My claims

The My claims page provides a list of your claims, notifications about your claims, and more. A message at the top of the page may also provide useful information. You can return to this page at any time by clicking My Claims on the navigation menu.

To view a claim from here or any other page, click the claim number.

The following sections are available from this page:

Welcome Message

A message at the top of the screen, if shown, introduces you to features available in mySedgwick. It may also provide useful information related to your claims.

My claims

This section consists of three areas:

A greeting with a list of important reminders for your awareness or action, if any exist, and quick links to common actions and features
Your open claims and any claims closed within the last 24 months
Tabs listing any payments or notifications for your claims

These sections are described in more detail below.

Sort what’s displayed in the claims list or Payments and Notifications tabs by clicking the Sort by option above a list and selecting the appropriate column. The arrow indicates the direction in which rows are sorted (ascending or descending); select the column again to change the orientation.

Greeting, Reminders, and Quick Links

The top of the My claims section includes a greeting and a list of important reminders for your claims, if any exist.

Screenshot of the top portion of the My claims portion of the screen

A list of quick links is also available, which vary by role. These may include:

Report a new claim
Report an absence (for leave claims with intermittent absences)
Communication center
Helpful resources

Links to additional employer-provided resources may also be available.

If you are a manager with access to your direct reports’ claims, click the Manager View link at the top of this section to visit the Manager view page.

Claim List

The middle portion of the My claims section provides a list of your open claims or those closed within the past 24 months. Future workers’ compensation and disability claims may also be shown. This section is not displayed if you have no available claims.

Screenshot of the middle portion of the My claims section, depicting a list of claims, their status, additional details, and an Actions menu

To view details about a claim, click the claim number. Click the Actions menu icon to access additional features related to the claim.

If you have multiple claims, click Filter to access a search field to locate a claim by any displayed criteria.

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

Claims
Feature	Description
Claim	Category of claim (e.g., Short Term Disability, Auto Liability, Workers’ Compensation, Accommodation Request) and the claim number. Click a claim number to open the Claim page for more information about the claim.
Status	Current status of your claim (Open or Closed). For disability, leave, and accommodation claims, the claim’s substatus is also displayed (e.g., Approved, Pending, Currently accommodated).
Detail	Display’s specific information based on the type of claim: Workers’ compensation: Claim’s Date of Loss Liability: Claim’s Date of Loss and the type of coverage(e.g., Bodily Injury). Disability: Begin Date (i.e., the employee‘s first date absent or the claim’s date of loss) Leave: Begin Date (i.e., the date the leave began) and Leave Type (e.g., Employee Medical, Military Leave) Accommodation requests: Begin Date (i.e., the start date of the earliest accepted accommodation) and Request Type (e.g., At work or Leave of absence)
Actions	Click the Action icon to access various actions for the claim. The list below includes possible actions; click an option’s name to view that feature’s help topic: Report return to work Report an absence Upload documents Manage direct deposit View pharmacy card Find a medical provider Mileage reimbursement

Payment and Notification Tabs

The last portion of the My claims section includes two tabs providing more information about your claims: Payments and Notifications.

Screenshot of the last portion of the My claims section, depicting the Payments and Notifications tabs with the Payments tab selected.

Payments Tab

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

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) and the claim for which the payment was issued (with a link to view the claim). 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.

Notifications Tab

This tab lists any active notifications related to your claim. Depending on the status of your claim and the features available to you, you might be notified to set up direct deposit for a workers’ compensation claim, complete a Medicare Consent form, provide Medicare beneficiary information, opt-in to email and text messages for your open claims, complete an authorization for release of information, or confirm your return to work date.

You can dismiss a notification from this list by clicking Dismiss Dismiss button . Completing a notification’s action also removes the notification.

Claims calendar

This section provides a calendar view of your time off work for all applicable claims. It also displays approved work accommodation periods, if applicable.

Note: This section is not displayed to managers viewing their employees’ claims.

The current month is displayed by default, with today’s date highlighted with a blue border. The status of each absence is displayed based on their color. A legend at the bottom of the section describes each status color.

Note: On the morning of an absence for continuous leave cases, the calendar displays the day’s absence status as Pending if the daily balancing process for that case has not yet finished. Once this process is complete (typically during the first six hours of the day), the absence status is updated to reflect the final evaluation (e.g., Approved or Denied).

If there are no off work periods associated with your claims, this section is collapsed by default. Click to expand the section.

Actions you can take from this section include:

To view the previous or next period, click the left and right arrows at the top of the section. Click Today to return to the current month or week.
To view a week at a time, click Week. To switch back to a month-by-month view, click Month.
Click Export to download a .csv file containing absences for a specified period of time.
Click an absence to open an Event pop-up providing details about the absence’s claim. The information displayed varies by claim type. See a list of information available in this window.

Claims calendar Event popup

Field Description

Claim Number Claim number to which the absence pertains. Click to open the Claim page.

Examiner Examiner assigned to an accommodation request.

Claim Type Category of claim (e.g., Short Term Disability, Continuous Leave).

Start Date Date a leave of absence begins.

End Date Date a leave of absence ends.

Benefits Begin Date benefits begin for a disability claim.

Date of Injury Date the injury or illness occurred that resulted in a workers’ compensation claim.

