Sedgwick Claims Management Services
reviews and complaints

So I was provided with what you call request for reimbursment of expenses supplemental job displacement forms so gina caudle who is currently my adjuster I was told that which ever I decided to do with it the expenses would be reimbursed if I provided receipts ok so I was reimbursed for my laptop so before I used my money for school I provided her with school info etc. She told me and I have proof that go ahead and pay out of pocket and she would send me back my money which was $4000.00 so I did after I send her the proof of completion she tells me sorry I cant send you the money I explained to her why if I did what she asked me to do I told how was that ok she told me well I dont know what to tell you tell them to give you your money back I was shocked and lost for words I told her that I beleive that she should explain to her boss that she made a mistake and provided me with wrong information I need my money back how am I supposed to ask for my money back thats absurd I then told her I would speak to my lawyer she said then go talk to your lawyer

My name is Ray Armour from the King Law, our office represents Nateisha Fullwood in a personal injury matter. Our office has sent the medical package to Debra Romero on JUne 7, 2021 Ms. Romero had family leave and Ms. Janet Galbreath claims to try to resolve this matter. The claim number is [protected]-GL we have not heard from any one or have they sent any emails regarding this matter in 6 months or more? When you call her on her phone the voice mail states she is on the phone on the first ring this continues all day I have tried to reach her 4 times in one day never to have any all returned and my boss has tried also.

File# 4A22037JTQK-0001

Injury occurred on 3/07/2022 at the CVS Pharmacy store in Helena, Montana. I was shopping and fell. My orthopedic physician and my physical therapist have completed their care related to my injuries. I still have limited range on motion in both my right shoulder and right hip. Right ankle remains more swollen than the left ankle due to the fall.

I have received the final documents from CMS/COB&R.

My yearly FMLA ended in 11/22, I received a notification for extension. I responded yes, got the paperwork filled out & return on 10/20/22. Received a text stating I was approved from 11/04/2022 through 11/03/2022. Then another text stating if extension is needed submit in 20 days. 11/14/2022 I opened a new claim, new paperwork was returned by 12/01/22. On 12/06 received a call stating my doctor missed #8, doctor completed #8 & returned on 12/07/22. 12/23/22 I was told on12/20/22 the paperwork has to be resubmitted & reviewed. I've been called stating days was denied for days I didn't report.

This grievance isn't about a specific date or name. It's more of a "more than 60% of the phone calls to Sedgwick about my temporary leave resulted in different answers from the different Sedgwick associates manning their company lines". My temporary leave began on September 26th 2022 and was originally dated for October 31 of same year. My first leave ever. I certainly did not have any guidance from my specific Walmart store so did not realize I was only making my requests difficult for me as the suggested specialists i needed to see would not be able to accommodate such a short leave. So having to repeatedly contact Sedgwick to extend my leave resulted in pay interruptions. Walmart company uses Sedgwick as their claims service company. A couple of things i am realizing is 1: Sedgwick does not update my claims file with pertinent information like who took my call and what was said or information they gave. 2: Because their records on my claims are not updated and they give out information associates on leave want and need to hear, when asking to complete said survey I gave a thumbs up because i believed them. Now, over this temporary leave that dates to December 31st, i am not being told the same information. For example, on December 5th 2022, I called to make certain my pay leave had been approved and would drop on December 16 (told this) to today, December 15th, am told December 22. I am a single income that is going without pay from November 21 to December 22. I cannot get to my physical therapy appointments without money. Please help Sedgwick to understand consistency and updated records are a must for associates on leave. If this isn't part of their claims work, what is? I am Debbie Jones and my phone number is 903.219.1466. My win # for Sedgwick is [protected]. Thank you

On 11/09 I filed a claim for STD I have been having neck pain and needed surgery. The agent assigned to my claim lied and said he tried to contact me but was unsuccessful. He never contacted me and denied my claim. I would have to file a appeal I just had major surgery on my neck 11/29 He denied my claim on 11/30 No communication was sent to me and I was told that a Nurse Care Team member would call me none of that happened. I called and a Employee in Advocacy Services Dept named Jacqueline hung up on me because I'm not supposed to be upset about this apparently. I spoke with another employee named Sara who made me aware that no one even looked at my appeal paperwork I submitted 3 days ago when I received a text message saying someone would be calling me back 2 days ago. They have treated me very much so like trash and I will definitely be letting my employer know asap.

I have not received my payment since July 2022. I am waiting for my payment from July to November 4th. My claim rep keeps telling me the supervisor is reviewing. It’s been over two weeks.

