How Sedgwick Workers' Compensation Works

Filing a workers’ compensation claim means going through a technical, often-complicated process. That’s doubly true if your company doesn’t handle claims itself and instead works with another company — a third-party administrator — to manage your claim. In these cases, you might have to interact with people from four different groups — your company, their administrator, the insurance company, and your doctors.

If you’ve heard that your company uses Sedgwick, that applies to you. So, what is Sedgwick? And what does it mean if your employer uses them? Let’s explore what you should know.

What is Sedgwick?

Sedgwick is a company that helps other businesses manage their insurance claims — like for workers’ compensation and long-term disability — so the business doesn’t have to hire and train its own team to handle claims. Today, the company has more than 33,000 employees working in 80 countries.

Keep in mind that Sedgwick isn’t an insurance company. It’s a third-party administrator, or TPA, meaning it acts as a middleman between you, the insurance company, and your employer.

Sedgwick and workers’ comp

Many of the largest companies in the country work with Sedgwick to handle their workers’ comp claims. Some U.S. employers that have worked with Sedgwick claims management include:

• Amazon

• FedEx

• Kroger

• Lowe’s Home Improvement 

• Target

• Walmart

How to know if your company uses Sedgwick

The most straightforward way to see if your company uses Sedgwick is to ask your employer. Someone in the human resources department or a benefits manager should know.

Sedgwick also offers an online chat feature that you can use to check whether your company uses Sedgwick for workers’ comp. If you click the “Chat With Us” button, it will open up a new chat window. In the first option menu, the chat presents, choose, “I have a question about a new or existing claim or leave.” Then, choose, “I want to begin a new claim or leave.” The chat assistant will then ask which company employs you. Type your company’s legal name. If the chat moves forward, your company likely uses Sedgwick. Otherwise, the chat may show a message like, “I’m sorry, I’m having trouble finding a company with that exact name. Is there a different way it could be spelled?” In that case, your company uses a different name for legal filings or it doesn’t use Sedgwick.

A word of caution with the chat feature: Your company may use a different name for taxes and legal filings than it does in day-to-day conversation. For example, Amazon’s legal name is Amazon.com, Inc.

Filing a workers’ comp claim with Sedgwick

Even if your company uses Sedgwick, your state’s workers comp laws trump any claim filing process set up by Sedgwick or your company. In other words, you need to meet state deadlines when it comes to reporting your injury and filing your claim.

While these requirements vary from state to state, there’s one thing every employee should know: You need to act fast. Most states require you to report your injury within a few days. That means going to your manager, supervisor, or an HR representative and telling them what happened. In some states, you need to submit a written notice or complete a specific form.

Your manager or HR team should get the filing process started and tell you about next steps to file your claim. Usually, you need to fill out and return some paperwork. Then you’ll get your claim number and contact information to connect with the appropriate Sedgwick claims administrator.

Where to get help filing a claim

If you run into problems filing a claim or if you just want help making sense of the process, a workers’ compensation lawyer is your best option. It may feel strange to include a lawyer at this stage of the process, but they’re trained in your state’s workers’ comp laws and will know what benefits you’re entitled to. A workers’ comp lawyer won’t sue your employer and you don’t pay them anything unless they help you win benefits, so getting started is free.

Related: What Does a Workers’ Comp Lawyer Do That I Can’t?

Setting up your mySedgwick account

Once your company gets the process started, you can create your mySedgwick account to track your claim moving forward. Note that within Sedgwick’s processes and the mySedgwick portal, you’ll be called a “claimant.”

It’s easiest to create an account if you already have a claim number from your employer. If you don’t have a claim number, you can make an account using your date of birth, Social Security number, and home postal code.

What if my claim hasn’t been filed yet?

Unfortunately, your hands are somewhat tied until your company kicks off the claim process. Even if you try to move forward on your own through Sedgwick’s “Start a Claim” webpage, the chat will kick you back and tell you that most claims begin by contacting your HR Department or supervisor.

Next step: talking to Sedgwick

Once your workers’ compensation claim is filed, Sedgwick will likely try to call you. It’s very important that when you talk to the Sedwick claims adjuster, you are prepared to answer their questions honestly and accurately. If you’re unsure what to say you can get professional help by getting a free consultation with a workers’ comp lawyer.

Why Sedgwick will call you

When someone files a workers’ comp claim, the insurance company needs to review the claim so it can decide whether to approve or deny it. Since there is a limited amount of time for it to make a decision, Sedgwick (as the middleman for the claim) will quickly try to confirm the details of what happened. That could mean calling you multiple times, if necessary, until it reaches you.

The Sedwick claims adjuster could ask you about the details of your work injury, the events leading up to it, and the symptoms you’re experiencing. They may also confirm your contact information and income.

Depending on the situation, Sedgwick may also try to get statements from your supervisor and anyone who witnessed your workplace incident. For certain injuries, it may seek photos, medical records, or additional documentation.

What to do if you have issues with Sedgwick

If you have issues with Sedgwick or getting your benefits, the best way to get straight answers is to get professional help from a workers’ comp lawyer. A lawyer’s job is to represent your best interests and ensure you get the payments and medical treatment that you’re entitled to. They can help you file paperwork, talk to insurance or claims adjusters for you, and negotiate a fair settlement for your injury.

Plus, paying a lawyer doesn’t come out of your pocket. A reputable lawyer (like all Atticus lawyers) offers a free consultation, charges nothing upfront, and then only gets paid a percentage of the benefits that they win you. Since settlements with Atticus lawyers are double what injured workers negotiate on their own, you're making money even after you pay the lawyer’s fee.

Atticus is a law firm with local workers’ comp lawyers across the country. If you want assistance with your claim or have questions about the process, our team can help. Take our quick workers’ comp quiz or call us at the number below to get help today.

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Related resources:

5 Common Questions About Workers’ Comp Lawyers

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How Much a Workers’ Comp Lawyer Costs in Every State

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