Claim

The Claim page provides all the information you may need to know about your workers’ compensation or liability claim. It also allows you contact your claim’s examiner and learn more about the claims process.

Note: This topic pertains specifically to workers’ compensation and liability claims. For features specific to other types of claims, select the applicable claim category from the menu to the left.

Accessing the Claim page

To access this page, select a claim number from wherever it appears.

Claim Page Features

To collapse a section of this page, click the Collapse this section icon at the top of the section. To expand a section, click Expand this section . Sections on this page may be collapsed by default if no information is available for display.

The Messages Messages button icon in the top-right corner of the page display the number of unread messages in the Communication Center. Click the icon to view the Communication center section of the Claim page. For more information about its features, refer to the Communication center section below.

If you have more than one claim available in mySedgwick, a View a different claim link is available near the top of the page. Click this link to select and view a different claim.

The following sections are available from this page.

Claim Information

The section at the top of the page is labeled with the type of claim and the claim number. This section contains the following tabs and features. Note that some features are specific to the type of claim or your access in mySedgwick.

Summary Tab

Provides basic information about your claim. Some fields containing no information may not be displayed.

See a list of features available in this section and their descriptions.

Summary Tab
Feature	Description
Message	If available, a message at the top of this tab provides additional information related to the claim.
Claim	Provides basic information about the claim. Fields listed under the Claim heading vary by the claim category. Click a category to view its available fields and their descriptions: Auto Liability Name: Claimant’s name. Claim: Claim category (Auto Liability) and the number assigned to the claim. Date: Date the accident occurred (also known as the claim’s date of loss). Status: Claim’s current status, such as Open or Closed. Type: Coverage description, such as Bodily Injury or Collision. Total Paid: Total amount paid for the claim to date. Not displayed to claimants. Policy Number: Policy number under which the vehicle is insured. Not applicable to third-party liability claims. General Liability Name: Claimant’s name. Claim: Claim category (General Liability) and the number assigned to the claim. Date: Date the event leading to the claim occurred or began (also known as the claim’s date of loss). Status: Claim’s current status, such as Open or Closed. Type: Coverage description, such as Bodily Injury or Property Damage. Total Paid: Total amount paid for the claim to date. Not displayed to claimants. Property Liability Name: Claimant’s name. Claim: Claim category (Property Liability) and the number assigned to the claim. Date: Date the event leading to the claim occurred or began (also known as the claim’s date of loss). Status: Claim’s current status, such as Open or Closed. Type: Coverage description, such as Building Damage or Contents. Workers’ Compensation Name: Claimant’s name. Claim: Claim category (Workers’ Compensation) and the number assigned to the claim. Date: Date the workplace injury or illness occurred or began (also known as the claim’s date of loss). Status: Claim’s current status, such as Open or Closed. Anticipated Return to Work Date: Date the claimant expects to return to work, if known. Anticipated Return to Work Status: Work status to which the employee is expected to return to work. Available to Controller users only. Work Status: Claimant’s work status, such as Off Work or Normal. Companion Claims: Claim number of any related claims. This field is not displayed if no companion claims exist.
Owner and Driver	Fields under this heading are shown only for Auto Liability claims. Available fields include: Vehicle Owner Name: Owner of the vehicle. Owner Type: Type of vehicle owner (first-party liability only) Driver Name: Name of the driver at the time of the accident. Driver Title: Driver’s title (first-party liability only)
Vehicle	Fields under this heading are shown only for Auto Liability claims. Available fields include: Year: Vehicle’s year of make. Make: Vehicle’s manufacturer. Model: Vehicle’s model name. VIN Number: Vehicle Identification Number (VIN) assigned to the vehicle and issued by the manufacturer. Vehicle Location: Where the vehicle is located (first-party liability only). Vehicle Estimate: Estimated cost of damage (first-party liability only). Vehicle Damage: Actual cost of damage (first-party liability only).
Property Damage	The field under this heading is shown only for third-party Auto Liability claims. Description: A description of the property damage sustained to the vehicle.
Third Party Carrier	Fields under this heading are shown only for third-party Auto Liability claims. Available fields include: Carrier Claim Number: Claim number assigned to the claim by the insurance carrier. Claim Office Name: Insurer’s office name. Claim Office Phone: Insurer’s office phone number Reported to Carrier: Indicates whether the claim has been reported to the carrier.
Actions	The Actions section provides links to a number of ways to interact with your claim. Click an action below to learn more about it: Report return to work (workers’ compensation only) Upload documents Manage direct deposit (workers’ compensation claimants only; not available when viewing another’s claim) Mileage reimbursement (workers’ compensation claimants only; not available when viewing another’s claim) View pharmacy card (workers’ compensation claimants only; not available when viewing another’s claim) Visit helpful resources Communication preferences (not available when viewing another’s claim) Find a medical provider (workers’ compensation claimants only; not available when viewing another’s claim) Chat with us
Claim Tracker	Displayed at the bottom of the Summary tab, the Claim Tracker depicts the claim’s progress. Completed steps are shown with a green check mark. The steps required to complete a claim depend on the type of claim.

