This is worst thing I have ever been through on a job. I got hurt on the job in March 2014. After realizing it wasn't an injury from the past I reported it to my job as work related it has been hell on earth since then. I have upper back pain which never existed in the past. They cut my pay innjun 2014. Tgen activeted it again in sept 2014. After which they demanded I send a check to catch up my premium for health insurance. Other priorities were more important like rent, utilities etc. So at the end of 2014 att cancelled my health insurance. So since there was no determination made yet whether it was work comp they cut my pay off because I couldnt provide updated medical because they cancelled my health insurance. I had to go to the VA Hospital and start everything over again. As of right now my long term disability is in denied status. The CWA is very weak from reading all the post this has been going on for at least 10 years. So for this to be still happening means the CWA has no power what so ever. They arenjust one of these unions that take union dues for the purpose of enjoying the conferences. Hate to say this but this issue exist because we unfortunately have weak union representation. By reading these many different post it is very easy to come to that conclusion since its been going on for a long time. This problem should be in the past employees should not still be going through nonsense in 2015.
They play games they approve treatment and deny treatment the same days. I received 2 letters dated the same day, one approved one denied. Mileage is never paid correctly they send you payment almost six months later and no explanation of why it's a different amount than what you submitted. Forget about speaking with the adjuster. Hire attorney
Get in on a class action suite against Sedgwick
Eric, I am kind of curious as to how Sedgwick has satisfied your complaint it was quite daming. I can't see that a letter to you would state resolve unless you actually have gone to the doctor and continued with all issues. I wouldn't just take their word for it remember who you are dealing with. Good luck Eric
Take care may your life be alot easier and go as planned in the future.