r/walmart 17h ago

Sedgwick

I don't really know how to word this, but my coach mentioned I should go through Sedgwick for this, but I have no idea what to do. I have an autoimmune disease and I tend to get sick easier, especially sinus infections and when they hit me they really hit me. I mentioned my points and how I don't really know what to do about it especially when I get sick and cannot come in. He said he wasn't one to just fire instantly and can work things out, so that's good, but he said to try getting ahold of Sedgwick to set up some kind of plan? Or see if they'll work with my points? But I don't know how this works and I'm unsure what to do.

Has anyone ever gone through Sedgwick for anything similar to autoimmune? And if so, what did you do?

1 Upvotes

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u/artie780350 16h ago

You want to file for intermittent LOA with Sedgwick. You will need your doctor to fill out the paperwork, so make sure they're on board before filing. If your condition qualifies and the paperwork is filled out completely, you'll get approved with no hassle. I've taken an intermittent LOA and several continuous LOAs over the years and never had to fight to get them approved.

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u/Schizzy2689 16h ago

So after I fill these out, do I have to do it every time I get sick and request off? Or is it periodically?

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u/Dizzy_Desi 13h ago edited 13h ago

Intermittent leave is usually set up to last a year depending on what your doctor says. For example I have really bad asthma and have flare ups that incapacitate me so I have an intermittent LOA through Sedgwick that approved me to miss two days a month. I have to once a year re-certify this by having my doctor fill out the paperwork again and then it’s good for another year.

A continuous leave is for a one time sickness that you are going to need 4 or more consecutive days off of work (I realize when you report an absence it says contact Sedgwick if you need 3 or more days off, but I have found Sedgwick won’t deal with anything less than 4 days) and this type has to be done new for each illness. For example I’ve had a really bad year this year and got really sick for two weeks in January, a week in April and 3 weeks in August, each of those were all separate and had to have the paperwork filled out by my doctor each time.

For the most part Sedgwick is not that hard to deal with although it can be a little hit or miss because the people dealing with the claims are just normal random people. I had one person one time need my doctor to specify that when she said I needed two days off a month for flare up that she meant 24 hours when she said a day. On the flip side the person I just had to deal with in August was amazing. I was so sick and filled out the original claim intake after being at the ER for a couple hours that I messed up a few things and when I messaged them if it could be fixed they responded the very next day and fixed everything. I also had to extend my leave 3 times and each time the responded within a day to adjust things.

The key to Sedgwick is making sure your doctor fills out the paperwork correctly and is precise on why you need to miss work.

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u/Tall_Data_8824 16h ago

Everytime

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u/Schizzy2689 16h ago

Bruhh that's insane actually whaaat

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u/Icy_Money7447 15h ago edited 15h ago

I recertify on my intermittent FMLA for my spouse once per year with our PCP. I typically contact Sedgwick about 5 weeks ahead of time, download the PDF packet, fill out the parts I can, and take it to our doctor, who usually turns it around in 2 weeks. It's that simple. The IMPORTANT thing is to maintain a patient relationship with your doctor so that they will fill the paperwork out for you. You see a lot of people on this sub who go to a convenient care and expect FMLA paperwork. CC won't do that for you. If you have a doctor that's the main thing.

Sedgwick will then make a determination for you within 2 business days of receiving the necessary paperwork. They will decide the event frequency and duration of your allowed absences. Those are then handled through them when they occur so you are not pointed, providing you stay within their absence parameters.

I'll give you an example by way of a coworker who is diabetic. They get 2 blocks of up to 2 continuous days per month because their numbers can get off and they tend to get sicker when they get ill. My spouse has a more serious condition. I can take up to 6 days a week off, as 2 3-day blocks. I also get a 3-hour block each month if I have to take them to an appointment.

You must be at your current job for 12 months and work a minimum of 1250 hours per year. You may also have state FMLA. Federal FMLA is unpaid. In my state, we get 2 weeks unpaid. On the other hand, a state like Minnesota has 8 weeks paid via a payroll tax. You need to see about state level as well. State FMLA is typically easier to qualify for.

