Livermore, CA asked in Workers' Compensation for California

Q: Can I sue Sedgwick Claims if they have ignored a referral to see an Orthopedic Surgeon for reevaluation.

It has been over a year in which the referral for a reevaluation was submitted through the Orthopedic Practice. Sedgwick has completely ignored the request. Initial surgery for carpal and cubital tunnel syndrome failed due to delay of two years fighting Sedgwick to approve the surgery. The current case is still on going presently litigated and pushed forward by Sedgwick fighting (QME) doctors claims. The Disability case is now entering it's eighth year.

Isn't Sedgwick legally charged to answer this referral or at minimum place it under UR or RFA review?

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1 Lawyer Answer

A: 8 years! your attorney needs to answer these questions for you. if you dont have an attorney, i see why your getting nowhere. we cant answer your question about Sedgwick's "requirement" to use the UR process without more info. work comp is very complex, as you well know. however an experienced attorney knows how to direct YOUR case, assert YOUR rights and move the case FAST. if you dont have an attorney, my advice is get one TODAY.

1 user found this answer helpful

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