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Sedgwick Claims Management Services complaints 390

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6:38 pm EDT
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Sedgwick Claims Management Services I'm complaining about getting approval from Sedgwick to use my CA Worker's Compensation SJD Voucher.

Im Ahmed M Abdelkader, claim# WC20171085853. I have a CA Worker's Comp. SJD Voucher issued by Sedgwick 14450 long beach, claim rep., Eric Rice. I called Mr. Rice to have him send Sedgwick approval to DCE at UCI as my training provider in order to finish my course enrollment. I was told that he isn't and wasn't my claim rep. to begin with.

MY email: [protected]@hotmail.com

Phone# [protected]

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9:24 am EDT

Sedgwick Claims Management Services case manager not returning phone calls or messages on open claim

I am on medical leave due to my type 2 diabetes being uncontrolled. I am seeing an endocrinologist. I uploaded paper work from my Endo doc and I have been trying to reach my case manager to see if there is anything else she would need and to give me a status update. My endo doc wants me to stay off work until we can get my blood sugars under controlled. I had originally submitted my LOA form from my PCM, but my Endo doc doesn't agree with me returning back to work. I am very upset that I can't get anyone to call me or message me. If you look in the communication box you will see my questions. Cory N did try calling but did not talk to me as it was expressed in his message.

Desired outcome: my leave extended as per my endo doc and back pay from April 12th.

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6:13 pm EDT

Sedgwick Claims Management Services Case manager neglect

What is the point of having professional case manager Working for you when all they do is call and hangup no conversation with your case manage.

Desired outcome: Do right by your customers We pay this insurance under our company's care...

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2:38 pm EDT

Sedgwick Claims Management Services incompetent employees

claim # [protected] I was medically retired from L.A.C. Sheriff. I am now having a problem with my back(reason for retirement) At the start of trying to get authorization to see a doctor I had to contact 6 representatives before one would help. I was assigned to rep. fahimie who did not seem to know what to do. She then went on vacation without making anyone aware that things needed to be handled with my claim.. I contacted supervisor bell who stated she would see that the authorization be sent to my doctor on Friday 4/29/2020, she then took time off and also did not make any one aware that the authorization need to be sent. I tried to call Sylvia, bells supervisor, but she was out of the office also. I finally was able to talk to Christian who said the authorization was confirmed on Thursday 4/28/2022 and would be send to the doctor next week. did say he would have the authorization sent to today(4/29/2022)

Desired outcome: I want another claims Rep assigned and authorization sent to my doctor,(Dr. Goff) to treat my back as he sees necessary now and in the furture.

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3:49 pm EDT
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Sedgwick Claims Management Services disability

I had out on sick for my back pain on 3/9/22. Then I had reported short time disability on 9/16/22. I was able to provide completed disability form by my doctor in time to get my pay without interruption because I had five days to provide those documents. In that form clearly stated that the patient needs to be reevaluated after five weeks of physical therapy, and follow up visit day on 4/13/22. In 4/5/22 your company send me email asking for more clinical information which I do not have because my appointment with doctor is on 4/13/22. I send email back to them explaining just that and resend the same forms I had send before. Then your company approved me until 4/13/22 which is the day of my follow up appointment. On the day of that visit, I could only get a return-to-work date form completed because doctor’s office said that they need 2 to 3 days to get the clinical report updated into the system. So, I had uploaded the return work date form. The form said I am returning work on 4/18/22. Now I did not get paid for 4/14 and 4/15. This is my problem. Your examiners are not acting like human. They are acting like robot, repeating the same thing again and again.. Your company said that examiner need five days to review. This is my question; Don’t you think that you have to approve at least five days after the follow up visit day to do the paper work? So I can get pay without interruption? You expect me to get the clinical information on the same day of the visit? Even I did that, you need five days to review. Is that make sense to you? My life depends on every week pay check. Now I have to pay late fee for credit card bills. It seems like your company purposely giving me hard time. You are forcing us not go out on sick. You are forcing us to go back to work without completely heeling our sickness. Your reps do not seem to care. I am not sure who is responsible for this thoughtless practice. This is not the first time your company did this to me. This need to be corrected. Those examiners have to trained to have some common sense. If I could, I really need to speak to someone about this. I am really upset. We do very physical work. We always get hurt. On top of that you want to punish us without paying us. Heatless.

Desired outcome: I need get my two days pay, the practice need to be reviewed and fixed

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3:45 pm EDT

Sedgwick Claims Management Services Claims Amount Incorrect and Mode of Payment

My partner and I are Singapore tourists who went to Canada from 29 Jan to 13 Feb 2022. We bought a 6 day ski pass at Whistler Blackcomb. My partner suffered an injury on Day5 and we stopped the trip, went downtown to see a doctor. We followed up with a Doctor review in SG again. Sedgwick asked for Doctor Memo (in their format), which we requested the doctor to include details as required.

