Sedgwick Claims Management Services
Reviews and Complaints

Over the course of my time on leave I encountered disruptions in pay many times. Every disruption was in error at no fault of my own. I spend may hours on the phone attempting to get the issues resolved. During this time I was severely disabled and hospitalized at this time. I was pregnant with twins and the added stress to my body was dangerous to my body and the viability of my pregnancy. I had to constantly worry about being able to receive my paychecks to support myself and my other children.

I would have calls lasting hours and get news that I wasn't eligible for leave (false) then call my supervisor and hear everything is fine. I would call back and different person would say everything was fine and they didn't know what I was talking about. I would never know if I was going to get paid or if Sedgwicks errors were going to inadvertatly effect my job position due to no fault of my own.

I returned to work 5/16/23. I notified Sedwick and my supervisor of my return to work date via sedgwicks text system (2/8/23, 3/24/23, 4/5/23, 5/9/23, 5/16/23) and via phone calls with automated response and call center response countless times. I also notified via email of return to work to be sure I was doing thing correctely. During that time my times were in the NICU under high intensity care and I had to worry about my pay on top of worrying for their health.

Today is 6/8/23 and I have been working full time since 5/16/23. Due to sedgwicks negligence I have not been paid a single dollar for my worked time since returning to work. I called and spoke with several people at sedgwick about this including supervisors who confirmed I had returned to work my case was closed and they could not help me. They were rude to me and made me feel like I was in the wrong. I then called my companies employee support who told me sedgwick has still listed me as on leave and has not given them notice of my return to work or unlocked my timesheet and so they cannot pay me. I had a representative from the employee call center call with me to speak with sedgwick. When we called the call center acted as if I was just not reporting return to work for the first time despite all of my prior communication. I then was transferred to their financial team who told us they were never notified of my return to work and that it would be noted starting today and they would need at least two days to process.

As of now I still have not been paid for three weeks of work and one week additional completed that would not be processed in payroll yet.

This company has taken a detrimental impact on my family by leaving us without a paycheck for almost a month. I have four children who rely on me and a strong financial and credit score reputation that could be tarnished due to this companies errors.

I want confirmation that this is handled and addressed so other families do not suffer the way mine has. Families living paycheck to paycheck could lose their homes over mistakes like this.

I feel I need to be reconciled for the stress this company has put me threw and the risk they put my pregnancy under due to negligence.

I wish to have formal reviews and disciplinary action against the case workers and representative's that has caused this stress and hardship on my family

In 2022, I faced health issues related to my right thumb surgery and subsequent wrist problems which led me to submit a short-term disability claim. As a long-haul COVID patient, I often experience joint pain that can impede my daily activities. Despite my ample medical documentation, my claim was denied. However, after consulting with Dr. Christopher Armor, a family medicine practitioner with over 21 years of experience, and Dr. Steven Orr, an orthopedic surgeon with Kaiser Permanente, I obtained supplementary medical documentation stating that I was physically incapable of working during this period. Both doctors' letters confirmed that wearing a brace/splint, which my Dr recommended, made it impossible for me to type, as my job involves typing and being right-handed. Dr. Orr also explained that pain and stiffness in my hand and wrist prevented me from performing my regular duties. I continue to receive medical care from both doctors for my right hand and wrist. Therefore, I firmly request a senior-level review of my claim to resolve this issue. My name is Delivial Nobles, and you can contact me at [protected].

Sedgwick doesn't process the entire claim. I billed a claim for $6346.00 but they processed it for $5646.00. I cannot find a legitimate phone number to talk to bill review. The hold time is 1-2 hours and the call drops. The adjuster said I need to submit a reconsideration which should not be the case if it was processed incorrectly.

I am EXTREMELY disappointed in the lack of professionalism with the adjusters and their refusal to ensure a claimants bills are processed correctly.

Sedgwick has no good contact phone numbers for bill review and adjusters DO NOT return calls.

Perhaps we should start sending bills to the employer and let them pay the bills and let Sedgwick reimburse them.

This is the most ridiculous company I have ever dealt with in my 30 + years in the medical field.

This isn't the only Medical bill processing company, but it definitely is the most difficult to do business with.

HORRIBLE COMPANY! none of their reps know what they're doing and they all give you different information! I was told by 2 reps I would be able to take a new leave since I'd reached my 91 days of work. Then 2 weeks into my claim I was told it was actually a relapse. My relapse for std was about to expire so I'd have to use long term and would be separated from my company which is a bit extreme so now I'm screwed with my whole claim. Anytime I've had to file a claim its NEVER a smooth process. There's ALWAYS issues because their reps lack all knowledge and they don't care and don't have a supervisor I could talk to. I've been waiting for days for a supervisor to call and I'm sure I'll never get that call. SEDGWICK IS THE WORST!

