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EMitchell108

Sedgwick Workers Comp Claim Denied

Question

I injured myself at work over a month ago. Wasted one month with AmCare experiencing progressively more pain and physical limitations until finally insisting on being refererred elsewhere last week.

Pain that started in my rotator cuff is now in my neck, back and upper arms, and every morning I wake up in pain, stiff and barely able to rais my arms for at leadt an hour. Doing anything physical at work requiring lifting, pushing or reaching aggravates the related parts and rebounds on mr the next day.

Filled out Sedgewick questionnaire online last Friday but didn't visit the approved facility until yesterday (within the five day time frame for doing so after the case was opened). Did physical therapy yesterday and today but will probably be cut off after tomorrow. Light duty recommendation was forwarded to my building but will be cut off after tomorrow, too.

While I was in the waiting room, before I'd even been called in for the consult, I got a denied email/letter from Sedgwick. The person never called me. I don't know if that's rven a necessary part of their determination.

Nature of injury was rotator cuff like shoulder pain with discomfort developing during a VET shift, but no real pain and kack of mobility kicked in until the next morning. Because this day was not on my normal shift I didn't report it to AmCare until start of shift two days later.

WHS has told me of my options for getting an evaluation and therapy at my own cost, but I need to know my options. I think part of this penalty is because there was no visible accident. I started feeling uncomfortable and changed the way I was working, then the next morning when I woke up I couldn't move.

Anyone have successful claims with Sedgwick for "invisible" incidents? Am I able to contest their determination and if so, how do I go about it? If contesting is possible, were you successful and if so, what did you do?

Posted Jun 3, 2026, 11:46 PM UTC

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