We submitted a claim to refund 1 day cost, and after multiple emails over 3-4 weeks - they finally approved it. But:

1) The amount refunded was different despite the ski pass being the same cost;

2) We asked for a refund on our credit card or a remittance as we are overseas, but they issued a Check instead. (Cost of cheque clearing would eventually almost nett off the claim amount).

I have emailed then about 10 times without any reply.

Desired outcome: 1) To obtain the same anount of refund and 2) to directly refynd back to the cardholder For example, I paid for the 2 tickets but why is the refund going to each ski pass holder’s name instead of whoever paid for it?

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12:21 pm EDT

Sedgwick Claims Management Services Auto claim

Claim number 4A21120D0WJ for claimant vehicle 2021 GMC Sierra belonging to Jim Owens. Dawn Alamanza is handling this claim and is not responding to numerous contacts asking for a reply for over three months. Dawn's phone number is [protected] x51084 and her email is dawn.[protected]@sedgewick.com.

The following is copied and pasted directly from my file documentations of the numerous attempts to get a reply. In addition to calling Dawn I have pressed zero to be switched to another representative to handle this - more than 40 times on two phone calls with no answer - either the next person was busy or didn't answer the call at all: [04/19/2022 11:35 AM / PHIL]

Called Dawn Alamanza again - VM LM Hung up - called back - dialed 0 another 20 times - no answer at all.

[04/05/2022 01:45 PM / PHIL]

Called Dawn Alamanza again - got her voice mail - hung up and called back - dialed 0 for the operator - four consecutive extensions were on the phone, hung up and called again - pressed zero at least 20 times - each time the extension was unavailable - called back and dialed Dawn Alamanza's extension and left a firm message to call back. CC'd Jim Owens. Called Jim to let him know what's going on - VM LM

[03/10/2022 09:23 AM / PHIL]

Called Dawn Alamanza [protected] x51084 VM LM - I've left messages and sent emails - what do I need to do to get it paid?

[02/24/2022 12:04 PM / PHIL]

Sent email again to Sedgwick

[02/02/2022 11:34 AM / PHIL]

Called Dawn Alamanza - VM LM

[01/27/2022 10:50 AM / PHIL]

Emailed the final to dawn.[protected]@sedgewick.com for a second time

[01/20/2022 11:35 AM / PHIL]

called owner to let him know the don't pinch your fingers stickers are here. Asked him to come on a warmer day bcz stickers don't stick well to very cold surfaces.

[01/14/2022 05:25 PM / PHIL]

Emailed the final to dawn.[protected]@sedgewick.com

Desired outcome: Get somebody to wrap this claim up and get us paid - ASAP.

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Denzelle1
Philadelphia, US
Jun 18, 2022 4:49 am EDT
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Interested in pursuing a class action lawsuit?.

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1:18 pm EDT

Sedgwick Claims Management Services Disability claim

First, I would like to say how appalled I am at the way I have been treated through this claim. My adjuster Rich is very rude and has showed zero empathy at all in my situation. I have suffered through unmeasurable grief and trauma that back in August-February and this claim has not helped at all. I lost my brother and Irish twin to the COVID delta variant, had to identify his body and handle funeral arrangements to only a week later my mother having suffered a stroke and having to have surgery to finding out she has stage 3 cancer. I am a single mother of three kids and have had a hard time keeping composure for them. I have a 12, 13-year-old and 15-month-old. In front of them I try my best to stay strong and do the everyday tasks necessary but even myself is human and I failed at functioning at everyday life. For over two months my family members had to be here full time to assist me in taking care of my kids as I did not want to get out bed, eat or sleep. I still to this day suffer from extreme insomnia and break down in anger and crying in random places and at random times. I hid in the closet to cry so my children wouldn’t see it. I gained 60 lbs., my hair has fallen out in unprecedented rates, and I have zero motivation or joy in much of anything right now. I did not get a chance to say goodbye to my brother. His girlfriend didn’t even tell me or my mother he was even sick or found unresponsive in his bed until two days later and it was already too late to talk to him or see him as he was in covid ward. My whole life we grew up as twins and did almost everything together. His loss has gutted me to my very core. The pain I feel daily is indescribable. No one will ever be able to understand the level of pain and depression I feel on a daily basis.