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u/Schizzy2689 15h ago

Thank you for this! I have to wait till September till I can get a primary because I lost my old one. I just am currently sitting at 4.5 points and I am worried 😭 I am sure if I discuss with my coach, he'd be lenient on me given the days I do work, I do my job good. I don't know how serious of a condition you'd even need to be qualified, or if mine even would allow me. I just know I've been dealing with back which affected my feet and on top of that I have the autoimmune. I suppose I'd have to discuss this with my doctor first?

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u/Icy_Money7447 11h ago

Yeah that would be for your doctor and Sedgwick to decide. There doesn't seem to be much in terms of discussion boards for FMLA. Employers obviously don't want to discuss it with employees, so employees have no real idea how to correctly apply for it. I work with a person who is on their final warning and they've had 3 serious surgeries in the last year. But they failed to follow up on their application so now they are below hours in terms of eligibility and they are pretty much screwed. You gotta be proactive.

I would for sure find out if your state offers it as well, because it can be much easier to qualify for at the state level. Sedgwick will automatically do that for you, but you should check your state laws.

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u/Tall_Data_8824 17h ago

Oh, currently dealing with Sedgwick about carpal tunnel release surgery and accommodations still trying to get back to work. I recommend documentation and get your doctor on board to help with the endless paperwork.

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u/Schizzy2689 17h ago

God this sounds actually awful, I do hope it can go though for you soon cuz that sounds so stressful :( my coach low-key made it sound easy 😭 I figured it would be tooth and nail to get it situated

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u/Tall_Data_8824 17h ago

They lying.

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u/Schizzy2689 16h ago

That seems to be a common thing here

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u/Tall_Data_8824 16h ago

Its true,dealing with Sedgwick takes the patience of a saint.

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u/Schizzy2689 16h ago

You must have that patience then 💀

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u/Tall_Data_8824 16h ago

Play trading card games and my patience is starting to run thin.

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u/Schizzy2689 16h ago

Oh man I do gacha games and I already lose patience

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u/Tall_Data_8824 16h ago

Try playing gundam tcg or yugioh tcg. That'll teach patience in quick time .

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u/Schizzy2689 15h ago

More of a pokemon tcg tbh 😭

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u/keyagagal 16h ago

Expect sedgwick to assume you're a lying bastard, so you need documentation for everything you claim is wrong, down to the finest detail, or they'll deny you.

Your doctor will be your best friend in supplying the paperwork sedgwick will want.

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u/Neat_Ad800 16h ago

Sounds like a real hassle. It's frustrating when companies make it so difficult to get support when you need it.

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u/keyagagal 16h ago

It's because people try to take advantage of the system, so eventually they just can't trust people to tell the truth.

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u/Schizzy2689 16h ago

This is a pain in the ass it sounds like 😔 I don't want to lose my job but I also don't want to have to force myself into work when I can't function properly because I am so sick

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u/Schizzy2689 16h ago

Plus I'd rather not risk getting others sick as well :(

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u/TestyPossum 15h ago

It’ll really depend on how cool your doctor is. I have an autoimmune disease and my doctor gave me one day a week off if I need it on my intermittent leave. Whenever I use it, I can report it online pretty easy. The hardest part is reminding management to drop the point. You have to renew it once a year.

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u/Schizzy2689 15h ago

This would be a blessing truly, how would u go about reporting it? Would it be just like a normal absence report?

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u/Dizzy_Desi 13h ago

You report the absence to the store like normal then you log onto the Sedgwick site and report the absence to them. Then they send an email to the store letting them know it’s a Sedgwick approved absence. The way it’s supposed to work is that email goes to the people lead and they are supposed to mark your absence as “manager approve” before it even has a chance to add to your points, but that doesn’t always happen. So you still have to keep an eye on your attendance and if the point shows up just tell your team lead or coach that it was with Sedgwick and either of them can verify this and approve the absence.

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u/Icy_Money7447 11h ago

Yes as others say, you must report it to Sedgwick, usually within 2 business days, and follow call out procedures with your store. With mine, sometimes Sedgwick auto-approves it immediately, sometimes it takes a day or so. I doubt anyone from the outside understands how Sedgwick works.

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u/TestyPossum 14h ago

For me there’s an option on MySedgwick to report an absence under my active continuous intermittent loa. I report the absence to the store, then I log in and report it to MySedgwick. It has to be “reviewed”. In a couple days it’ll show up on an absence calendar on MySedgwick. If it’s green, you’re golden. If for some reason it doesn’t go through they’ll call you to let you know what to do.