In January I was a victim of a violent crime due to Domestic violence. I submitted for a leave of absence and was advised I needed to take an unpaid protected legal leave of absence. I submitted this on my employers leave link as managed by Sedgwick. I provided court order documents, a signed and notarized letter indicating I needed to take a leave of absence as a result of being a victim of a Violent crime related to domestic violence, so I could seek help, receive therapy, treatment and rehabilitation and put safety measures in place, I provided a letter from the district attorney office for my subpoena, I provided police reports, I provided a letter from my victim advocate. Yet I was still denied. I was told I needed to file for Short term disability. So I did. My healthcare provider and my doctor has been aware of the medical and mental health history of the documented domestic violence and it is noted accordingly. I have been in therapy and asked for more intensive therapy because this is what I need in order to heal, get well again and recover. Sedgwick denied me still. My employer and Sedgwick forced me to give full access to my medical records. How is it possible they still denied me even after giving full access to my medical forced. I find this rather strange because they forced me sign the electronic medical release of my records form. But they made a decision to deny my claim based on 2 documents in the file which was considered insufficient documentation and does not support their approval and the decision they made was medically not relevant or accurate information at all. If they have my electric consent to view my entire medical record then it seems logical they had everything they needed to make an approval happen. What was in my file was the referral from my PCP to see a therapist and information stating I am unable to perform 2 or more of the necessary life activities.

Even after giving this documentation to Sedgwick, it still resulted in a denial letter after I personally uploaded countless documents at Sedgwick’s advisement, They only want a progress report with a detailed doctor summary of notes from all of my last and current /relevant doctors appointments from the time the claim was opened. I provided a certification of Health Care Provider for Employee’s Serious Health Condition, I provided a Physician Certification for Reasonable Accommodation, I provided work status activity letter, I have provided a signed doctors letter for FMLA from the US department of labor. Yet I continue to be denied. I was told the reason for my denial was because there was insufficient documentation to support why I am unable to perform my job duties. This is categorically incorrect information. I have provided the documents my self. Additionally Sedgwick and my employer forced me to sign an electronic consent form giving them full access to my medical records yet they still have denied me over and over again. The undue stress this is causing me is further victimizing me be making me feel discriminated against, harassed, my privacy has been invaded by forcing me to sign and electronic consent for full access to my medical records other wise they threaten with termination for non compliance. They

continue to lie to me and make it seem like it’s normal standard operating procedure to have my private medical records. They have taken since January 4, until April 28, and I still have no approval. Only denials. Meanwhile my employer just sent me a demand for return of over payment of my payroll in the amount of over $8,300 for one over payment bill and another $1400 for the other over payment They demand the overpayment be re-paid back in full or by an approved negotiated lower monthly amount to be auto deducted from my payroll check. The negotiated payment amount has to be accepted by them first. The said it must be paid by April 26. I received the letter in the mail less then 8 days prior to when they want the payment made. If I don’t pay up or make a payment arrangement they will send me to collections. I notified my supervisor, I notified Sedgwick, I notified the leave of absence department at my employer that I was taking an unpaid loa. I submitted a signed and notarized letter of intent. My intent to take a protected unpaid LOA under the California Labor Commissioner RIGHTS OF VICTIMS OF DOMESTIC VIOLENCE, SEXUAL ASSAULT, STALKING, CRIMES THAT CAUSE PHYSICAL INJURY OR MENTAL INJURY, AND CRIMES INVOLVING A THREAT OF PHYSICAL INJURY; AND OF PERSONS WHOSE IMMEDIATE FAMILY MEMBER IS DECEASED AS A DIRECT RESULT OF A CRIME LOA law. There is nothing in the system reflecting an approval because had their been an approval I wouldn’t have received a demand for repayment of payroll.

I am a victim of a violent crime. I have medical documentation along with countless other legal documents to support my need for a medical time away from work for my health to improve and I am disabled. Why I am being treated like I am guilty until proven innocent. Why am I being further victimized by Sedgwick and my employer. This is illegal and further more a complete invasion of my privacy and my civil rights and so many laws.