The timeline of the events is listed below:

- Aug 12 (Taken out of work after Bereavement period expired)

- Aug 11 & 17th called my doctor advised there is no appointment available for Dr. Brown or Davis until Jan or Feb. Advised Kalman available 8/30 (accepted appointment)

- Davis office cancelled and rescheduled appointments several times. I was able to keep up treatment with Kalman as his scheduled permitted. Kalman advised he would take me out of work until I am better and can function at work. (8/30). But would need to make appointment with Psychatrist for medication management and get back on meds.

- Sedgwick: 8/12-8/30 denied due to delay in treatment. 9/1-10/11 approved and paid with on going benefits approved until 2/2022 in portal with updated treatment notes.

- 10/18 filed appeal for Dates 8/12-8/30; First level appeal reviewed and denied due to delay in treatment even though disability papers filled out by MD was back dated to 8/12. When appeal denied for Dates 8/12-8/30 Adjuster denied everything from 10/12 on stating medical did not support disability despite previous approval.

- In late January a ADA claim was filed on my behalf and they approved everything from 8/12- 2/14/2022 advising notes supported disability.

My doctors have attempted to reach out multiple times for peer to peer with no avail as schedules between my doctors and peer adjusters have not been available at the same time. They have filled out the forms several times supporting my need to be on disability while sorting through and dealing with the trauma that I have faced and continue to face. They have submitted treatment notes, formal letters and are just as aggravated as myself as this situation and yall’s inability to understand the large case load they face due to Florida being on of the top states absolutely devastated and turned upside down by the COVID 19 pandemic. I should not be penalized for the fact that your peer adjusters have not made themselves available to my treating physicians when they have attempted to reach out. Not only have yall added stress and caused damage to the progress I was making. You have caused me to not be able to take care of my kids like I should and have caused devastation and financial turmoil delaying this process. This has been unethical and appalling in how little yall care about the well being of people. I pray that one day yall feel the pain and trauma I have suffered through so someone can belittle your mental condition and cause you to lose everything and not be able to take care of your kids basic needs. Shame on you! I have spoke to several attorneys who have advised me I have multiple claims stemming from those actions taken on this claim. I really don’t want to go that route. I just want what is due to me yall have been with holding over 6 months of pay since august of 2021.

I have raised this issue to my HR rep, My supervisor, and my CEO. A copy of this statement will also be published with the EEOC and the department of insurance. My doctors and I have complied with your requests. This is ridiculous.

Desired outcome: They need to pay me

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5:40 pm EDT

Sedgwick Claims Management Services Vehicle insurance claim against the at-fault driver who is covered under sedgewick

I would give a 0 if I could. Corrupt is all I can say.

Jan 24th my car was hit by a guy who had a rental car and carried insurance through continental casualty company. Apparently they have Sedgwick manage claims. I have been given the runaround. They called to tell me they have an incorrect e-mail. I spoke to someone from Nationwide appraisals and gave her the correct email which I did. I received no emails from them after the appraiser came by to look at my car. They send me a super low-ball check of about (no break down of what it is covering) that wouldn't cover the damage let alone a rental car for me to get to work and wiped their hands clean of me. Meanwhile, I have had 2 appraisals in my area that are 3 times the dollar amount in repairs. I called Ryan the claims handler twice as he said I would recieve e-mail from him. Nothing. And he will not answer my calls. There is NO WAY to track this claim. I have recieved absolutely no documents or e-mails from the insurance company, Sedgewick or the appraisal company. I will have to contact my attorny and this will cost more in the long run as I will have to take time off work to handle this apparently.

Desired outcome: Cover the complete cost of damages and a rental car for me that was inflicted by covered person(s) without having to sue for damages including loss of wages.

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7:46 pm EDT

Sedgwick Claims Management Services Work compensation

Hi. I had injury at work in December 23/2021. I was talking with a nurse and explained to her that my English is no good and i need the translator so she was asking me about my physician doctor appointment than she told me you have to see a doctor between March 3_15 i was thinking she talked about my physician doctor no segdwick doctor because i had a appointment with a doctor in March 9 and i didn't know she talked about a segdwick doctor so i apologize for my miss understanding and i said can you reschedule a segdwick doctor appointment soon even tomorrow i can come but she was rude and she refused she text me in March 15 and she said i sent you a email but i didn't know that since March 15 because i didn't receive any call or text me message notifie me i had a appointment with a segdwick doctor talking with the adjuster Stacy denied my claim you can found all the proof below. Other way they told me you don't have to pay nothing for your brain test at saint Elizabeth hospital they already take care of that but yesterday i was receiving a letter from the hospital to pay a bills they was liars to me that really illegal and unprofessional so please 🙏🙏 please can you fix this issue for me i need just the insurance cover my spending for visiting doctor and medication and the days i wasn't working thank you for help have a good night

