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Sedgwick CMS Sedgwick Causes Delay in FMLA Process, Denies Claim for "UNTIMELY SUBMISSION," Costs AT&T Worker His Job, Over Bronchitis Contracted on the Job! Tulsa, OK (DBA AT&T FMLA OPERATONS) Nationwide
These inept (or purely evil?) criminals cost me my job and jeopardized my home and family with their obstructive tactics.
I was just fired last week (April 18, “Good” Friday) from an AT&T Mobility call center in Tulsa, OK, where I’ve worked for 16 months as a Customer Care Rep. In Dec 2013/ Jan 2014 there were multiple ‘bugs’ going around in my work area. After about two weeks of dealing with an uncontrollable cough that progressively interfered more and more with my ability to handle calls, I woke up on Jan 01 in a cold sweat, dryheaving, thinking I had a stomach virus.
Next day I went to an Urgent Care clinic near my home, was swabbed, tested, diagnosed with bronchitis, given a heavy antibiotic (Zpack, which made me worse for 48 hrs before getting better), a pill Rx, and albuterol inhaler. I missed 4 work days. Jan 3 was an off day, no penalty, but the absence added 4 attendance points to my then SIX. Termination level is 8, so the claim was do-or-die. I returned to work on Jan 6, found that two others on my team were also out with bronchitis, one hospitalized, and I put in my FMLA request. I gave them my cell number and my personal email address, and requested updates to be sent there, because I knew my “work email,” which can only be accessed when I’m clocked in and taking calls, with every second being monitored, was VERY difficult to keep up with, especially when still not quite back to normal yet. I didn’t want even a chance of missing an update. (Hold THAT thought for a minute.) I called the clinic where I’d been diagnosed, emailed them the form I was sent, gave them my Visa info to charge me for sending the fax. They faxed it in on Jan 12, six days after my return to work.
Two days later, unbeknownst to me, a reply was sent to the very email address I did NOT want to have to rely on, with nothing sent to my personal email, which as I said, was the one I expected it to be sent to. And of course I was late finding it too. That was the very reason I wanted it kept OUT of that inbox in the first place, so it could be done more methodically, in an email acct I could access on my own time. Nothing had come to my personal email. The reply I found late said “Documentation that would meet (our) requirements WAS NOT received within the allotted time period.” This email also contained an FMLA physician form. It seemed to look a little different. I notified the clinic of the problem, and at that time they informed me that the form I had sent them originally was NOT even an FMLA form, but an AT&T Worker’s Comp form… (Sedgwick had sent me the wrong form the first time)… but they told me that they had put my info into it anyway and sent it on to prevent a delay. They agreed to send another, in the proper format (WHICH I NOW HAD), at no charge due to the extenuating circumstance. However, the rules of the clinic dictated that only the doctor who examined me could legally fill out this form, and that doctor worked in another town two weeks out of every month. So I had to wait for the doc to return to town before it could be done. I called the FMLA office, informed them of the situation, and they told me that the deadline had passed, but that the deadline for any ADDITIONAL info to be sent in was going to fall on the day after the doctor’s return to the clinic in my town. It was skin-of-the-teeth timing, but barely safe, or so I thought. (Even so, IT WAS OUT OF MY CONTROL.) The doc’s first day back in town, I was there, with the right form, and the info was faxed in FOR THE SECOND TIME as I watched, all because Sedgwick had started the process by throwing me a curveball I had to deal with and a mess to clean up. My claim was final denied, and the excuse given was “lack of a sufficient reason for the untimely submission,” even though the delay was their fault, a result of their sending me the wrong form to start with. Add to that the delay caused by their sending my reply to the very email I requested they NOT use (due to the KNOWN difficulties in keeping on top of it), plus the delay of the doctor being out of town, which my conversation with them had led me to believe had been taken into consideration.