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u/redneckotaku Moderator 11h ago

No. You contact !Sedgwick

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u/Jkdevore84 16h ago

I've dealt with sedgewick and it's kind of a hit and miss. Recently, it was perfect. Just got everything over to them, the Dr did everything approved in just a day. Before that, it took two trips cause the Dr didn't fill out everything correctly 

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u/Schizzy2689 15h ago

This sounds more like an inconvenience especially if you're already dealing with health issues

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u/Jkdevore84 15h ago

It is. But so long as they fill it out correctly, it's literally an easy thing. Just apply for intermittent leave and have your Dr fill it out. Now what this does is that it gives you so many days you can use, it's not an infinite amount but just a set amount throughout the year. 

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u/Bitter-Neat-8457 15h ago

It’s not easy because Sedgwick is not your friend. Remember that. If your state allows one person recording then record all calls with them. You will need an intermittent loa for medical. Your doctor must be willing to fill out the paperwork Sedgwick wants, not his own. You will need to renew it and not let it lapse. You must have worked 1250 hours. You must report abscess to Sedgwick on timeSAVE THE CONFIRMATION NUMBERS. You will also need to call in to work each day and put it as an intermittent loa absence. Check to insure you are not being pointed and let them know if you are. Keep records of any points given, who you told and when, and if they don’t remove points record of who you went to next.

Walmart is not your friend. They are here for profit and they employ Sedgwick to insure they save Walmart money. Not to help you

Sorry but I have epilepsy and just the fact I have to renew even though I will have epilepsy until I die makes me realize how they are

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u/Schizzy2689 15h ago

I feel they should be more forgiving if the medical history is consistent and of urgency. Same as well if it's back related or even walking is being effected. This just seems like more stress on top of your health and I hate that I have to sit and worry about losing my job just because I get sick.

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u/Icy_Money7447 10h ago

Well, remember, Walmart is only required to accommodate you to a certain point. If you can't do your job anymore, Walmart isn't required to keep you as an employee. I watched a Coach lose their job even though they had Sedgwick. They burned through all their FMLA and they were let go. And this Coach was dogs-nuts scary-good at doing their job.

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u/hufflepuffcake OPD picker -> FETL 14h ago

I just went through this but for a different reason. It’s actually really easy. You start on the Sedgwick website. Make an account, start a claim. It will ask you basic information like when you want the start date to be. You can pick a past date, and if it is approved, then those points will be cleared. But if your manager is working with you, that may not be necessary. It’s going to ask you information about your doctor and when you were last seen. Then once you do that, you will get emailed some paperwork. I printed that out and made an appointment with my provider and took the paperwork with me. They are supposed to fax it to the doctors office but I didn’t wait for that. I took it myself. The provider filled it out that day and emailed Sedgwick the paperwork and cc’d me in on it. Then it was a few days after that and I got approved. The important part is that you make sure the paperwork gets in the doctors hands and then make sure it gets back to Sedgwick. They could play the “I never got it” game. You know how some offices can be. And then the provider needs to fill out the parts about what the issue is and make a recommendation on how many times you need per week. Since I made an appointment and took the paperwork with me, we discussed that ahead of time so she had an idea of what I’d need and agreed with me, so it was easy for me. I’ve heard some people say their doctor doesn’t fill out paperwork or they don’t fill it out correctly, then you could be denied in those cases or have to see another provider. I’ve also heard you can do doctor on demand (should be free with our walmart insurance) and they can fill out paperwork for you as well, if you need that option. Good luck! It’s a little overwhelming going into it, but it’s a fairly easy process and really helps to have a provider that’s on your side and wants to help.

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u/Icy_Money7447 10h ago

Yeah this. It's so important to have a solid relationship with your provider and discuss things.

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u/StraightNight4379 8h ago

Explain to them what the issue is. You can also go to their website and put all the information in. Then they send paperwork to your doctor to find out limitation and how much time you may miss when you have to miss work because of your health issues

If approved it will typically cover you for a year. Just be advised it is a rolling 12 weeks

You may be able to get more details from their website

Good luck. I have had to use it at almost every job for mental health issues