Desired outcome: Work compensation

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8:08 pm EDT

Sedgwick Claims Management Services Sedgwick short term disability

As usual for co workers and myself included the most stressful payment delayed process ever. I have been through 5 terrible experiences with this company in 7 years. This last experience exactly as expected terrible. November 29 total knee replacement. I filed all paperwork 20 days in advance. Doctor clearly states March 1 2022 return to work. Submitted same documents updated notes medical visits half dozen times. Same excuses, fax not legible resubmit. The other excuse not enough supporting documents . They will do this until deadline is missed . Doctors staff will cooperate with everthing asked but its a Sedgwick scam to hold funds long as possible.The month of February and a week of march no pay. I returned to work as usual on due date with no pay. They finally approved my claim then expect me to wait till end of month be compensated. The excuse is i missed deadline . For every surgery by the 30th day they do not pay

Desired outcome: The desired outcome is i want the money iam entitled to. I dont want to now have to wait till march 25 to be paid. I want that examiner looked into .

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11:39 pm EST
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Sedgwick Claims Management Services Sedgwick

The claims manager I have who actually denied a test from April 2020 until Sept 2021. When she finally approved after sending me to the 4th doctor who she contracted with who submitted for the same identical test this claims manager who you obviously value is now doing the same strategy as she has done on the emg test is so wasteful I can't imagine who is watching over her. I would suspect her immediate supervisor needs to be fired along with her.

This case manager didn't like what the doctors recommended which was surgery from the findings of the test. The case manager is doing your company's strategy let's not pay for that service. The thing is your company has no choice you will pay for my surgery all injuries were reported.

This same claims manager hired a IME she didn't like his recommendation, she hired another IME from a well known Institution and his findings were patient not at MMI that patient needs two surgeries if one of the two surgeries possibly a third surgery which is more invasive would have to be done. She has now set an appointment with a Nextcare doctor to do a MMI she will not get away with this for I will tell the doctor what she is doing show him the test.from the Major Medical Center and The Levine Institute and he will tell them he isn't giving them no kind of sign off for I know this doctor personally he will not do anything illegal. This case manager needs to watch her step she is on a slippery slope.

Sedgwick needs to understand you can't continue to run over the little man.

I have ran out of family leave because of her mishandling of my case now I am out of a good paying job thanks to her incompetence. I have broken down her waste on on test she denied that was done anyway here is the calculation just for the time period and waste of 1 TEST that mind you cost $675.00 my wages for 14 months $17647.28, the 2 doctors approximately 3500.00. Plus $615.00 mileage TOTAL $22437.28 that's for 1 test. Again I say that she ultimately approved anyway and wasted 14 months in doing anyway. This claim mgr does one injury at a time this process will take forever Is this what you represent and teach your clerks./employees not sure if they even have to follow any guidelines. I would like to know is she accountable to anyone these actions certainly can't prove profitable nor impressive to a client. She works at home she obviously has a pool for sometimes when I speak with her I can hear the functions of a pool. I lived around a swimming pool all my life I know the sounds.

I do want to make you aware of how bad she has mishandled my case. I only told you of one test. I did have a surgery but it took her six months to approve and for that has probably left me with an issue to my kidney, I only have one as she knows. My store my manager did ask me in a text if I was seeking to file a claim against your company Sedgwick for the mishandling of my case. I ask you if your own client thinks seeking damages against your company would be appropriate then you might ask yourself might I not check out my clerk/ claims mgr.. I found they my employer had know qualms in me filing a suit against your company, therefore I have hired one of the top 25 SUPER LAWYERS in my area.

The only solution I would see fit is for her to be replaced and I am sure that would not be an option you would consider. It appears your company hires this type of employee.

Desired outcome: For Sedgwick to inform their case managers that there are some things they are not permitted to do by law

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Update by Injured in USA
Mar 11, 2022 1:06 pm EST

When I stated my wages that was workers compensation reduced 66.33 wages that I posted.

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4:14 am EST

Sedgwick Claims Management Services Withholding medical care from work related injury

Torn miniscus in my right knee while at work. Been seeing an LPN who put in a request for an MRI, it finally got approved. Went in for an MRI. Had to wait just over a week before I could get in to see the LPN again. He told me the MRI shows that it is a miniscus tear like he suspected. He referred me to NW Orthopedic, to see an orthopedic surgeon.

I waited 2 days, called over to NW Orthopedics, the lady asked me a few questions and said she would call me back. She called me back to inform me that she couldn't schedule the procedure because Sedgwick hasn't approved my claim yet. She also told me that the claims manager told her to tell me that he scheduled an Independent Medical Exam by another Dr for 3/24/2022.

That's over 3 weeks away!

