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  • Report:  #938952

Complaint Review: Sedgwick CMS - Internet

Reported By:
Mariecr - Glen Lyon, Pennsylvania, United States of America
Submitted:
Updated:

Sedgwick CMS
11350 Mccormick Rd, # 800, 21031 Internet, United States of America
Phone:
(410) 773-4200
Web:
http://sedgwickcms.com
Categories:
Tell us has your experience with this business or person been good? What's this?

    I injured my self on the job on March 9th, 2012.  I work for the American Red Cross and I am a phlebotomist.  I fell from a tote about 3 ft down onto a ceramic floor.  I hit my head, back and lumbar area. I followed the proper routine to file the workers comp that very day. But I could not go to a hospital and no one could take me because we were too far from where our office is in PA. And the blood drive was in NY.   

     I did go to the hospital the next do to the ER and had a X-ray done on my cervical area and back. And that was it. Sent me home with a list of what to do when I get home with ice and heat and follow up with the companys worker comp Dr. Which I did that following Monday.  The doctor there treated me with injections first and regular IBprobhin.

     After seeing the WC doctor for about 2 weeks and tried to work in between and kept complaining about the pain I was having in my chest and back. So the WC Dr sent me for a Thoracic MRI only to find out the next day I had a Compressed Fracture of the vertebrae, T3. Now Sedgwick CMS was notified and about 1 week after I was diagnoised with fracture which was 2 weeks after the fall is when they finally called to get an evaluation. Now the woman that called was Jennifer Mace and set me up with their nurse Lisa Redifer to keep in contact with me and go to the Dr appts with me.

     I was set up with an Orthopedic Surgeon to eval and treat me. Dr O'Brein has been a great Dr in treating me as well. He had me on very strict restrictions for 3 months. No bending, twisting, lifting more than 5 lbs, no laundry, no doing dishes or cooking. I was only allowed to drive no more that 15 minutes at a time.  Which I did and listened very well. He then released me around June 7th to start physical therapy. And it was water therapy.  I had only gone maybe 3 times for therapy because I also had been dealing with migraines the whole time after I hurt myself.  I had received a call from Jennifer Mace like I did on the once a week check in, to see how I was feeling. Prior to her call I also had seen my family Dr as well who sent me for an MRI of the Cervical area due to the Migraines.  So the reason for her call was to trash me and was ignorant to me about the medical records she had received. She chewed me out and up and down about certain conversations I had with my family Dr, she then accused me of using my WC as a vacation and I was not allowinga  my fellow employees to go on vacation. I told her I had barely been going to PT, still had pain in the chest and back which they were sending me for an MRI for and a follow up with Neurosurgeon. And for the Migraines as well. Her answer to me was, " Take a pill for the migraines and people work with pain, so deal with it!" Two days later I received a call for my appt for an IME with the insurance Dr.

     Now I barely have been going for PT, still in pain and still haven't gone for my MRI as of yet.  The Dr who performed the IME seemed to be confident and agreed with me that due to lack of PT, still  having pain and movement problems and needed to follow up with a Neuro surgeon, that for sure he still would say I could not go back to work. Well 2 weeks later I received my email from Jennifer Mace CMS of Sedgwick, sent me my IME report, at 10:30 PM.  which I found to be very unusal???  The IME report stated that I was 100% able and capable to go back to work, I had no pain, and move ever so effortlessly during the IME. EXCUSE ME!!! WHAT!! Something isn't right here!! I thank God the whole time I have had a lawyer. And he has been receiving all my info.  The office visit I had with the Dr and the papers were like a total 360. And I do believe Jennifer Mace at Sedgwick altered the papers.  Because I called the Drs office and the secretary of the Dr actually confirmed that even the numbers on the copy I had from Sedgwick did not match up on their copy on their computer. SO WHAT DOES THAT TELL YOU! 

     I started receiving Return to Work papers from the American Red Cross in CT. And I wrote back to them what Jennifer Mace said to me and that I don't believe the IME was right nor what she said was right.  I received a phone call from Jennifer Mace 2 weeks ago about what I wrote to the Red Cross and denied every word.  I proceeded to tell her I wrote everything down in my kept documents she in turn said that they record conversations. Well the President of Sedgwick better  get a hold of our conversation and listen to it. Because what was said to me was the truth!!!

     Now last friday I received a letter from the Red Cross lawyer stating that my WC was being dropped and would no longer be receiving my checks. I sent everything to my lawyer and he said he was expecting this. All my Return to Work papers that I sent to Red Cross stated that I didn't sign not because I was refusing but because the IME Dr is not my attending Dr. And my attending Drs, both the Orthopedic and Neruosurgeon bothe agreed I still could not go back to work. And my most recent MRI proved it. I had a Spur (bone) grow on my vertabrae where the fracture was. And the fracture still is not healed!! 

     I even sent Jennifer Mace and Red Cross the results of the MRI and what the Drs said. But due to Jennifer Sedgwicks ways of lying, manipulateting, and conjuring up a fake IME now they are going to try and stop my benefits. 

     WELL I DON'T THINK SO!  I really hope by writing this that more people start steping up to the plate aboout Sedgwick CMS and how they are the biggest SCAM third party insurance ever!!!  Thank you for listening.



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