Payments Tab

This tab lists payments issued for your claim within the past 12 months. It is only displayed if allowed by your employer.

If applicable, a message near the top of the tab informs you of the date the next payment will be sent to you.

See a list of features available in this section and their descriptions.

Payments
Column	Description
Issue Date	Date the payment was mailed or direct-deposited.
Payee	Individual or provider to whom the payment was issued. An icon also indicates whether the payee is the claimant or, for disability and workers’ compensation claims, a medical provider.
Amount	Actual amount of the check issued to the payee.
Payment Method	Method by which the payment was issued, such as Direct Deposit or Check. If present, the payment’s Mailing Address is also shown. A Void indicator is displayed if a check was voided.
Detail	For payments issued to you, this section lists the mailing address to which the payment was issued (if applicable) It also displays the dates for which the payment applies. For payments issued to a provider, this section may also include a link to view the Explanation of Bill Review describing the line-item services billed by the provider, the adjusted amounts paid for each, and explanations of adjustments. This option is only available for payments issued to some providers. This feature is not available to managers or others viewing their employees’ claims.

Click Export Export icon to download a .csv file containing the details listed in this section.

Work Status Tab

Displays a list of work statuses from most recent to oldest. This section is only displayed for workers’ compensation claims.

See a list of features available in this section and their descriptions.

Work Status
Feature	Description
Work Status	Type of work status, such as Off Work or Normal.
Begin	Date the work status began.
End	Date the work status ended.

Restrictions Tab

Displays a list of work restrictions, along with dates for each restriction. This section is only displayed for workers’ compensation claims.

See a list of features available in this section and their descriptions.

Restrictions
Feature	Description
Working With Restrictions	Dates the claimant was working with the specified restriction.
Recommended Dates	Dates the claimant was recommended to be under the specified restriction .
Type	Type of restriction, such as Permanent or Temporary.
Activity	Type of restricted activity, such as Drive.
Restriction	Duration or frequency of the restriction.

Documents Tab

The Documents tab lists documents associated with your claim. It may display documents sent to you via email, files you have uploaded, and forms relating to your claim.

If available, you can upload a document by clicking Upload Documents.

Note: Supervisors and managers can only access this feature for their own claims, not those of others.

The following sections may be available to you from this tab.

My documents

This section lists claim-related documents sent to you via mail or email. This section is not displayed when viewing another’s claim.

All files are in .pdf format. You must have Adobe Acrobat Reader (or similar) installed to view these documents.

See a list of features available in this section and their descriptions.

My documents
Column	Description
Document	Type of document; always shows Claim Correspondence. A New label displays when the file is unread.
Date	Date the document was originally sent.
Open	Open the file in a new browser tab or window.

Upload documents

This section allows you to upload files related to your claim and lists files you have previously uploaded.

See a list of features available in this section and their descriptions.

Upload documents
Feature	Description
Upload	Click to select one or more files to upload from your device. See the Upload Documents help topic for instructions.
Document	Uploaded file’s name.
Date	Date the file was uploaded.
Status	Current status of the file. Options include pending (the file is in the process of being uploaded and complete (the file was successfully uploaded). Files that cannot be successfully uploaded display the reason for the error.
Open	Click to view the file. Files in pending status cannot be viewed until they are complete. Files that cannot be successfully uploaded display . Click to remove the file.

My forms

This section contains forms you can fill out and submit. Forms available here may include those allowing Sedgwick to release your medical information for claim purposes, forms required by your claim’s jurisdiction, or Medicare-related forms. This section is not displayed when viewing another’s claim.

See a list of features available in this section and their descriptions.

My forms
Column	Description
Document	Form name.
Open	Click to view and complete or download the form. See Forms for details.

Important Contacts Tab

Provides information about how to contact the examiner. If available, click Contact Examiner to open the Communication Center page where you can send a message to the examiner.

Claim activity

The Claim activity section shows you all milestone dates relating to your workers’ compensation claim, with the most recent activity listed first. To locate specific entries, enter a term in the search bar at the top of the section.

Communication center

The Communication center section provides a simply way to send a message to an open claim’s examiner and view their responses.

If messages already exist for the claim, they are displayed here in descending order (with the most recent shown last). The sender’s name as well as the date and time the message was sent are displayed above each message. Also, an icon is displayed beside each message to help identify who sent each:

: Message you sent.
: Messages from the examiner.

To send a message, type it in the field provided and click Send. Messages cannot exceed 1000 characters each.

If available, you can also click Upload Documents to open the Upload Documents window and submit files pertaining to your claim.

Your contact information

Displayed for open claims, this tab displays your current contact address and electronic notification preferences and provides links to update them. This section is not displayed when viewing another’s claim.

Contact Address: This address is used for any communication sent by mail pertaining to your claim if you have opted to receive it by this method. Click Change Contact Address to change you preferred contact address.
Electronic Notifications: Displays the email address and text/SMS number at which you will receive electronic notifications about your claim, if enabled. Click Change Communication Preferences to update your selections. Refer to the Change Communication Preferences section of the Account Settings help topic for more information.