FAQ Page

   
FAQ Type:  
 

 
    
1. How do I file a Short-Term Disability claim?
2. How do I know if Sedgwick received the fax I sent?
3. What should I do if my doctor releases me to return to work earlier than my original expected return to work date?
4. What About Social Security (SSDI)?
5. Kaiser is my medical provider. What do I need to do differently?
6. Kaiser is the medical provider. What do I need to do differently?
7. Kaiser is the medical provider. What do I need to do differently?


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Question : How do I file a Short-Term Disability claim?
 
Answer :
If your employer does not require you to file your claim directly with them (very few do), then you may file with Sedgwick using the procedures described below:
To file your short-term disability claim online: Use our self-service online claim form on our website. Once your claim is entered into our system, you will receive an email with your Sedgwick claim number.

To file your claim by telephone: Call Sedgwick at the toll-free phone number listed on your benefits card. If you do not have your benefits card, you can call us on our main claims line at (818)591-2772. A customer service representative will take your claim information over the phone, and provide you with additional information. Be sure to note the Sedgwick claim number provided to you.


After you have filed your claim online or by telephone, you need to take the following 4 steps to ensure the fastest possible processing of your claim:
    1) If you have not already done so, notify your employer of your disability.

    2) Have your doctor's office call Sedgwick to certify your disability. This is very important, since we cannot process your claim until your doctor has contacted us. (Remind them that when they call us, they will need your medical file and social security number available.) Should your doctor require a "release" from you before they will contact Sedgwick, you can download the Release of Information Form. Complete it, and fax it to your physician.

    If your doctor prefers to mail or fax the certification to Sedgwick (we don't recommend this, since it may delay your claim), you may download the Certification Form for Initial Certification of Disability. Fill out and sign the top portion, then forward the entire form to your doctor's office. Once they complete the remainder of the form and send or fax it to Sedgwick, we can begin working on your claim. (If your medical provider is KAISER, click here.)

    We suggest that you follow up with your doctor's office until you are assured that Sedgwick has received the medical certification. Once we have your physician and employer information, short-term disability claim processing usually takes just 4 days.

    3) Complete and return the forms sent to you. Sedgwick will be sending you a Release of Information Form and a Right of Reimbursement Form in the mail. Please verify that the information is correct, sign and date the forms, and immediately return them to Sedgwick by fax or mail. Our general fax number is (818) 591-7664. (We need you to fill out these forms, even if you already did so in step #2)

    4) Continue to follow up on the status of your claim on a regular basis. You can check the status of your claim anytime on our website www.SedgwickCMS.com/calabasas (you'll need to register first using your Sedgwick claim #). You can also obtain claim status on our Automated Telephone Voice Response System at the toll-free number indicated on your benefits ID card or in your benefits booklet. Our customer service representatives are available between the hours of 6:00 A.M. and 4:45 P.M., Monday through Friday, Pacific Time for email and phone call inquiries.

PLEASE NOTE: Filing a claim for disability does not guarantee that you will receive benefits. You must first meet the medical criteria and provisions of your company's plan. For a copy of the plan document, please contact your benefits department.
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Question : How do I know if Sedgwick received the fax I sent?
 
Answer :
Sedgwick logs in all faxes received and they can be found in the Document Delivery screen.
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Question : What should I do if my doctor releases me to return to work earlier than my original expected return to work date?
 
Answer :
Contact Sedgwick immediately, and inform us of your early return to work date. When you report to work, present the signed release form to your Supervisor or HR representative.
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Question : What About Social Security (SSDI)?
 
Answer :
Sedgwick will assist you in making Social Security Disability assessment if you are on LTD.

The definition for Social Security disability is the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.

Social Security legal requirements state that disability definition requirements must be met before the claimant reaches age 64 and 7 months. An applicant must be fully insured. Usually a fully insured claimant has 40 quarters (less are required for individuals under the age of 31) and must be currently insured. If the claimant meets insured status, the medical aspects of the claim are fully developed. Extensive correspondence with medical and vocational sources is conducted; claimants are required to assist. A consultative examination is pursued when it is necessary to obtain more detail or clarification about the claimant's condition.

If the application for SSDI benefits is approved, the claimant is issued an Award Certificate. The Award Certificate contains the entitlement date, payment amounts and effective dates, medical re-exam date, (if any), the claimant's rights and responsibilities, and indication if the SSDI benefit is reduced by any known State Disability or Worker's Compensation amount. Your LTD benefits may be reduced when Social security benefits are approved.
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Question : Kaiser is my medical provider. What do I need to do differently?
 