I've contacted sedgwick 2 times since starting this physically demanding job. I'm 63 years old. I have arthritis in my back and night vision impairment from cataracts.the first time I contacted sedgwick their rep took down my medical history and my Drs contact. Told me I would get a release of information form in one week I had to sign, plus I had to attach a note from the Drs. Why do I need to pay a $190 copay to have a Dr sign a note when the information is in my digital PT portal? It's been a month. Still no response from Sedgwick. No form in my mail. These ppl are frauds. Deliberately delaying and denying claims. The ADA is federal law and they're in violation.

I have been trying to get in contact with my claims support representative with no avail. I have had my claim open now for over a month and was told I would be updated on it's progress multiple times and have heard nothing. I have not had a paycheck in over a month now and have been burdened by this and not quite sure why. Please address this and get this rectified so we can move forward. Thank You

Jason Pekau

[protected]@gmail.com

I have been on Worker’s Comp. and hurt since I was hurt on February 2020 2 1/2 years went by and I was denied treatment and pay that whole entire time to where my injuries got worse due to not being treated. I have a lifelong injury now and then once I start getting paid all the sudden checks began to come late at that time. My attorney contacted the adjuster and her supervisor and nothing was done until two months later we’re for two weeks. My check came at the same time of the week as the prior week I was told it was because it was the US Postal Service that it was late well they use FedEx and the checks are still late. I am $1000 in debt because of late fees my electrics been shut off because of balance checks, I’ve lost credit cards because they close my account because of late fees and bounced checks just because I’m an injured worker does not mean that I should be paid any different. I have contacted our state representatives. I have filed a complaint with the Ohio bureau of workers comp which I’m doing again today. This is uncalled for and no one should be treated like this. Isn’t it bad enough? I have a lifelong injury and then I don’t deserve to get paid on time to keep my nine-year-old daughter having clothes and shoes on her feet I paid into Worker’s Comp. it’s not free money. I worked as a nurse for 25 years and I will not tolerate this ever again. We will go to court or whatever we have to do at this point because I have been treated unfairly and wrong. I have contacted my adjuster and her supervisor where I was promised. I would be getting my check on a Monday and here it is Tuesday and nothing has come so that was a lie. I was lied to purposely, knowing that Chuck was not coming they told me it was. I have rights as a injured worker and I’m going to make sure that my treatment is approved because I have an injury and I get paid on time that is discrimination. I am no different than a regular employee except I’m hurt so they get paid on time. Why should know I’m not letting us go this time.

I have claimed as third party, my business property has been damaged by segwick insured. they have assigned claim examiner Christopher Godfrey since December 2022. since then i have left him more than hundred voice messages but up to now he has never reply. i haven't talk to him at all. i request his supervisor, thay gave me Sherry's contact number but same thing no reply. I have gas station branded with Citgo brand. the damages are making me loose points for Citgo brand. please resolve this issue ASAP or I have no choice but to hire an attorney.

Company doesn’t maintain communication equipment which results in paperwork not sent or received. Communications are unclear or nonexistent. Extensions was added to regular Leave of absence multiple times resulting in taken of schedule and losing unnecessary time from work. Sedgwick employees have different views of policies. Was discouraged from using my Short Term Disability as it would delay my Leave of Absence.

I am filling a complaint against Jessica Deragon. This person has harass me at my job. I have sent her several email and left most messages to her not to call me at work. I work in the school with disabled children. I cannot receive any calls or answer any calls while I am on duty. I have emailed her several times asking her not to do that. But she has continue to do so as well she has ready to close my workers comp case because I will not answer my phone doing my work hours. As well I have coworkers that have heard me on the phone asking her not to call me doing work hours that I will get reprimanded or even fired. As you have not comply with my request. All I get from car is I’m going to close your case. I have not received one cent of any payment from Sedgwick. I have complied with going to the doctors office except for one visit that I miss. And because I was sick and I couldn’t go she email my supervisor at Kroger‘s letting them know that I was no longer on light duty. As well the last time I went to see the doctor for my injury he informed me that he was order to release me.

I only saw him twice and on the second visit he released me. Jessica Deragon has treated me very unprofessional. She has been rude on the phone not on allowing me to explain anything to her. I have the right to be treated professionally. She has called me a liar she has accuse me of not complying with doctors orders. I she has accuse me of not contacting Physical Therapy.

