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I injured my back while working for Kohl's. Luckily, I had Sedgwick CMS as my worker's comp carrier *insert sarcasm*. The injury happened at the end of August 2009, it is now the beginning of May 2010. The adjusters at Sedgwick will do everything in their power to delay any medical care needed and deny coverage of doctor/specialist visits + medications. The specialists that they do cover (if you are lucky) are hasty in their evaluations and incompetent at best.
I did manage to get two months of physical therapy covered, from October through December. Sedgwick then took it upon themselves to "close" my case without notifying me in January, while I was still seeing my doctor and filling prescriptions, which won't be covered.
Throughout this whole ordeal I wanted a second opinion on my back. Sedgwick sent me to my doctor for another evaluation, refused to pay the bill, and is trying to get me to see the original incompetent orthopedic surgeon for a second opinion?
Another fun-filled game they play is "ignore phone calls for as long as possible." It's a blast, really. You call your Sedgwick adjuster, leave an urgent message, and allow them to ignore you for as long as they can stand it. Leave more messages over a two week period and wait for the call to be returned (if ever).
Moral of the Story: If you get injured at work and they have Sedgwick CMS as their provider, get a lawyer early on. You can also be a fool like me and play their games until the pain wreaks havoc on your everyday lifestyle and then consider a lawyer. It's your choice, but I strongly suggest you don't be a fool.
The complaint has been investigated and resolved to the customer’s satisfaction.
Absolutely I have dealt with my Case mgr. now 33 mths with her game playing. I said I am done this ** has done put a big fork in me the last time. I said I got to find me a SUPER lawyer. I wonder if they have those low and behold guess what. I Googled in the area I live in, and out of approximately 2500 or more attorneys in the state they have 25 SUPER lawyers and I got me one fine one woman lawyer. My manager at Wags made a suggestion and I am going to take him up on that to file suit against Sedgwick for their mishandling of my case and delay of medical care. These delays are detrimental to my health and he knows first hand. I am also going to including the case manager and all other participants. The will make Sedgwick sit up and take note when I am done.
Sedgwick is really bad to work with and my jerk lawyer is trying to get me to resign from my job at kohls in order to settle which isn't right can't leave right now end of dec that isn't even enough time to put in my two weeks notice. Plus I was told their is nothing in the statue of workers comp that says you have to resign from your job. Also he was making fun of me for wanting to stay at kohls hello that's not for you to judge as in the lawyer hello that's why I had to go with you cause your no money to pay you until we win the case for you if I had money wouldn't you think I'd hire an attorney / lawyer.
GRRr
So think sadly I need to find a new attorney some how even though this one has all the details of my case at least maybe go / try and go for another free consultation
You must hire an attorney. I did & won ! Kohl's is a terrible employer. They will not be around like other retailers. That is a fact. No one in their dressing rooms. A lot of theft w/accessories ..
I was at Winn Dixie recently and brke my rt wrist falling backward over 2 empty pallets. Surgery required anesthesia, pain, pain and more pain, pins, plates, co-pays of $400 out-of-pocket n 2 days. The Sedgwich rep called, took my statement and said she would get bk to me when she "...completed her investigation...". So I said "I don't suppose that would mean I will hear from u later today? Can ya feel the sarcasm in my voice? She kinda chuckled under her breath, and said "...as a matter of fact I'm going on vacation next week (April 1st). I could feel her grinng thru the phone. At this point, I began to tell her I live on S.S., wor pt-tme, so far I hv been forced to borrow $300 4 dr visits plus $50 for RXs. I could feel her grinning rt thu the phone! Needless to say, the only person she'll be talking to would be is MY ATTORNEY ON MONDAY MORNING!
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My adjuster is nancy adams I've been on workers comp for 2years because of an injured back. I just saw there doctor this year that shows there stupidity. They appealed my case and lost and the judge required them to pay me my required rate. Only for them to appeal it again. Now with that being said they have stopped paying me until the case is seen. The last appeal took one year. They do not respond to my doctor request for medical assistance. Never returning there calls or responding months after. This been the most difficult time in my life and they have made it so much worse. After this phase of my life is over, i have decided to fight for the rights for the injured employees because of the mistreatment they are given by the insurance company and the employer.
They will call you back, when they are ready. They don't want to talk to you, they won't call. They are liars, scam artist and prostitutes for your employers. Fight back. Get a good attorney and a box of popcorn, sit back and enjoy ride
Sedgwick is a complete scam! These mother F's are messing with the the BULL and I'm going to give them the horns eventually! Had shoulder surgery 5 weeks ago and denying my claim. I climb telephone poles for a living and lift heavy ladders to do telephone repairs. These yahoo's have no medical license to approve or deny a medical claim but somehow get away with it daily! WTF! Welcome to America! Land of the Free. What a disgrace the way they treat humanity! To be continued...BTW, customer service is non-existant!
I agree! The adjusters will ignore phone calls, tell you they do not have the information from the Doctors, and then it appears suddenly when you fax the information they say they do not have. I've had enough after 6 months of being ignored, I'm going to the lawyer tomorrow.
this happen wen we had the tunado on [protected], i got hit in the head an back? at kohls on germtown rd.
i got hurt at kohls too you right they dont pick up the phone or call back?last year in july 7-30-09 an im getting bill from were they sent me wat to do? ms. kohls ins.sedgwick cms not doing there job?