Answer :
Kaiser needs a signed Medical Release from you before they will provide Sedgwick with medical certification for your disability. There are three options for providing this to Kaiser:
  1. A hand-written note with your signature and date authorizing them to release information to Sedgwick
  2. The Kaiser Release of Information form given to you by Kaiser at each visit
  3. The Sedgwick Release of Information Form which you will receive from Sedgwick after filing your claim (or one can be downloaded directly from our website).
Be sure to take this important step of providing Kaiser with a release as soon as possible, as the Kaiser Disability Office will not release information without one of these forms. (Most Kaiser locations will accept a fax.)

To assist the Kaiser Disability Department in providing medical certification, you may also provide them with a Certification Form for Initial Certification of Disability (Physician's Certificate) at the time you provide them with your medical release form.
You may also ask them to phone in your certification by having them call the toll-free 800 number for Sedgwick (this method is the quickest way to expedite your claim). If they will not call Sedgwick, follow the steps listed above.

Continue to follow up with your Kaiser location until you are assured that the forms have been completed and sent to Sedgwick. You can check the status of your claim by going to our Claimant Home Page, and clicking "Check the Status of Claim". Just follow the easy instructions for registering to see all details of the status of your forms and claim information.

If you are planning a future disability (e.g. pregnancy, surgery), you can expedite your claim by downloading and printing the Physician's Certificate and Release of Information forms ahead of time and taking them to your Kaiser Disability Office.

Kaiser's website is: www.kaiserpermanente.org

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Question : Kaiser is the medical provider. What do I need to do differently?
 
Answer :
Kaiser needs a signed Medical Release from you or the patient before they will provide Sedgwick with medical certification for your leave request. There are three options for providing this to Kaiser: 1. A hand-written note with your signature or the patient's signature and date authorizing them to release information to Sedgwick 2. The Kaiser Release of Information form given to you or the patient by Kaiser at each visit The Sedgwick Release of Information Form, which you will receive from Sedgwick after filing your leave request (or one can be downloaded directly from our website). Be sure to take this important step of providing Kaiser with a release as soon as possible, as the Kaiser Disability Office will not release information without one of these forms. (Most Kaiser locations will accept a fax.) To assist the Kaiser Disability Department in providing medical certification, you may also provide them with a Certification Form for Initial Certification of Disability (Physician's Certificate) at the time you provide them with the medical release form. You may also ask them to phone in the certification by having them call the toll-free 800 number for Sedgwick (this method is the quickest way to expedite your claim). If they will not call Sedgwick, follow the steps listed above. Continue to follow up with the Kaiser location until you are assured that the forms have been completed and sent to Sedgwick. You can check the status of your leave request by going to our Claimant Home Page, and clicking "Check the Status of Leave". Just follow the easy instructions for registering to see all details of the status of your forms and leave information. If you are planning a future leave request (e.g. pregnancy, surgery, bonding), you can expedite your leave request by downloading and printing the Physician's Certificate and Release of Information forms ahead of time and taking them to the Kaiser Disability Office. Kaiser's website is: www.kaiserpermanente.org
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Question : Kaiser is the medical provider. What do I need to do differently?
 
Answer :
Kaiser needs a signed Medical Release from you or the patient before they will provide Sedgwick with medical certification for your leave request. There are three options for providing this to Kaiser: 1. A hand-written note with your signature or the patient's signature and date authorizing them to release information to Sedgwick 2. The Kaiser Release of Information form given to you or the patient by Kaiser at each visit The Sedgwick Release of Information Form, which you will receive from Sedgwick after filing your leave request (or one can be downloaded directly from our website). Be sure to take this important step of providing Kaiser with a release as soon as possible, as the Kaiser Disability Office will not release information without one of these forms. (Most Kaiser locations will accept a fax.) To assist the Kaiser Disability Department in providing medical certification, you may also provide them with a Certification Form for Initial Certification of Disability (Physician's Certificate) at the time you provide them with the medical release form. You may also ask them to phone in the certification by having them call the toll-free 800 number for Sedgwick (this method is the quickest way to expedite your claim). If they will not call Sedgwick, follow the steps listed above. Continue to follow up with the Kaiser location until you are assured that the forms have been completed and sent to Sedgwick. You can check the status of your leave request by going to our Claimant Home Page, and clicking "Check the Status of Leave". Just follow the easy instructions for registering to see all details of the status of your forms and leave information. If you are planning a future leave request (e.g. pregnancy, surgery, bonding), you can expedite your leave request by downloading and printing the Physician's Certificate and Release of Information forms ahead of time and taking them to the Kaiser Disability Office. Kaiser's website is: www.kaiserpermanente.org
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