The MRI proves I have an injury that requires a surgery. I am to the point that I've been off work for 6+ weeks no. I'm losing sleep because I wake up to my knee throbbing, I limp around because it hurts to put too much pressure on it.

What is the purpose of the IME appointment, other than dragging out the claim and wasting time? I am considering filing a few complaints with the State of Washington about the handling of this claim by the claims manager.

Desired outcome: I'd like for the NW Orthopedics office to call me and schedule this surgery.

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Mermaid110
, US
Apr 25, 2022 7:52 pm EDT

You should always get a Workmans' comp lawyer when injured on a job they will make sure that you get seen quicker than you are doing it by yourself. I hope you get better.

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Liberty Belle
, US
Apr 22, 2022 2:20 am EDT

Yes, file a complaint. This company is notoriously negligent. They are particularly tyrannical with WC claims. Keep meticulous records a daily journal + a paper trail of everything. Seems like the right time for a class action lawsuit. They illegally close active claims with no warning which all have a right by law to appeal. Know your rights. Research your state's WC laws. Sedgwick doesn't pay legitimate claims, falsify documents, manipulate the vulnerable injured, pay MDs to submit false and incomplete assessments and facilitate their abandonment of their Hippocratic Oath of doing no harm. Their whole, ineffective "process" (WC scheme) is a scam! They pull every unethical, immoral act, even in court with deliberate malice and lack of conscience laughing all the way to the bank denying honest claims! Class action time.

Injured in USA
Injured in USA
Best Place, US
Mar 11, 2022 1:19 pm EST
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Robert that is not how the process works you need to call your case manager. When speaking with the case manager ask them have they not received and reviewed the test results and the recommendations? Then ask them what are you suppose to do in the mean time about pain while you wait for this appoinment? Also ask the case manager what is the purpose of asking another doctor to see you he can't change the injury noted on the imaging approved by her/him the case manager. I would then ask case manager her/his immediate supervisors name and give them a call. If they refuse call Sedwick 800 number tell them your claims mgr ask what their supervisors name is and then tell them the issue you are having with this case manager. I would also go ahead and get an attorney you need to smother it now.

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11:33 am EST
Resolved
The complaint has been investigated and resolved to the customer’s satisfaction.

Sedgwick Claims Management Services LOA Filing

I had initially called to file a LOA for short term disability which they started the process for. They sent me paperwork to have the doctor fill out. However, after talking with them a day later they decided the injury I had was work related and told me to file for workers comp and not to have my doctor fill out the paperwork as that would be done by worker's comp if needed. I had asked if I get denied would that mean that it isn't work related and I they would switch me back to short term disability, they said yes.

I eventually got denied workers comp. I called back Sedgwick to verify what they needed and was told to just upload the denial letter and have verification that I'm paying Walmart for short term disability benefits sent over from Walmart benefits. I asked if they would need documentation from my doctor, they said no. I asked if they would be the ones I get payment for in regards to short term, they said yes. They said the worker's comp denial letter was all they would need.

After two days I call back to find out the denial letter has no impact on the LOA, they need documentation from my doctor, and my short term benefits wasn't going to be handled by them. So, everything I was told in my previous call to Sedgwick was an false information.

Desired outcome: Retrain all the the operators and hold the supervisors accountable for false information being given out.

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Resolved

I was told that they would be coaching the agents who provided the misleading information and will be holding a discussion with supervisors to correct this issue going forward. They looked up my call records and were able to see who I was talking to previously who supplied the incorrect info and will be pursing appropriate action, and if need be coach them (as mentioned above).

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Injured in USA
Injured in USA
Best Place, US
Mar 10, 2022 1:47 pm EST
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I absolutely can understand your frustration. I have been dealing with Sedgwick for 33 months yes I said 33 months. I have to have either the most incompetent claims manager or over worked. It is like pulling teeth to get my injuries taken care of even after being sent to three doctors for the same injury. This is a practice of my claims manager to try and get a different answer only to get the same evaluations and I still have no resolve of injury. These TPA's should be held accountable by law not only by lawsuit but forbidden to be an adjuster once found guilty of gross misconduct.

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4:03 pm EST

Sedgwick Claims Management Services Gross incompetence in administration of the state of Ohio's Workers' Comp System

DOES ANYONE EVEN WORK HERE ANYMORE?! Terrible nightmare I wouldn't wish on my worst enemy. Worthless to the nth degree. My husband has lifetime medical workers comp for an incurable cancer. We thought we finally had billing under control as claims were being paid, until he noticed treatments being billed to and paid for by primary insurance. He called his Sedgwick nurse case manager only to be met with a message that stated, "I will be out of the office for an extended period of time." What does that even mean? And why the heck wasn't my husband assigned another nurse to look after his claim?! Looking back through the claims, there hasn't been any correspondence from said nurse case manager for 3 months now. Gross incompetence or willful incompetence to avoid paying claims? Sedgwick, it isn't even your money. It's the state's funds, and they accepted liability. Disgusting, dehumanizing, and insulting to make injured workers jump through hoops. Complaints will be filed with the state worker's comp ombudsman and appropriate federal entities.

