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09-19-2019, 07:04 PM
Hello Everyone,
I live in NJ and settled my workers compensation case. I signed all the appropriate paperwork, and it states that the company that is paying my settlement is Sedgwick CMS. Has anyone else received a settlement payment from Sedgwick? What is the process like with them? Any information is much appreciated.
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(09-19-2019, 07:04 PM)eclark16 Wrote: Hello Everyone,
I live in NJ and settled my workers compensation case. I signed all the appropriate paperwork, and it states that the company that is paying my settlement is Sedgwick CMS. Has anyone else received a settlement payment from Sedgwick? What is the process like with them? Any information is much appreciated.
it appears that your employer is self insured. Sedgwick has a contract with them to adjust the claim and pay the benefits. all costs will be directly charged to the employer. if they contract with another company your claim will be moved. I suspect sedwick handled everything up thru your settlement. future benefits and dealings should continue as they have.
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1171,
Thank you for the response. My case is actually closed and I will just be receiving a lump sum settlement. Therefore, there will be no other payments in the future. Are you familiar with this insurance company?
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Are you closing medical too or just the work part? They are my insurance carrier and having a battle with them. Closing the work part was real easy.. was told to keep medical open so I could be treated... That's a laugh... been one fight after another with them. They keep denying all types of tests, scans and procedures. I'm at the point now that they refused to pay a ER bill and had my private ins. pay it... So now my lawyer is trying to get a hearing set up for that bill and 2 others they are refusing to pay and drawing up the papers to close medical...
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(09-20-2019, 07:44 AM)tbear6410 Wrote: Are you closing medical too or just the work part? They are my insurance carrier and having a battle with them. Closing the work part was real easy.. was told to keep medical open so I could be treated... That's a laugh... been one fight after another with them. They keep denying all types of tests, scans and procedures. I'm at the point now that they refused to pay a ER bill and had my private ins. pay it... So now my lawyer is trying to get a hearing set up for that bill and 2 others they are refusing to pay and drawing up the papers to close medical...
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(09-20-2019, 08:26 AM)eclark16 Wrote: (09-20-2019, 07:44 AM)tbear6410 Wrote: Are you closing medical too or just the work part? They are my insurance carrier and having a battle with them. Closing the work part was real easy.. was told to keep medical open so I could be treated... That's a laugh... been one fight after another with them. They keep denying all types of tests, scans and procedures. I'm at the point now that they refused to pay a ER bill and had my private ins. pay it... So now my lawyer is trying to get a hearing set up for that bill and 2 others they are refusing to pay and drawing up the papers to close medical...
I closed medical because they were also refusing to give me treatment. We ended up just settling with them and I am currently waiting on my settlement check. I’m sorry you had the same experience. When are you due in court?
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Don't know.. Lawyer is trying to get one done up... He wants me to be seen one more time with my surgeon and Pain Management office and to try and put in one last MRI request... even though 8 have been denied..
I know when I settled the work part, I got my check within 2 weeks... I was told the carrier had 30 calendar days to send it.. if they didn't, they are charged interest each day it's late...
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(09-20-2019, 10:48 AM)tbear6410 Wrote: Don't know.. Lawyer is trying to get one done up... He wants me to be seen one more time with my surgeon and Pain Management office and to try and put in one last MRI request... even though 8 have been denied..
I know when I settled the work part, I got my check within 2 weeks... I was told the carrier had 30 calendar days to send it.. if they didn't, they are charged interest each day it's late...
It’s so strange they would deny treatment especially if you are still suffering from your injury. I thought the only way they could deny medical is if you settle with a section 20. I settled mine is August and it’s been a little over 3 weeks and I still haven’t received my check. I was told they pay out settlements quickly but we’ll see. It seems as though your lawyer is on the right path and regardless of if they keep denying treatment, can’t he file a motion? That way you can go before a judge and have them decide.
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He's filed so many motions that I lost count. The thing that hurts is that Sed is just giving info and findings on scans that are old.. My surgeon can't just say this is new.. that's new... unless he has a new MRI to compare...
Did have an EMG cause of the problems I'm having with my legs from the lower back... The doctor put in her report that a MRI is needed to see how much new damage is done to the nerves... But the Judge said since there is no new anything, he went with Sed and ruled they will not be responsible for payment if a MRI is done...
Denials have been going on since I settled work part 2 years ago..
Good luck and hope your check shows up soon... My lawyer told me I should hope the check had come late so they would of gotten hit with interest...
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(09-20-2019, 12:06 PM)tbear6410 Wrote: He's filed so many motions that I lost count. The thing that hurts is that Sed is just giving info and findings on scans that are old.. My surgeon can't just say this is new.. that's new... unless he has a new MRI to compare...
Did have an EMG cause of the problems I'm having with my legs from the lower back... The doctor put in her report that a MRI is needed to see how much new damage is done to the nerves... But the Judge said since there is no new anything, he went with Sed and ruled they will not be responsible for payment if a MRI is done...
Denials have been going on since I settled work part 2 years ago..
Good luck and hope your check shows up soon... My lawyer told me I should hope the check had come late so they would of gotten hit with interest...
That’s so unfortunate, how can anything be proven if they won’t allow further testing?...I hope that your lawyer is able to get some change soon. Thank you, it’ll be thirty days on September 30th at which point I will be contacting my lawyer. Thanks again for the input and best of luck to you.