I received a call from a nurse and when I called back, I was transferred to Kaiser?!?! I tried calling again and they said they didn’t have any record of me calling. When I asked to speak to the nurse again they said my claim was with the supervisor. I received a message from my rep saying they didn’t have enough justification to approve the claim but my doctor has provided all the documentation they have requested and even called and left a message. Still waiting. Rep advised me to have my doctor call the general number! And then what? No Instructions on whom to ask for, nothing! This is ridiculous!

waiting on my checks for 3 wks. It was coming regular in Oct. it started coming later and later, they say it's the postal service, then they say they're waiting to see if I cashed it well it doesn't take 3 wks. I'm glad they're receiving their check cause I'm not . They're just telling LIES to try and make people happy. I hope they have a wonderful Christmas because I'm not. I can't even pay my bills. now they're saying my checks come from Ca. and Ilive in N.C.. Well if they do come from Ca. what in the hell happened? Like I said one LIE after another

My claims examiner Marilyn Mack had been unresponsive to my questions. She contradicts herself thru email and will not take my phone calls so we can discuss my case and my concerns. I am being paid but my providers are getting very rude responses from her. I was contacted by One Call Care Management which is a vendor of Sedgwick. They set up my PT appointments and after 2 appointments Sedgwick denied payment to the PT by saying I could not set up the appointments myself. I explained to Marilyn that if was her company/vendor that set up the appointments. She continued to say my PT was not in network. I have been leaving phone messaged for her that are never returned and emails are short and vague and does not address my issue

I have been on workman’s comp since May of 2022 & it has become a full time job. I do not feel like my new examiner is there to help facilitate my recovery. My first examiner was great. She went above & beyond to help but then they switched my examiner on me 6 months into my claim & it has been nothing but a hassle. Her name is Ciara Gilpin & she has no empathy or compassion for the situation at hand. She sends authorizations without following up & I end up finding out from my Physical Therapist that she continues to send the wrong forms/authorization over & over even after I inform her. So I have to leave emails & messages on the portal to tell her that she needs to send the same authorization that was always sent & not switch it up. My Physical Therapist has a protocol to go by just like Sedgwick does. It took almost a month for her to send the right authorization & in that time I had no PT on my shoulder & it froze up on me. She claims she doesn’t get the new scripts which I know they were sent because nothing has changed except for her being my new examiner. And I call my doctor & they tell me it was sent & they give me the dates. So I have them send it again. This never happened before. I feel like my recovery is being prolonged due to her negligence. I spend so much time dealing with all this when I should just be focusing on my recovery. I just had an IME appointment & the doctor suggested I get a cortisone shot in my shoulder to free it up & in my finger that is locking up on me due to my shoulder injury. Which has been a Sequela injury that occurred from my shoulder injury a month after I was injured. And now her exact words to me are “As for the cortisone shot for your finger, that will not be approved due to your IME report findings. Thanks!” No empathy whatsoever. I am very frustrated. I was injured on the job & cannot work & only make a fraction of what I was making. All I want to do is heal & get back to work. I should not have to do her job. She should follow up to make sure what she sends is actually right & it goes through. That way there is no glitches in my recovery. As soon as I send my work release from my follow up appointments with my doctors there is ALWAYS a new script that follows. You know this because my work release is still to not return to work. And if she doesn’t receive the script like she says right after I send the work release then she should call & see what’s going on. That would be caring. Instead I just assume she gets it because I know my doctor sends it & when I remind her to send the new authorization she tells me she never received the script. My question is why doesn’t she let me know she hasn’t received the new script within a week of me having my follow up? Or why hasn’t she called the doctor? It is not my fault that I was injured & I expect to be treated as so. Sincerely.

He is my claim adjustor for over a year & I have only spoken to him ONCE. He does not respond to email or voicemail & most things I need have to go through him. I am still under workmens' comp so they will only do what he approves but since he does not respond to anyone I have been waiting around with no way to actually resolve anything. It is a very bad way to do business and is very frustrating as I have been extremely patient.

i request a loa for medical family care . i tarveled out of my state to suppor a family, sedwick is asking me for my medical documents and they decline my LOA, i was not the person tha was sick , i can"t understand why they are asking for that and denied my LOA, i need somebody rewiev my case please, thanks,

Berta leon

walmart hourly associate

W#[protected]

LOA DATE: 10//22/2022

Claim #:4A2210R0GF10001GL

My name is Surayya Benjamin. My storage was compromised. I filed a claim. I sent the pictures, police report etc. I have had three different claim adjusters and they all have the same attitude which is not responding to the emails nor the calls. I have emailed and called daily for months. It's frustrating having to have an unit compromised (some items will never be replaced) and not giving the updated or just to speak with someone is unacceptable. I have contact BBB to help as well.

I have a claim that Sedgwick administers on behalf of AT&T. My claims examiner is non-responsive to my dozens of emails and phone calls. I would appreciate someone giving me a response on my claim. AT&T did the work laying fiber in our neighborhood. This caused a wash out under my driveway and required repair. We filed a claim over 2 months ago and our "claims analyst" has been non-responsive to my calls and emails. We have submitted all the required paperwork, photos, etc that they required to be sent to them in 14 days. Yet, they can go quiet on you for over 6 weeks with no recourse. The fact that AT&T allows this to their customers is unbelievable. This is poor customer service!

