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Serving Clients Throughout Virginia

Why Does Sedgwick Insurance Workers’ Comp Want to Talk with Me?


Sedgwick is a third party administrator (TPA) for insurance companies and employers. They’re tasked with managing claims for property damage, car accidents, long-term disability, and workers’ compensation. 

For workers that get injured on the job, it’s normal to receive calls from TPAs like Sedgwick. They’ll handle and process the insurance claim on the employer’s or the insurance agency’s behalf. 

A Sedgwick claims representative may sound concerned or sympathetic about the injury, but they’re not a neutral third party. They’re always going to put the interests of their clients first – including lowering their costs. Lower costs on their side means less in the way of benefits for the worker. 

A Virginia workers’ compensation lawyer won’t just help an injured work apply for their benefits, they’ll also guide them throughout the process, ensure that they’re not making any irreversible mistakes that can adversely affect their claim, and protect their interests and rights. 

Who Handles Workers’ Comp Claims at Sedgwick?

Sedgwick is hired by employers and insurance companies to help them reduce overall claims costs. When a worker sustains an injury at the job site or while they’re performing their duties, Sedgwick does either one of two options:

  1. Assign a claims associate if the case begins or is only a medical-only claim. This means that the worker has not yet missed time from work while seeking medical treatment.
  2. Assign a claims examiner if the worker was not able to go back to work because of a work-related injury or an occupational medical condition

How Does Sedgwick Handle a Workers’ Comp Claim?

If an employer or insurance company is working with Sedgwick, the injured worker is likely to hear from the TPA shortly after the incident. Sedgwick will follow the steps below to manage the process:

  • Assess the information available to check for potential fraud. This includes identifying any red flags and even checking the worker’s social media profiles.
  • Compiles a list of doctors from which the worker can choose as their authorized attending physician
  • Determine whether medications, treatment, surgeries, and even doctors visitors should be approved or denied
  • Decide whether the worker requires temporary total disability benefits, temporary partial disability benefits, or wage loss payments 
  • Work with an insurance benefits attorney to evaluate whether they can defend against the case or reduce the compensation the worker is going to get
  • Save money for their client by auditing medical bills
  • Decide with their client whether they need to make a settlement offer

Essentially, all of these steps are designed to enable them to formally determine whether they need to pay workers’ compensation benefits. This process may take some time, and it can be frustrating for any worker who’s waiting to hear back from them. For some of these workers, any delay, and even a straightforward denial, can prevent them from focusing on their recovery. 

Even if the claim is approved, the worker may find that there are things they don’t understand or don’t make sense.

If a worker has suffered from a work-related injury, it’s crucial to hire a qualified workers’ comp lawyer immediately. 

Call a Virginia Workers’ Comp Lawyer Today

If your claim gets denied or if you feel like the compensation they’re offering isn’t enough to cover your medical bills, get in touch with a workers’ compensation lawyer right away. A workers’ comp lawyer can help you deal with Sedgwick and your employer or your insurance provider. They’ll make sure that your claim won’t be handled in a way that is disadvantageous or detrimental to you.

Slominski Law will aggressively fight for your interests. We are committed to representing your rights and we’ll do our best to make sure you get every cent that you’re entitled to. To schedule a consultation, call us at (434) 384-9400 or (540) 554-3762 today.