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Sedgwick

NATIONALLY RECOGNIZED. CHICAGO STRONG. LONG TERM DISABILITY FIRM

Bartolic Law handles Long Term Disability cases at all stages, from filing a claim to lawsuits under ERISA § 502(a). We are who the most discerning clients hire when an insurer denies their claim, and the one they wish they had when another firm loses their appeal and abandons the case. We are Innovative, Authentic, Compassionate, Transparent and Chicago strong. Bartolic Law is nationally renowned for our Innovative work:

Claims Handled by Sedgwick

Bartolic Law has helped many clients get their short-term and long-term disability claims approved by Sedgwick. In one case, Sedgwick denied the long-term disability claim of a clinical pharmacist suffering from Fibromyalgia. Clinical pharmacy work requires being on one’s feet for extended shifts. Sedgwick both overstated the client’s physical capacity and understated the demands of pharmacy work. We combined medical evidence of limitations with vocational evidence of the occupation demands. When Sedgwick requested an Independent Medical Examination, we attended with the client to document the duration, and prevent the IME doctor from making our client sit in the waiting room beyond the client’s documented capacity. We demanded the examination begin on time, or the examination would be forfeited. Shortly after the examination, Sedgwick approved the claim. In another case, Sedgwick asserted a 24-month mental health limitation applied to a formerly highly compensated client in an executive role, disabled by permanent damage from stroke. Like many insurers and claims administrators, Sedgwick imposed the limitation because the medical records documented depression and anxiety, secondary to the physical impairments. We persuaded Sedgwick the limitation does not apply and the client continues to receive monthly payments, as promised.

Sedgwick Claims Management Services

Sedgwick is one of the largest third-partyclaim administrators of short-term and long-term disability plans. Large employers with self-insured disability plans hire Sedgwick to manage short-term and long-term disability claims. Sedgwick markets itself to employers as helping to manage the cost of absence, meaning it is particularly aggressive with claims. If Sedgwick manages your long-term disability claim, your benefits are likely enforced under ERISA § 502(a). Sedgwick does not pay benefits itself, so the plans evade state bans on discretionary clauses, subjecting your claim to deferential judicial review. What this means for you is that if your long-term disability claim and appeal are not successful, a court will only review Sedgwick’s decision to determine if it is “arbitrary and capricious,” and will only review the evidence and information you submitted to Sedgwick. This places heightened importance on effectively advancing the disability claim and any appeal of a denial.

Sedgwick’s handling of your claim generally receives less scrutiny from a court than insurers receive, because it does not pay the claims itself. It purports to be a neutral third-party claim administrator, but its business model is dependent on reducing employers’ cost of disability benefits. This generally means more denials and faster benefit terminations.

Sedgwick must strictly follow all the processes and procedures of ERISA claims procedure regulation for its decisions to be upheld, and when you put the right lawyer on your side, you can often show Sedgwick falls short of these requirements. Sedgwick often gives too little consideration to favorable evidence, overlooks some evidence altogether, or fails to engage in the kind of dialogue ERISA requires to explain why your claim was denied and what you can do to show you are entitled to benefits.

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We Turn Denials Into Payments

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