What do you do when your STD agent is not qualified for your situation

The rep from sedgwick stated his personal opinion of my claim and may denie my claim because he doesn’t agree with a medical professional, what gives him the right?

It maybe that your case manager is just bullying you so you go back to work or give up your claim or quit your job. It tends to work :slightly_smiling_face: Don’t fall for it and follow your doctor’s recommendations.

If you get denied you can always appeal or sue your insurer.

And don’t quit your job!

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They have the right to make a decision based on the information available. They are entitled to disagree with what your doctors are saying, but it should be based on them having an alternative medical opinion. They may have had your case reviewed by a doctor behind-the-scenes so you wouldn’t know about it.

You have the right to appeal. Also, if your disability ins ongoing, you should also apply for long-term disability benefits even though they have denied your STD claim. If they give you any problems with applying for LTD, then you can consider that a denial of the LTD claim and then have the right to take action against the STD and LTD providers. Sometimes legal action is the only way to cause them to approve your claims.

You should get a legal opinion on your specific situation because all LTD plans are unique and the strategy would be different depending on your situation.

David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliabile manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.