I wish again I tried to explain to her I cannot pick up my phone what I am at work and if I don’t recognize the number I would not contact them because I receive a lot of solicitations on the phone people trying to scam me out of money. I also explain to her if they leave me a message I will get back to them. But that is not what she wants she wants me to pick up the phone every time someone calls me even if I am at work. She will keep on calling me with no regards that I am at work and I will be recommended if I pick up my phone. One of my coworkers heard me on the phone telling her that I could not talk to her because I was in the classroom with students. During the conversation as I tried to explain to her all she did was threaten me that she was going to close my claim. I have not receive one sent a payment all I have receive and approve for was going to the clinic to see the knee doctor I don’t even know if he’s a specialist or not. The times that I went to the clinic to see the knee doctor I kept seeing different ones.

I did not have one doctor that was in charge of my treatment. The last time that I saw the knee doctor that’s when he told me that he was order to let me go. I explained to him that my knee still hurt. His reply was there’s nothing we can do for you. Jessica Deragon has accuse me of not going to therapy. I have proof that I’ve been going in spite of her not excepting that I have been going to therapy. I will also be filing a complaint with Worker’s Comp. and Austin Texas I was submit them my emails to file I have reached out to her and ask her not to call me during working hours.

I work for an employer that uses Sedgwick CMS services for leave claims. I am a seasonal employee so the process for me is a little different than the normal fulltime employee. On 02/02/23 I injured myself at home. I contacted Sedgwick on 02/06/23 and filed claim 4A23025X9MD0001GI. What should happen is the claim is moved past FMLA once it is denied and moved onto unpaid medical. What occurred is the claim agent that was assigned closed the claim once FMLA was denied. This is even though I messaged/called and explain I was seasonal and knew FMLA would be denied. I was assured it would be no issue, I was a seasonal employee. No one ever told me the wrong claim was filed or processed. I called again on 02/09/23 and was told the original claim was opened incorrectly and another claim was opened with the same information. The claim that was opened on 02/09/23 was 4A230280HSX0001GI. I had already provided doctors paperwork that I needed to be out 7 days. I was once again told that it would be no issue processing the claim as a seasonal employee. The claim would go through FMLA but would move onto unpaid medical since I was a seasonal employee. Again the claim was closed without allowing the claim to move onto unpaid medical. Calling does not help. I have sent an email to customer service and no response. When the claim was closed for the second time almost two weeks after I was out of work. I could not keep calling and getting the runaround. The claim being closed incorrectly will affect my attendance when I did everything I should have. There is an issue with Sedgwick processing claims for seasonal employees.

Hello, I have been trying to file an intermittent leave to get to Doctor's appointments which are 2 hours away from my home. The doctor's office filled out the paperwork wrong and the request was denied. They told me I had thirty days to appeal. I resubmitted the paperwork and waited a week. Unknown to me the examiner denied it again due to one missing box. I had to call to find out that it was denied again. A week later now it's too late for me to have the paperwork submitted. They say we have to allow them a week after we submit paperwork for them to review it. They never communicate what they needed fixed or even that anything needed fixed. They just deny it. They communicate via customer service reps who don't know what they are talking about and I am left with no information to tell the doctor's office about how they need to fill in the paperwork. The organization is terrible and keeps people from their federal rights. I am going to the doctor regardless if I lose my job or not.

Claim [protected] / Sedgwick has not responded to me nor my Doctor and he has not been paid. I cannot get my RX approved by them as they say my case is closed. Repeated calls have not been returned despite messages left. This same thing happened a couple years ago and I had to request a hearing with Workers Comp... then Sedgwick responded and I got my RX filled.

I was involved in an accident on 1/28 with someone driving a Zipcar. It was his fault and he was ticketed on scene. The accident totalled my car. Zipcar gave me the claim number for the claims that was reported and the name and number of the claims adjuster. Nobody has called me back. I've left 10 voicemails. My car is not driveable and is sitting in storage at the yard where it was towed. It is costing storage fees every day that it sits there. I have no car to drive to get to work. I need a rental car or I need this claim settled so I can get to work. I have photos, a police report, and my own insurance company adjuster has been trying to reach you as well. Please have someone call me back, I need to know what is going on with this claim. The claims number is [protected]. I can be reached at [protected] or [protected]@gmail.com.

I currently have a Worker's Comp claim with Sedgwick(4A2208ZKNLX-0001)and the customer service is to say the least horrible! From what I have been told through customer service the Claim Adjuster is suppose to make contact via Email or Phone w/in a 3 business days...what a joke. After making numerous phone calls and emails regarding my claim and checking on my benefits I have yet to hear back from my claim adjuster. There are no updates on MySedgwick regarding my claim and a payment should be coming however, the way looks it's uncertain. I have no idea how a company can stay in business with customer service like this! If this were any other occupation not following proper protocol they would be out of a job! It is needless to say that Sedgwick does not take into account that individuals are paying bills with these payments, so since it's not affecting their pockets the injured employee is just another number. They will say "You can contact the supervisor" then you call and it's the same thing...NOTHING! Dealing with Sedgwick has taught me 1 great lesson NEVER GET HURT ON THE JOB AND IF YOU DO ASK IF SEDGWICK HANDLES THEIR WORKER'S COMP BEFORE EVEN ACCEPTING THE JOB.