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7:24 pm EST

Sedgwick Claims Management Services Scamming company

All I can say is they will never pay you or answer the phone. Scamming company

Desired outcome: It won’t an outcome they scamming

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1:53 pm EST
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Sedgwick Claims Management Services Workers comp claim service and unpaid medical bill

My daughter has had nothing but problems with company starting with no communication from her Workers Comp claims examiner. Her incident date was Nov 19, 2021 and all she has received was initial 'welcome' packet and then the form to confirm her treatment was complete. Her claim was closed Jan 18, 2022 with no notification and with an outstanding medical bill that the examiner was aware of since Dec 12, 2021. She has sent 4 emails through the 'contact examiner' link on the claim, 6 emails directly to him, 1 email to general box, 2 voice messages at his extension, and 2 voice mails on the general mailbox. The phone number listed on the claim to call if she has questions on a closed claim is a wrong number. She has not had ONE return response! To date the medical bill is still due and she cannot get any help.

Desired outcome: Medical bill to be paid before a negative mark is placed on my daughter credit.

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Update by HMeyers
Feb 03, 2022 3:05 pm EST

Like many of the other comments, if I could leave a Negative rating I would. My workers comp claim examiner has not responded to ONE message I have sent. The claim was closed 1/18/2021 without notification and with a medical payment due (as of today 2/3/2022) that the examiner has been aware of since 12/14/21. I have sent 4 message directly through my claim account, 6 emails directly to examiner, 1 email to general box, 2 voice message to examiner, and 2 voice messages to the general mailbox - all with NO response. Phone number provided to call if you have questions on a claim is a wrong number. If your company uses Sedgwick, good luck if you have a workers comp claim!

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Injured in USA
Injured in USA
Best Place, US
Mar 10, 2022 4:11 pm EST
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It sounds like the examiner feels your daughter had no injury. I am becoming quite an expert for I have seen a few wc at my work it is a big company. I would like to know if you dont mind how was your daughter hurt? Did she immediately report to Mgr. Or ASM. Did they have her call the hotline to Sedgwick immediately before leaving work? Did she go take a drug test and be seen at a Nextcare or similar Dr provided by Sedgwick?

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7:35 pm EST

Sedgwick Claims Management Services Payment of temporary disability

I suffered a heart attack on Nov. 26, 2021

I filled out the forms with all my Nordstrom, personal and banking information and submitted it to sedgwick. I have spoken to sedgwick representatives and received mail stating deposits were made to my checking account.

I have not received any money. Please respond and or send money.

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11:27 am EST
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Sedgwick Claims Management Services Service is what I'm complaining about

They sent out my money on 01/14/22 and it's now 01/27 and I haven't gotten my money yet.

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7:49 am EST

Sedgwick Claims Management Services Sedgwick failed to inform walmart of my leave of absence

