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Sedgwick Claims Management Services / short term disability

I had to go on Short term disability for a heart condition, I was undergoing to undergo surgery and treatment. Sedgwick requested for paperwork to be faxed by my surgician and cardiologist several times; they claimed they never received it any paperwork. After two weeks of going to my doctor to verify if the paperwork was faxed, I decided to take the paperwork to the UPS store had them fax it . Sedgwick, admitted to getting the paperwork, however it was not filled out by the medical doctor the way SEDGEWICK wanted it filled. This took another two weeks, in the meantime, SEDGWICK denied the claim for lack of medical substantiation.
I requested to speak to a supervisor the representative said there is no supervisor or manager that I can speak to that can help me. I wanted a clear answer as to the reasons of denial and appeal process.

Next step,
I called Human Resource for Express Scripts to report the abuse and how its impacting my health. Express Scripts HR supervisor called SEDGEWICK to investigate the delay in the process. SEDGEWICK seemed to be more cooperative towards me, I got answers regarding appeal process and this time the medical documentation was enough for the appeal.

At this point, you might assume that SEDGEWICK started being professional by providing good customer service. NOT! I was told that the denial is final, although the appeal is still pending. In addition, I was told they are doing everything legally within the law. I am still fighting for my benefits 6 weeks later.
I am starting to seek for an attorney to assist me with securing benefits.

Ef
May 31, 2018

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