My final FMLA denial had one single sentence at the bottom, in lighter font (set up to be overlooked), mentioning something called an IDSC claim, which I had never heard of before (FMLA is more a household term). This was another ATT acronym (don’t get me started on “Acro-nese,” a language born of neccessity due to being so rushed that we don’t have time to use real words) for “integrated disability service center,” and since I am not a “disabled” person, never been on disability, don’t fall into any “protected class,” I dismissed it as not pertinent; and despite all the hands-on help available for literally everything (else) done in that call center, even filing insurance or 401k, I was blind to the fact that this secondary claim could help even ME, until a manager clued me in and advised me to file IDSC claim ASAP. I did, that very morning. Proper form was sent this time. I saw what the doctor wrote. No way this one will fail, right? (THIS IS MY THIRD TIME TO SEND THESE PEOPLE DOCUMENTATION, the same info in three different formats now.) THAT claim gets denied, due a time window that had already passed before I filed it. The FMLA denial’s single sentence in the footer about this IDSC claim also said that IDSC had to be filed within ten days of FMLA denial, a date which had passed before my IDSC claim was started. But Sedgwick didn’t inform me that it was a wasted effort (and a wasted faxing fee) until the denial of that claim.
Both claims were denied despite what I still perceive as a great effort on my part in getting them all the documentation they needed, not to mention having to make up for their initial error. I was told that there was no avenue of appeal either, even though Sedgwick’s error indirectly caused the very delay that they used to deny me. Unbelievable convoluted mess to say the least. I feel this whole thing was set up for failure. Gaming, scheming, intentionally making things difficult… I’m not sure really HOW to best describe this fiasco. Honestly I’m still in a mild state of shock I suppose.
Now it is March, and I am basically a dead man working, two attendance points over termination level, despite EVERYTHING I did, just waiting for the hammer to fall. I approach managers, asking what is going to happen to me, over the course of several weeks, while I’m still working there, with 10.25 attendance points hanging over my head. The stress was unbearable. (I’m still not back to sleeping or eating normally.) Several had told me during March that since prior to the January illness, I had only gotten one “first written notice” for attendance (step 2 of a 4 step process, with step 4 being termination), it was likely that I would be retained and placed on “final written notice” rather than terminated.
It wasn’t until April 18 (the day after my wife, a CWA Local 6012 Union Steward there, had just returned from a mass CWA protest rally at ATT Headquarters in Dallas), that I was expedited out the door after a brief meeting, at the beginning of the day, before logging into the phones (which I never touched again). Union Steward present at the termination questioned the AM about skipping the “final written notice” step of the disciplinary process, and the reply was “uh… some policy changes are taking place in the back, don’t have all the details yet…” The Steward didn’t buy it, but I was still terminated. The Union has filed my grievance, but I have no idea what it will come to.
Now I don’t have a job, and all I did was get sick, with bronchitis I picked up at work, exacerbated by taking calls and talking all day, and missed an email that I did my best to make sure would not go into the “vortex,” or work email. This just does not seem morally right.
1 Updates & Rebuttals
Randy
Owasso,Oklahoma,
Sedgwick CMS Tampering with Medical Records?
#2Author of original report
Fri, May 02, 2014
This is NOT a rebuttal. This is an update. Following my termination, I returned to the Urgent Care clinic that had diagnosed me and had sent the three fax transmissions mentioned in my story. I wanted to get the dates and times of the fax transmissions, as well as copies of what was transmitted, the most important of which being the very first fax that was sent, SIX DAYS AFTER MY RETURN TO WORK... WITHIN THE PRESCRIBED TIME FRAME (the one that the clinic had told me was not a FMLA form but a workers comp form). The clinic had full documentation as well as dated copies, of the SECOND fax sent, as well as the THIRD fax sent. But not only was there no COPY of the initial fax (the proof of Sedgwick's error), there was no record whatsoever that it ever happened! Nothing! I had two different people in that clinic scouring my folder as well as my computer records, and even the receptionist was amazed and confused, as she specifically remembered sending it herself! I then produced a bank statement from January, proving that it had been authorized on Jan 10 and transmitted to Sedgwick on Jan 12. The clinic took my email address and said they would look into it. Have not heard back from the clinic. Several articles I have seen since my termination speak of Sedgwick's paying off certain doctors and clinics to make things go away, in order to support their denials. I have proof of what these people have tried to make disappear. I may not have a copy, but I have proof that the clinic charged me $25.00 on Jan 12. The clinic does not have a single shred of record that the charge, for a fax fee, or ANYTHING, happened on that date. What does that tell you?