I would love nothing more than to give positive feedback, however, the handling of my claim has literally DESTROYED my life. I returned to work on 12/12/2021 after being on leave due to COVID exposure. I suffered a fairly substantial knee injury where I could no longer bend my knee & when I would pivot and/or twist, structurally, my knee felt like it was going to give out. So on 12/13/2021, I called in due to personal injury and went online to start a claim related to such. On 12/15/2021 I went online to check the status of my injury claim and it was nowhere to be found, so I thought it was maybe due to not uploading the corroborating paperwork. So from 12/15/2021 thru 12/17/2021i attempted to upload the paperwork several times and each time, I would be alerted with "unable to perform function due to low memory." My phone had plenty of available memory and storage so I tried with two other devices only to get the same alert message, so I contacted someone through your communication portal and explained the problem I was having and their response was "try again later, I'll let tech support know." My medical excuse had me off of work through 12/18/2021, so on Sunday 12/19/2021, I did the health screening before my shift and failed it because 4 kids in my stepson's class tested positive & eight kids in my daughter's class tested positive for COVID on 12/14 & 12/15, respectively. We pulled them both out of school on 12/15, and by 12/18 we were all very sick. So due to failing the health screen I was instructed to stay home through 12/31/2021. So, I went online and it stated that (paraphrasing) "... if I was already on leave & needed to request more time due to.." and it listed a few different reasons, one of them being a failed health screening, then I didn't have to open a new claim, I could change my return to work date. So I thought that was all I had to do, so I looked for my claim change my RTW date to 12/31/2021, which is an off day for me, so technically my first return to work date would have been 1/2/2022. However, I still couldn't find my claim, I didn't understand what was going on because whenever I would hit submit to submit the claim, I would get a thank you notification stating "thank you, your claim..." it would list the claim number ".. has been received." So I'm thinking that you are receiving my claims because I'm getting that notification yet when I would go online to either check the status, to upload documentation, or to change my return to work date I couldn't find the claim anywhere. So I thought maybe I had to file a new claim because I was coming off of leave due to injury and starting a leave due to COVID. So, I filed a new claim for COVID with first absence being 12/19/2021 through 12/31/2021, my first shift after that would have been 1/2/2021. On 1/2/2022, I was on your site trying to find my claims again to no avail and I caught a glimpse of the word "Terminated". To make a much longer story short, I called my supervisor that evening to ask him why I was terminated and he said dude to no call no shows, mind you, I called the Walmart Associates line to report each and every absence I have ever had, I explained to him that I had been on leave (he was the person that told me to get my knee looked at & to submit the necessary claim to Sedgwick.) He said they never received anything about me being on ANY leave except for the one from 11/29/2021 through 12/11/2021. Much to my dismay, I couldn't understand how this was possible cuz as I mentioned earlier, each time I would click on submit to submit my claim I would always get the thank you notification that my claim had been received. I explained to him everything, every step, just as I have explained it in this message to you. He said if I could provide proof that I was supposed to be have been on leave for those dates that they would reverse my termination and I would be able to jump in right where I left off. This was right at the point where all my benefits we're just about to kick in because I was approaching my 90 days of employment with Walmart. So the following evening 13/2022, I went to work and met with my supervisor and gave him all the evidence I had, he stated "I absolutely believe you.. 100%, but what I need is something from Sedgwick stating that"yes Dorian Haggerty was supposed to be on leave for these dates."So I tried calling Sedgwick on 1/4/2022, wait times were more than 90 min, so I requested someone call me when my place in line came up, waited all day and the next and never received that return call. So, it was on 1/6/2022 I believe, when I called back and waited on hold close to THREE HOURS before I was finally able to speak to someone. At the end of that call, I was confident the rep fully understood what the problem was, after all, she basically regurgitated everything I had just said to her to confirm exactly what my claim was for and the dates it covered, which was from 12/13 thru 12/18/2021. That being said, a few days later I received an email from Sedgwick stating that they had been informed that my employment with Walmart was terminated on 12/26/2021 so they were therefore closing my claim... SMH... I was speechless.. I had already told them this more than once, I was terminated strictly because Sedwick NEVER informed my supervisors that I was on a leave of absence. The rep I spoke to on the phone knew this, understood this, and assured me she would let my superiors know that I indeed was supposed to be on a LOA for those dates, so I would then be able to get my job back. But... they dropped the ball again, by closing my claim because I was terminated by Walmart SOLELY because.. Sedwick didnt inform them of that claim in the first place. Now, if I may explain, how this has completely ruined my life. First, my payroll check that I received right before Christmas was almost nothing because my injury claim wasn't on there, even then I thought that it due to the fact that it just wasn't covered by the policy, I had no idea it was because the information that I submitted, (on SEVERAL occasions, AND was given a notification that my claim was RECEIVED by Sedgwick's website) was NEVER sent to my job and I was fired STRICTLY because of THAT failure. So, not only was I fired, it ruined Christmas for my children. Due to me ruining their Christmas, my fiancee left me, so my children won't speak to me, I am now homeless, I have had to sleep at a homeless shelter, on concrete floors, on the bus, anywhere I can close my eyes for a few minutes without having to worry about being robbed, beaten, stabbed or shot. I had a home a month ago, a house, a nice house.. in a great neighborhood. Ive been battling severe depression, I've even contemplated suicide a few times because of all of this. All the benefits that had just kicked in for me as a Walmart employee, were no longer available to me. There is literally not one area of my life that has not been affected by this. And the worst part of it, the figurative"salt on the open wound", is that I did everything exactly how I was instructed to do it, I was simply following the instructions in each and every step of this process... And as a result, its as if my entire world was thrown into a garbage disposal, because it has been that catastrophic and that rapid when it comes to ripping apart my entire life. And I don't know if Sedgwick has ever given that information to my job because I have yet to get my job back.. I just don't understand how this happened or why this happened.. I never will!.. and unfortunately, even if you could fix the situation, you would never be able to FIX the situation! I guess I'm just another unfortunate soul that it happened to. I hope, hell, I PRAY that no one else EVER has this same experience, it is extremely hard to keep it together when everything you have known is falling apart or disintegrating before your very eyes. Your system is fatally flawed, and anyone I have spoken to at Sedgwick seems to be completely incompetent, or at the very least, incapable of doing the job they have been hired to do, because I don't know how much clearer I could have been in my explanation of the issue. I lost EVERYTHING because of this. I HAVE LOST EVERYTHING! Never even received an apology.
So Thank you Sedwick

