Sedgwick's $1.13 Million Settlement: A Pattern of Negligence and Denial Exposed

In 2016, Sedgwick Claims Management Services, a major third-party administrator known for handling workers' compensation claims, faced a $1.13 million settlement with the California Division of Workers' Compensation (DWC). The settlement followed troubling revelations about Sedgwick’s mishandling of claims — violations that echo my own experience with the company.

This landmark case sheds light on Sedgwick’s pattern of negligence, abuse, and denial tactics that countless injured workers, including myself, have endured.

The California Case: What Happened?

The California DWC launched an investigation into Sedgwick’s handling of medical treatment requests after multiple concerns were raised about their Utilization Review (UR) process. UR is the process that determines whether medical treatments are necessary for injured workers.

The investigation was triggered after an injured worker, whose hospitalization was denied by Sedgwick, died from an infection contracted during surgery. This tragic outcome prompted a full review of Sedgwick’s practices.

The investigation uncovered a series of violations, including:

• Failure to Follow UR Regulations: Sedgwick ignored critical timelines and procedures, delaying necessary medical care.

• Inadequate Documentation: The company failed to properly maintain records for their UR decisions, limiting transparency.

• Improper Denials of Treatment: Sedgwick repeatedly denied medical treatments without sufficient medical justification, putting injured workers at serious risk.

The $1.13 Million Settlement

To resolve the case, Sedgwick agreed to pay $1.13 million in penalties and committed to improving its UR practices. The California DWC held Sedgwick accountable for failing to meet their legal obligation to protect the health and rights of injured employees.

While this settlement was significant, for many workers like myself, this was only a glimpse into a larger pattern of unethical behavior that Sedgwick has perpetuated nationwide.

Why This Matters to My Case

Sedgwick’s failure to uphold its duties in California mirrors my own experience. Despite my documented injuries and urgent medical needs, I faced repeated delays, denials, and manipulations designed to discourage my claim. Like the injured worker who tragically passed away, I found myself caught in a system that prioritizes corporate profits over human well-being.

It has taken multiple FOIA requests, public outreach, and ongoing efforts to even obtain pieces of my own documentation. I continue to push for accountability for Sedgwick’s tactics and the toll they take on injured workers and their families. And now the subsequent harassment that follows from exposing their illegal activities.

A Call to Action: Share Your Experience

If you or someone you know has experienced similar treatment from Sedgwick Claims Management, I encourage you to come forward. Whether your case involves:

• Unjust claim denials

• Unexplained medical delays

• Manipulative tactics to block compensation

• Intimidation or legal threats

Your voice matters. By sharing your story, you can help expose a pattern of misconduct that has harmed countless individuals.

I invite you to contact me directly at joefulmer@protonmail.com or visit JoeFulmer.com to connect with others facing similar struggles. Together, we can shine a light on the truth and fight for the justice injured workers deserve.

Holding Corporations Accountable

Sedgwick’s settlement in California shows that accountability is possible — but only if people speak out. By standing together, those impacted by Sedgwick’s abuse can make a powerful statement: injured workers are not disposable, and no corporation should be allowed to manipulate the system unchecked.

Stay informed, stay strong, and know that you are not alone. The fight for justice continues.