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AT& T IDSC Administered By Sedgwicks

Posted: May 10, 2013 by    

denied relapse claim

Complaint Rating:  100 % with 2 votes
100% 2
Contact information:
PO Box 14627
Lexington, Kentucky
United States
Phone: 866-276-8878
My name is Beverly Anderson .I am a re-hire since 10/2/2011. In December 2012 I had an injury that triggered an underlying medical issue called Degenerative Cervical Disc disorder. It created pain so severe because of 2 damaged spinal discs, my entire upper right extremities, and could not sit, or type for long periods . I was**approved for FMLA on the initial claim # B225012754000-10. In February 2013, I had a relapse and was ** approved for short term disability, claim # B2250127540001-11, and was under Orthopedic care 2 weeks physical therapy. I returned to work, as my Dr said, too soon and had to leave work early on 3/10/13, I was rushed to after hours urgent care . The issue had worsened, a Surgical Nerve Block was ordered, by the same Ortho Physician, for the recurring, worsened issue. . I was ordered to be off work prior to the surgery, , follow-up and PT was ordered for an additional 2weeks, I was not released to return to work until 4/4/13. (documented )ATT IDSC agent advised this would be considered a relapse because it happened within 45 days of the last claim. My claim was denied, stating the Dr did not provide enough clinical evidence that I should be approved for short term disability . I have appealed and included the US Department of Labor Law 29. CFR 825.306 & 29 CFR 825.307 that states: Under regulations issued by the Dept of Labor, an employer cannot require the diagnosis of the employee or covered relative . Furthermore, once medical certification is provided, the employer **may not** request additional information from the healthcare provider. While the employer may contact the employees healthcare provider for purposes of clarifying and authenticating the medical certification, the contact must be made by the healthcare provider representing the employer "only". 29 CFR 825.307. Not only did they deny a claim that was recurring, it was at a more serious level, and they had the case worker contact the hospital staff before I was even out of recovery, the day of the surgery, the agent Monica Brewer, called my phone before the anesthesia wore off and threatened to deny my claim if they did not get the surgeons clinical notes by the end of 3/20/13, ( the same day of the surgery ) I was off 3/10 thru 4/3/13. and my claim is still in denial. I am of again because the surgery failed and I am scheduled for yet another and am afraid I may lose my job now. This is not legal or fair, Please help Beverly Anderson
Complaint comments Comments (0) Complaint country United States Complaint category Employers

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