-Dorian Haggerty

Desired outcome: For my superiors to be notified of my LOAs for Decemeber 2021 so i can get my job back

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Smarti-Marti Owens
, US
Jul 06, 2022 10:27 am EDT

Wow. I am so sorry for what you've endured. I hope things have starred to get a little better in your life.. I too am going thru something similar. My child tested positive, and I needed to quarantine and care for her.. my LOA was too closed because I never tested + .. ..never recieved ANY pay..and went thru my savings while caring for my daughter..my return date was 6/5 and I've been there every day(team scheduled) yet I'm NOT active in system.. my HR told me if I can't get sedgwick to approve a LOA, I'll get pointed for each day eventhough I called out per One walmart and did as website directed..and followed guidelines set forth by CDC (which I BELIEVE supercedes sedgwick) but.. here we go, another day off being spent on hold trying to get this issue resolved!

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Jen Setters
, US
May 27, 2022 6:47 am EDT

What a joke i was sent home by my manager at walmart because after 2 energy shots 2 monsters and about to start on my 2nd Starbucks coffee my boss whom I was doing a project with witnessed me falling asleep standing talking to her like eyes rolling in my head. Well as we all know it takes time to get into the Dr and then a specialist and what Dr wants to fill out medical disability papers if they don't have any answers yet well turns out I have internal bleeding and am basically lucky to be alive my dr provided a dr note to try to make sedgwick happy until he got my results in but no go I provided them my entire medical record while we waited on the Dr to complete my paperwork the next day I go on to check on my claim and to my dismay no open claims no evidence or record of a claim even existing I ran myself in to the ground for that place coming in early staying late being the runner with my bosses keys because no one was in sight or to he found while still keeping my pick rate up as i was ogp scalling racks like Spiderman to get that item for an order that just had to be gotten but no one to help or even try to help you working threw a broken ankle because they were so busy working threw an injury that flayed my leg open like a fish because they were slammed in which I am still trying to get to heal 6 months later and they do Mr like this really u lived breathed that place and have begged mt manager not to make me take leave and now I'm [censored]ed I was already severely depressed because of all the crazy symptoms a severe lack of red blood cells causes but now I'm just done I don't care so [censored] it I stopped taking my meds last night so I shouldn't have to worry about surgery or be reminded of what a failure I am everytime I go outside and see the store because my red blood cell count is as so low I was told ya the meds are gonna have horrible affects but there temporary If you don't take the meds it's a permanent outcome sorry for any spelling errors as the condition has hopefully temporarily taken almost all my sight. Dies sedgwick care NOPE they dont even have the respect to take the time to respond to communications you have sent them despite being deathly I'll and having to deal with ins doctors test etc etc and jumping there hoops on top of it mind you while your sicker than crap

Injured in USA
Injured in USA
Best Place, US
Mar 10, 2022 4:40 pm EST
Verified customer This comment was posted by a verified customer. Learn more

I am sorry and as much as I can say that Sedwick is a pourly ran company. Sir your beef is with WALMART, you can't open a claim. That is the responsibility of your direct manager who has to report the injury to Sedgwick who in return opens the claim then you are assigned a claims by a mgr who calls you within 48 to 72 hrs depending if a weekend. He/She will take your statement down on what occured he/she has already taken the managers statement. You are then sent to a Nextcare or some type of cheap fly by night doctor where you will take a drug screen and then get xrays if needed. That is how it is handled so again your grievance is with Walmart.

About Sedgwick Claims Management Services

Sedgwick Claims Management Services, Inc., is a leading global provider of technology-enabled risk and benefits solutions. At Sedgwick, caring counts; the company takes care of people and organizations by delivering cost-effective claims, productivity, managed care, risk consulting and other services through the dedication and expertise of more than 14,000 colleagues in some 275 offices located in the U.S., Canada, U.K., and Ireland.

Overview of Sedgwick Claims Management Services complaint handling

Sedgwick Claims Management Services reviews first appeared on Complaints Board on Nov 24, 2008. The latest review Property damage was posted on Apr 16, 2024. The latest complaint LOA Filing was resolved on Feb 25, 2022. Sedgwick Claims Management Services has an average consumer rating of 1 stars from 392 reviews. Sedgwick Claims Management Services has resolved 41 complaints.
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