Report: #1370199

Complaint Review: Sedgwick ,CMS

  • Submitted: Fri, April 28, 2017
  • Updated: Fri, April 28, 2017
  • Reported By: anonymous — Los Angeles California USA
  • Sedgwick ,CMS
    P.O. Box 14648
    Lexington, Kentucky

Sedgwick ,CMS County Department of Human Resources,Employee Benefits Division I was denied benefits after suffering from a worker's comp physical injury mental injury caused by my employer. Commerce California

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 First claim: I fell going upstairs into my job at 5555 Ferguson Dr, Commerce, CA 90022. I injured the right side of body (hand,arm,shoulder,knee and hip).I filed a Workman"s Comp report on August 2014. I was seen by Kaiser Occupaational Health doctor. Dr, Kim, I received physical therapy from Select Therapy. The County's disabliity adjuster TriStar let my therapy treatment lapse withouuut notice to me and Dr. Kim. I contacted TriStar and informed them that I still needed therapy and was waiting for approvalll for more therapy since March 2015. This had happened before in Novemeber 2014 with me having to contact before for treatment. I recieved an authoriation for more therapy August 2015, but Dr. Kim had closed my case before I recieved the authoriation. 

I contacted a attorney,because that was the only way I could keep the case open. It took to January 2016 for TriStar to authorie physicall therapy. I filed for long term disablility with Sedgwick, CMS in February 2016 according to there filing purposess. I was to received benefits starting in April 2016, but for some reason they did not receive my application. I had to submit a new application which woullld have lead to me getting benefits in October 2016 retroactive to April 2016. I was then told that my claim was denied because my employer claimed that because I continued to work while injured. I did work but I thought the therapy was working unitl I started have severe spasms in my hand. fingers, wrist and elbow, shoulder. I totally recover from the hip and knee injury. I attempted to go back to work October 2016  but lasted only 10 days. Sedgwick order for me to be reviewed by two of there Doctors for my two claims

Second claim: I was bullied,harassed, retailiated and humiliated for 10 months starting January 14, 2015 til September 26, 2015 by several co-workers and supervisiors because I participaate in a fraud investigation regarding my department. . During this time my co-workers attempted to filie a false report on me. Hung a unprofessional flyer directed towards me, and took photos to intimidate me. I was told by the head supervisior that I was not safe at work. I went into a partial pscyological program and saw a psychriatrict. I was also evaluated by a QME psycatris who found my claim reputable and stated that I should not return to my job if the situation I had to endured was still present.

I was seen by a Dr. Gross for my orthopedic problem for Sedgwick who intimadate me because I was in a spasm and could not perform the functions he wanted and told me that if I could not perform he would give me a bad report. He informed me that I needed (3) cortisone shots to my hand, but yet nothing was wrong with me. The psychiatrist  Dr. Hochman believedI  I received enough treatment sinve I was no longer on medication or seeing a psychiatrist..

I have been denied long term disablitiy by Sedgwick which I have paid for years  under my insurance benefits.and I did everything including waiting for the eligibility period twice.  I am currrently recieving acupunture therapy for my hand. I have used all my accured time for payment. 

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