April 22. 2022 - My primary care physician took me out of work due to stress and anxiety. At my appointment the date before my blood pressure was 170/110. I was informed by Sedgwick i had to be seen by a physiatrist within 30 days. I have been seen by 4 physiatrists and I am in Therapy with a talk therapist since I went on LOA. Sedgwick has so far denied my paid FMLA claim they did however approve my unpaid LOA. I am continuing under a physiatrist and Therapist. They always have an excuse why they deny my paid FMLA claim. I need help to be paid for my time out of work due to stress, anxiety and PTSD.

On 07/29/2022 Im delivering freight. I go in the Truckers break room. Employee comes to me is that your truck you might wanna take a look. I go outside Truck is leaning to the side. I go back in to the check in clerks window . She says we had a accident. Management told forklift driver to use pallet jack but shift changed and worker used forklift. Ill let you in Secured warehouse to take pictures. Forklift has crashed onto Truck. I file claim immediately. I was not even near the Truck when negligence happend. 1 week later Sedgwick is handling claim and fault is clear. The company they represent is contacting me hey our vendor couldn't fix as parts have been discontinued you can have your insurance come get it. Sedgwick comes in separate communication. We can fix it in 2 days this is 1 month in. Offerd the price of rental truck for 2 days and payment to get it fixed. I decline immediately. Send a letter to Sedgwick and Company they represent stating what happened and price for rental and price for same Truck along with 90 days of companies invoices in a spreadsheet as im a Owner Operator but also have contractors drive rental Trucks . Now i get a different adjuster who promise to get Truck fixed by outsourcing parts. For a month trucking going to be pick up and towed to shop. Finally adjuster says truck is in the shop being fixed. I ask for damage report they give me nothing. Finally I file complaint with Insurance Commission and get a lawyer. I asked for copy of policy adjuster will not comply. I say its for Insurance Commission Investigation still nothing. insurance commission contacts me hey we need the insurance info since Sedgwick is just a third party. I email adjuster agin to get info nothing and still no damage report . So adjuster comes back hey your Truck is fixed and has been returned to the facility where accident happened over 200 miles away and 62 days in. I state since I have no income for 2 months and paid company bills for August thinking claim would be finished theirs no wayI can come down their. Meanwhile send damage report and oolicy info. They send a invoice estimate of supposed work done. My lawyer advised me to pick up truck since they fixed leaf springs but not rest of rear suspension for boxtruck. So i pick Truck up. Truck is wobbly shaking jumping and hard to control. Almost crashed multiple times. No way I could haul anything. Plus Company stole my pallet jack and straps. So i get it to parking lot near home. Email adjuster truck is not fixed she swears it was fine when they dropped it off. Tells me send repair estimate from my mechanic. Also to have Insurance Commission contact her. He is steaming and says add them to email thread. Meanwhile I submit actual rate cons for loads Ive personally done not from contractors I hire. So I finally get Truck to my mechanic he went underneath the parts they fixed is still broken. Probably other things as well especially since you drove with it broken

The worker Rick Pope has been making false statements to my employeer.. he has been relaying them wrong information and refusing decisions from a workers compensation law judge.

Advising my employer I do not have a valid WC claim when I do and it has resulted in over $200,000 in lost wages as well as being wrongfully terminated due to a work related disability.

I had two hand surgeries this year to repair tendon and nerve laceration. Surgery is a small part of this type of repair with immediate commitment to physical therapy as being equally important if not more so any positive outcome. My job is 90% typing Sedgwick repeatedly denies my STD claims in the past 2 mths. My surgeon spells this out but Sedgwick LIES about receipt of paperwork. Their job is to make sure employee gets to collect their benefits. It's frustrating, unnecessary stress, even leading to bankruptcy in extreme cases. I do not know how this company is allowed to operate legally.

Hi my name is Maria Rodriguez I have been dealing with my claims management for the last two months and i am not very happy with him when i try talking to him he talks over me to where dose not want to here me out I feel that I am being discriminated against because of my name I have been getting paid every month around the 12 every month and know he wants to pay me where when every he wants to and because of him I am behind on my bills. I dont remember his name because I have had to deal with 4 claims Managements in the last 7 months.

On September 3, 2022 I brought my vehicle to National Tire and Battery in Houston, Texas for a simple oil change. The service technician improperly installed the oil filter resulting in a total damage of my engine. I immediately filed a claim with their insurance company Sedgwick. However, I have discovered that Sedgwick's primary practice of handling claims is simply to allow your claim to drag out with little to no communication from the claims adjuster or representative, it has now been a month and two weeks, and I have heard absolutely nothing from them. It is no wonder that Sedgwick has a D-

rating with the Better Business Bureau.