I have been on disability since March. Sedgwick CMS is the disability administrator for AT&T. (When I first became disabled the company was SBC, but is now AT&T.)
Sedgwick tried to deny my short term disability about 8 months into my disability. The lawyer I hired to represent me for Social Security appealed the denial and my benefits were reinstated. At the end of the 52 weeks of std, I was entitled to a disability pension as I had 25 years of service. I was also approved for ltd. I have hydrocephalus (due to a traumatic brain injury). The injury has caused me to have cognitive deficits which prevent me from working. I was approved for Social Security disability in February. I have not been receiving ltd benefits as the pension and social security "offset" ltd payments.
Sedgwick left my ltd claim "open" and I was reviewed every 6-12 months. Their physician advisors stated that my condition was most likely permanent and that until they received updated medical info showing my cognitive impairments had improved, that I was entitled to disability. There had been some discussion at Sedgwick of whether or not I should go for further neuropsychological testing but they deemed that is not necessary.
In July I received a letter from Sedgwick stating that they had determined I was no longer disabled and this was effective back to April. They had a "vocational expert" to say I could do sedentary work based on my education and training, etc. She has never seen or talked to me. She didn't take into consideration the brain injury. They said they denied my disability because my neurosurgeon stated that my shunt for the hydrocephalus was working ok (which it has since May). They also said my family doctor stated that he thought I could do sedentary work. He does not recall saying that.
In my appeal, I pointed out their PA's stating that my condition was permanent and that until my cognitive improved I was entitled to disability. I also had my neurosurgeon correct the chart note to clarify that I had no new symptoms but still had the same problems that caused my disability. My family doctor also wrote a statement that he could not say one way or the other whether or not I could work.
In March I was notified that they were upholding their decision. They never made any mention of my brain injury, etc or anything relating to my disability. One doctor even stated there was no evidence of any cognitive problems to prevent me from working. Based on what, I don't know.
One of the physicians reviewing my case was a neurosurgeon alright, a pediatric neurosurgeon who does research at the University of Florida. I'm sure he is well in tune with adults with brain injuries in the work place. Right.
I am contacting legislators, my governor, the president and any disability advocates I can find to see if I can get someone to investigate this company. I am doing this a the advice of an attorney. I contacted the Department of Justice today. Maybe if we can all make enough noise about Sedgwick, someone will investigate this.
I was told by a CWA representative that AT&T was not satisfied with the numbers of claims that Sedgwick was approving, so evidently Sedgwick is just going through trying to clean house, so to speak.
The lawyer said this is a "breach of contract". As another poster stated they are not handling the ERISA situation prudently as the fiduciary. On that note, I didn't find out until after I had paid a lawyer to obtain my social security, that SBC (now AT&T) used Allsup, Inc and PAID for them to help their employees on ltd obtain SS. They sure weren't looking after my best interest.instead they were trying every way they could to deny my benefits. Then they wanted to turn it around that it wasn't there fault that I declined Allsup. It was never offered to me. I found out about it from a lady at the social security office when I was applying for the benefits for my children.
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