Status Current status of the disability claim or accommodation (Open or Closed) and the claim’s substatus (e.g., Approved, Pending, Under Review).

Claim Status Current status of the workers’ compensation claim (Open or Closed), the claim’s substatus (e.g., Accepted or Pending), and the reason for the substatus, if applicable.

Leave Status Current status of the leave of absence claim (Open or Closed) and the claim’s substatus (e.g., Approved or Pending).

Absence Status Status of the absence (e.g., Approved, Pending).

Loa Specialist Leave of absence specialist assigned to your claim.

Leave Type Type of leave of absence (e.g., Family Medical, Employee Medical).

Date of Absence Date the leave of absence began.

Leave Caused By Reason for a leave of absence.

Exhaustion Date Date that a leave of absence’s benefits (e.g., FMLA) are exhausted.

First Absence Date of first absence from work for a disability claim.

Current Work Status Employee‘s current work status for a disability or workers’ compensation claim.

Actual Return to Work Date Date the employee returned to work.

Relationship Employee‘s relationship to the individual for whom a leave of absence is taken (e.g., Self, Parent).

Anticipated Return to Work Duty Role to which the injured employee is expected to return for a workers’ compensation claim.

Anticipated Return to Work Date Date the employee anticipates returning to work.

Duration of Absence Length of a continuous leave of absence.

Begin Accommodation period’s begin date.

End Accommodation period’s end date.

Type Type and subtype of the accommodation (e.g., Work Schedule Change - Additional Breaks).

Long Term Indicates whether the accommodation request is a long term accommodation.

Claims calendar Event popup
Field	Description
Claim Number	Claim number to which the absence pertains. Click to open the Claim page.
Examiner	Examiner assigned to an accommodation request.
Claim Type	Category of claim (e.g., Short Term Disability, Continuous Leave).
Start Date	Date a leave of absence begins.
End Date	Date a leave of absence ends.
Benefits Begin	Date benefits begin for a disability claim.
Date of Injury	Date the injury or illness occurred that resulted in a workers’ compensation claim.
Status	Current status of the disability claim or accommodation (Open or Closed) and the claim’s substatus (e.g., Approved, Pending, Under Review).
Claim Status	Current status of the workers’ compensation claim (Open or Closed), the claim’s substatus (e.g., Accepted or Pending), and the reason for the substatus, if applicable.
Leave Status	Current status of the leave of absence claim (Open or Closed) and the claim’s substatus (e.g., Approved or Pending).
Absence Status	Status of the absence (e.g., Approved, Pending).
Loa Specialist	Leave of absence specialist assigned to your claim.
Leave Type	Type of leave of absence (e.g., Family Medical, Employee Medical).
Date of Absence	Date the leave of absence began.
Leave Caused By	Reason for a leave of absence.
Exhaustion Date	Date that a leave of absence’s benefits (e.g., FMLA) are exhausted.
First Absence	Date of first absence from work for a disability claim.
Current Work Status	Employee‘s current work status for a disability or workers’ compensation claim.
Actual Return to Work Date	Date the employee returned to work.
Relationship	Employee‘s relationship to the individual for whom a leave of absence is taken (e.g., Self, Parent).
Anticipated Return to Work Duty	Role to which the injured employee is expected to return for a workers’ compensation claim.
Anticipated Return to Work Date	Date the employee anticipates returning to work.
Duration of Absence	Length of a continuous leave of absence.
Begin	Accommodation period’s begin date.
End	Accommodation period’s end date.
Type	Type and subtype of the accommodation (e.g., Work Schedule Change - Additional Breaks).
Long Term	Indicates whether the accommodation request is a long term accommodation.

Closed leave claims are not displayed on the calendar. Only open claims or disability and workers’ compensation claims closed within the past two years are included. If accommodation requests are available, only accepted requests are shown on the calendar.

Communication center

The Communication Center enables you to communicate directly with the examiner assigned to your open claims.

Click View to open the Communication Center page and view or start conversations with your examiner.

Helpful resources

The Helpful Resources section provides links to various features of the Helpful resources page, such as the Learning Center, Links, and more. For more information, see the Helpful resources page topic.

Leave balance summary

This section, displayed if your employer enlists Sedgwick to manage your open leave of absence claims, provides a graphical representation of the amount of time used, pending, and available for each leave policy for which you are eligible under the Family and Medical Leave Act, State Leave Laws, Military Leave, or other company leave policies.

See a list descriptions of this section’s features.

Leave balance summary
Feature	Description
Hours / Days / Weeks	Select the period increments by which to display the amount of leave used, pending, and available; options are Hours, Days, or Weeks.
Leave Policy (and maximum)	Displays leave of absence and eligibility information reported to date by or on behalf of the employee for consideration and protection under the Family Medical Leave Act, state leave laws, military leave, or other employer leave policies. Absences taken under a paid time off program, such as vacation and sick time, is not included. The maximum amount of time allowed per policy is displayed in parentheses beside each leave policy in hours, days, or weeks, as specified. Lifetime is displayed instead of a numeric value for lifetime policies such as the Uniformed Services Employment and Reemployment Rights Act (USERRA).
Used / Pending / Available Days	The amount of time used (purple), pending (blue), and available (green) for the policy, based on the period used to determine the maximum time allowed for the policy (hours, days, or weeks).