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Sedgwick CMS / disability benefits

1 CA, United States Review updated:

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.

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  • Ci
      8th of Feb, 2009
    +3 Votes

    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

    disatified worker

  • An
      27th of Feb, 2009
    +1 Votes

    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.

  • Dh
      30th of Apr, 2009
    +3 Votes

    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.

  • Sl
      6th of Jul, 2009
    +2 Votes

    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...

  • Ek
      2nd of Aug, 2009
    +2 Votes

    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 and in subject place sedgwick

  • Do
      13th of Aug, 2009
    -3 Votes

    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

  • Ub
      17th of Oct, 2009
    +1 Votes

    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!!

  • Te
      6th of Nov, 2009
    +1 Votes

    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

  • At
      12th of Dec, 2009
    +2 Votes

    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 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% ...

  • Cr
      27th of Jan, 2010
    -2 Votes

    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

  • Ac
      16th of Mar, 2010
    +1 Votes

    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?

  • Da
      19th of Mar, 2010
    Best Best Advice +4 Votes

    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.

    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.

  • Ha
      26th of Apr, 2010
    +2 Votes

    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.

  • Do
      20th of May, 2010
    0 Votes

    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!

  • De
      1st of Jun, 2010
    +1 Votes

    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.

  • Jw
      7th of Jun, 2010
    +1 Votes

    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.

  • Ca
      20th of Jul, 2010
    0 Votes

    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

  • Se
      14th of Sep, 2010
    +1 Votes

    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!!!

  • Bi
      16th of Sep, 2010
    +1 Votes

    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...

  • Ge
      13th of Oct, 2010
    0 Votes

    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?

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