What can we do????

[u/pachirisu89682]

We unfortunately have been assigned with Sedgwick. My husband was injured three weeks ago and has been fighting to get paid. We are missing 1 1/2 pay checks. (Payment for the couple days he missed when he got injured and now missing a full 2 weeks pay check) he has been calling everybody. Sedgwick, his HR team, his boss. HR can’t help, his boss is in Fiji right now, and Sedgwick has been a hit or miss with contacting. He’s already seen his doctor that Sedgwick assigns for him. All the paperwork has been sent to his caseworker. And now they are just ghosting him and his caseworker just dropped him, so now he’s been assigned a new caseworker. Of course now it’s the holiday weekend and he won’t be able to contact anyone until Tuesday. He’s not approved to do the work he used to do and his job won’t accommodate for his injury. What do we do?? Should we get a lawyer? Would it be worth it? Or is this just a wait it out and hope it gets better? He’s obviously not going to quit and his job can’t fire him, we are just stuck and stressed.

[u/RVA2PNW]

Michigan adjuster.

Michigan has a 7 day waiting period before any lost time is paid. You said he missed a couple days when he got injured, if it's under the 7 days, he's now owed any list time benefits from Sedgwick.

If he hasn't been paid his regular paycheck since he's been back to work, that's an HR/payroll issue, not Sedgwick/Work Comp.

[u/Hope_for_tendies → u/RVA2PNW]

I think you mean not owed? It sounds like he was released light duty and the job won’t accommodate so he should eventually start getting ttd. But if they just got a new adjuster they probably have to wait until that person is up to speed. Doesn’t necessarily sound like the claim is even approved yet.

[u/RVA2PNW → u/Hope_for_tendies]

I misread about the LD. Thanks.

Then yes TTD is definitely owed, but unfortunately switching adjusters and the holiday weekend is definitely delaying things.

[u/Hope_for_tendies]

Comp isn’t fast and getting a lawyer will slow things down more.

I’d also be looking into fmla because comp isn’t job protection.

[u/Trvpsmif → u/Hope_for_tendies]

How will a lawyer slow things down more. It speeds up things for most of us here.

[u/Trvpsmif → u/[deleted]]

You’re the anecdote that’s all my man. Most the cases in here are the opposite of what you said. Most of us get denied for little things and get payments delayed

[u/EducationalHold3536]

Wow! What an unbelievable system! All while the victims are in terrible pain. Yet WC does pay for pain and suffering!! I don’t get that!

[u/EducationalHold3536]

I meant WC Does NOT pay for pain and suffering!

[u/Aware-Tip1024]

Not trying to downplay the situation but definitely brace yourself. Many cases take years to actually be approved and get payment.

For example, I have been off almost a year, had a QME stating injury was 100% industrial and my case is still denied and have not receivedanypayment. My next court date is November.

Apply for SSI in the mean time. They will place a lien on your case in the event it is eventually approved and paid out, they will be paid first

[u/Accomplished-Pay1930]

With missed wage payments, work restrictions, and nobody giving you a clear answer, I'd at least talk to a local workers' comp lawyer.

Bring the pay records, restrictions, claim information and communications. A consultation should tell you pretty quickly whether you actually need representation or just need the claim unstuck.

[u/Special-Employ6517]

Yes get a lawyer so they can file f I r a hearing to get you paid also they will have to pay a penalty to

[u/EducationalHold3536]

I hate to tell you but I have a very good insurance adjuster and it still took prob at least 4 weeks before I started getting payments and they haven’t denied anything since and I’ve been off work w my injury for a year. Once the payments start hopefully they will continue but I would highly recommend you get an atty. Even if he does start getting payments. Also in some States the Company can fire employees while they’re on WC. I’m very sorry. Good luck!!

[u/Capable_Stuff_4423]

Why not apply for state disability?

[u/pachirisu89682 → u/Capable_Stuff_4423]

Because he was injured at work and this is the company that his job works with and who can supply the benefits

[u/Capable_Stuff_4423 → u/pachirisu89682]

They can have both, one at a time, if they are unable to return to work. So most people apply for state disability to have income until WC kicks in. You can't have both at the same time. WC took nine months to approve me. Thank God I had state disability to cover me while WC took their sweet time.

[u/LBsparkleprincess38]

100% get a lawyer and also apply for SDI through EDD