Sedgwick CMS / short term disability

KY, United States Review updated:

I injured my back on a trip to S.D. There was no accident, but I've been fighting my back problems for almost 20 years (from work injury). I filed for short-term disability Aug. 17th 2010. It is now Oct. 18th 2010 and still no results. I was told it was denied because of "lack of info from the Dr.) I sent in 3 medical reports, and was told they don't have them. It is in appeal, and won't be decided intil Nov. 25th 2010. Where are my records I sent in? I was standing right there when they were sent. I am entitled to 22 weeks full pay and 11 weeks half pay, but right now...I'm not getting any pay. What is the problem here? I can't work because I'm still under Dr's care. I'm "very" dissapointed in them !!! They are very rude and don't give a hoot about you.

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  • Je
      Jan 08, 2009
    Sedgwick Cms - Rocio Lopez Alcala!!
    United States

    My Gosh!! this woman (girl) has given me the run around, she speaks in a very, very low voice over the phone so you can't hear her, she won't take down valuable information when first hearing a claim, then treats you like dirt. I hope she has some idea of the damage she does so carelessly.

    0 Votes
  • Ek
      Aug 02, 2009

    Jean are u employed with ATT I would love to hear more about your complaint email me [protected] subject sedgwick

    0 Votes
  • Ro
      Jun 13, 2011

    Is the same type issue Iam going through, since march 6, 2011.

    0 Votes
  • Or
      Mar 04, 2012

    so what happen to your claim for your back?

    0 Votes
  • Em
      Feb 16, 2013

    I have to agree with the comments posted. Sedgwick CMS is horrible. I have Daisy Lopez as my examiner for my claim. I have a herniated disc and have been out of work since January 2. Daisy Lopez doesn't return phone calls, she doesn't send my checks out like she's supposed to, and to add to that she never changed her voice mail phone New Years. I recommend that any one having problems with this company call their corporate office immediately.

    -1 Votes
  • Ou
      Jul 03, 2013

    I agree also. on jan30 2009 my employer force me to take FMLA from my job.HR filed STD sedgwick denied stated they doesn't have enough medical info from my DR. in march 2009 i was told this this was a worker compensation case they can't pay me benefits. may 2010 my work comp ended with 5% MMI i didn't get all my payment . in June 2011 i received LTD benefits i was told they still owe me payments for monthis before i started receiving SSI and he will get that check out to me two weeks later i called asking when should i expect the check i was told all my benefits has been paid and I'll only get my monthly check. I've had three surgeries last one Sept 2011 and pending another still not able to go to work. they are no good company very rude

    +1 Votes
  • Ka
      Jan 17, 2014

    I am having issues with Sedgwick. My claims examiner is Kelly Pivaroff. In my opinion she is rude and not truthful. I called Head of Labor & Industries to file a complaint. Really no luck, because Sedgwick is a third party, not licensed thru L & I. Is there anyone that cares about the treatment we get from these people?

    -1 Votes
  • Ra
      Mar 18, 2014

    +3 Votes
  • Ja
      May 18, 2015

    Kelly Pivaroff is my adjuster for Sedgwick and she did a wonderful job managing my claim. My checks were received promptly and she was very pleasant to deal with. She is very caring and kind hearted. The problem I have now is my claim was transferred to Greg McPherron and everything has gone downhill. I do not receive my checks any longer, he is very hard to get in touch with and when you do, he is rude. I have requested Kelly to continue to manage my claim and Greg said "you get what you get and quit complaining" In my opinion, he is rude! Kelly where are you? No one will transfer me to you and I need your assistance.

    0 Votes
  • Mj
      Aug 04, 2015

    I am a United Healthcare employee that has applied for short term due to a severe medical condition. My claim was denied due to my provider not sending enough supporting documents (which I understand). However a peer to peer was requested. I reached out to both doctors that I see, only to find out that one provider did not receive a call at all, and the other received only 1 call. My case worker said that it was documented there were several calls attempted and voice mails were left. After speaking to my doctors again, I found out ALL calls and messages are recorded and logged and there was nothing. Its apparent that there is a quota Sedgewick employees must meet so they FALSIFY notes and close out the claim. Now I have to appeal, and my doctor is aware of the situation as well. Has anyone had this issue yet? Any suggestions? I'm thinking at this point maybe a complaint with BBB and/or attorney or contacting a government regulator? Can anyone help? Thank you in advance.

    0 Votes
  • Br
      Sep 01, 2016

    I filed a claim with Sedgwick my point of contact is Patty Dooty. My claim is a terminal Lung Disease, I'm working with the best doctors in the country (Yale and Brigham and Women's) and am currently in a study for a new medication that has shown great results in lab animals, we are the first humans to try the new drug which is done intravenously once a month. My doctors have bent over backwards to help me with Sedgewick informing them that my disease is terminal there is no cure. Sedgwick still requires monthly updates on my condition and what I'm doing to return to work. and when we send them the information they requested they say they haven't received it but when I put Patty on the spot because I asked for the fax received confirmations and told Patty I had them she checked again while I was on the phone with her, she said she would review them the next day. I got no response and my check was short due to her not updating my claim. I am also a Disabled Vietnam Era Veteran. I am at risk of losing my company paid Insurance and with my medical bills that would ruin my life and family. This after 35 years of service with General Dynamics, Electric Boat Corporation. In what Country due we allow a company like Sedgwick to EXIST!

    +1 Votes
  • Sm
      Jan 11, 2018

    @breavis I totally agree!!! How does this company continue to be in business. I am having the same problem with this company. The fact of the matter is they just don't want to have to pay any claims. They want to take your money for the insurance you take out but heaven forbid you have to actually file a claim with them cause they will make it as hard as possible for you to receive any of your pay. They find every excuse there is to deny your claim including lying to you. I am going to contact the Insurance commission and the BBB and see what steps they say I can take. This is ridicules.

    0 Votes
  • Ky
      Apr 02, 2018

    I would like to know if anyone has ever gotten paid??? Ive been denied twice & have decided to Retain a Lawyer.. Ive done everything Ive been asked to do & Sedgwick keeps finding reasons to deny my claim.. Is there anyone that has been paid by Sedgwick & how long did you wait???

    0 Votes
  • Cr
      May 02, 2018


    0 Votes
  • Ky
      May 02, 2018

    @creighton jones How do I get the Info for the Suit ??? I have been off on Short Term disability since August & I have Not Received a Single payment, it is Now May... They continue to deny me.

    0 Votes
  • Ky
      May 02, 2018

    I am interested in The Class Action Suit Please Email Me Any Info & Instructions you may have. Thanks

    0 Votes
  • Dn
      Oct 06, 2018

    My experiance with Sedgwick gas been terriable. had surgery over a month and a half ago and have not received my short term disability as on writing this (10/6/18). I have contacted my case worker severals times and get the run around. I ask to speak to a superviser and nothing. This company is horriable. I would like to be apart of the class action suite as well.

    0 Votes

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