I have been dealing with a claim from a break-in in a Public Storage from April 2022 and finally resolved in Oct 2022 then had another break-in in Sept 2022. Mind you this whole time I have only spoken with my claim adjuster maybe 5 times in 9 months. I call on a daily, multiple times, leave messages, sent numerous e-mails and you can never get her on the phone always to a voicemail, you don't get a response to your e-mails, surely do not get a call back. This is the worst experience I have ever had with a company. Well after finally getting the 1st claim resolved. Just when I thought I was done with this horrible experience and getting the 2nd claim resolved. Somehow the incorrect routing number was entered. So this was January 3rd, 2023 I still haven't received. After escalating to speak with the boss of my claim adjuster and find out that the incorrect routing number has been entered and after going back and forth checking with my bank. Funds have yet to be received. Sedwick says there is nothing they can do. Escalated to the next in command and he tells me the same thing. After me doing the research that routing number does not even exist. So I call once again finally getting thru giving them this information that there is no way this deposit came or will come to me because of wrong routing number they keep saying well it hasn't been rejected and it shows paid. Of course cause it is a transaction I tell them you can recall the deposit because YOU know the routing number is INCORRECT funds will go back into SEDWICK's account and then you can send a check or send to correct routing. Still they say there is nothing they can do... I do not know how this company is still in business. The communication is the worst ever.

Sunni Yi- Good Day

Workman Comp request submitted 12/30/2022-

I am putting this into written format due to the fact that the only contact that I have with this workman comp claim and your office is one of your peers calling me to take my statement and in the middle of the statement she told me it was too complicated and you would be in contact with me the following week upon your return. (1st MISS)

Second contact is the decline letter received last week. I called and left a message and received no return call.

I am really sick due to the toxic biotoxin exposure that has taken place in my workplace. I have two doctors appointments next week on 1/31/2023 and 2/2/2023. I am seeing Dr. Alfred Johnson and Dr. Nancy Didrikson for assessment and treatment.

Since I only received a decline letter I have included my attorneys in this correspondence and I am going to wait on your next steps to rectify this incorrect declination process. Usually in most cases of anything there is a request for supporting documentation to be reviewed.

Attached again is the written statement that I sent via email.

See initial written statement- I would like to keep communication in written format going forward since there has been a lack of follow-through and action with regards to my sickness caused by mold poisoning. My expectation is receive a response from your office and proper handling of my situation. Please respond via email that you have received and you are aware that next steps need to be taken.

From: WCHLP [protected]@bofa.com

Sent: Friday, December 30, 2022 9:48 AM

To: Pollard, Angela - 2 [protected]@bofa.com

Cc: Cross, Jill jill.[protected]@bofa.com; Crosier, Scott scott.[protected]@bofa.com; Chao, Jonathan jonathan.[protected]@bofa.com

Subject: RE: Toxic Mold Sickness

Thanks Angela. I am sorry that you are having issues. The date of injury has been changed to 8-15-22 as that is when you stated that you started having serious symptoms. The bank’s work comp insurance company with be in touch with you within 5 to 7 business days to discuss your case.

Regards,

Alyre Efird

VP, Insurance Manager

Enterprise Insurance Management – Claims

Bank of America - Charlotte, NC

Email: alyre.[protected]@bofa.com

Phone: [protected]

Below is my communications contact with them. I still do not have my 2021, W2

Holly Wastler-Miller

Over a month since our last chat here. We have still NOT received the 2021 W2. I'm not sure what to do next. I suspect I have to notify the IRS that we can not submit our 2021 tax return because we can not get a duplicate W2 from Sedgwick and ask them what to do next. I know we have late fees that will be due because of this... Less

1/23/2023
3:03 pm
Case Manager
Conversation resolved through telephone call as more appropriate communication channel... LESS
1/24/2023
12:13 pm
Holly Wastler-Miller
There is nothing resolved here. As I asked before what phone number should I call?
1/24/2023
1:31 pm
Holly Wastler-Miller
Clearly you do not want us to call you. Can you please call us at [protected]... thank you... LESS
1/25/2023
2:22 pm