Workers’ Compensation Tracking Table

Name EID # Assignment Type of Injury Name of Adjustor at Sedgwick Name of MLU Advocate/Contact Time “Wasted” Because of Delay (number of days) Issue(s) of Workers Compensation Treatment Member’s Registered Email Address Entry creation date
Karina Youssef 12345 Testing Testing Testing Testing 1

Testing

admin@velarium.com January 27, 2025 at 7:16 am
Leonard Allen 381812 3b Eye Robert Montes Kevin Davis 54

I have seen multiple Doctor’s and Specialist including those referred to by workers comp regarding my eye. All of which state i need surgery. Once Sedgwick was informed surgery was required, my claim ws delayed. I took initiative in finding surgeons and had surgery scheduled as early as December for an injury that occurred in November. I have tried to contact Sedgwick several times however my calls nor emails are being returned. I could have returned to work in January had i been allowed to move forward with surgeries.

January 28, 2025 at 10:08 am
mike spears 32572 23b Right shoulder. Also, back Erika Guevara Anyone who answers the phone 30

Erika seams ok, but doesn’t always respond. For example, I’ve requested 5 different shoulder doctors who are on the city approved list. She doesn’t reach out to inform me that they are not taking work comp patients anymore or at this time. Btw, how is that possible…. All 5 doctors I requested?

January 28, 2025 at 11:27 am
Clinton Cadena 69651 Drill Tower 81 Left knee injury Barbara Palser Capt Crossen 6

Claim was denied from 8/22/24-9/2/24. Then was approved for surgery. My 6 SK days were not converted to ID. Claim number 4076130

January 28, 2025 at 12:30 pm
Shawn Lenske 72412 QIS-S Respiratory COVID Meguel Mendoza Dont have one 60

Still they are not paying for my doctors appointments. I have paid for them out of pocket for 8 months

Payroll Deduction Issue

I was still today not paid the remaining 50% balance owed to me, as referenced in payroll email early January for mid December paycheck only paying me 50% of my pay and deducted 80 hours of my 75% sick. $3,000. The current paycheck also shows no reimbursement. Please advise on how to resolve this immediately, as I am on a fixed income while off IOD and it has been over a month now. And still no reemburst for this error 1. Pension Reimbursement: * My pension payments as of the pay period ending 3/23/24 totaled $3,746.27 before I went off IOD on 3/25/24. * On the pay period ending 11/16/24, the pension payments reflected $12,732.49. I was charged $589.30 during this time. * I received a reimbursement of $2,134.62 on pay period ending 10/19/24, but I am still owed $11,187.20. Please clarify when this will be resolved. 2. Medicare Overpayment: * While off IOD, I should be exempt from Medicare payments. However, the following amounts were deducted: * $616.01 on pay period ending 3/23/24 * $2,172.30 on pay period ending 11/27/24 * Total overpayment: $1,556.29. Please confirm the process for reimbursement of this amount. 3. Voluntary Health Pension Contributions: * I noticed significant discrepancies in deductions for “Voluntary Health Pension” while off IOD: * $624.53 on pay period ending 3/23/24 * $1,049.84 on pay period ending 11/30/24 * I should only be paying $89.97 per pay period. As of pay period ending 11/30/24, I have been overcharged a total of $2,579.33. Kindly review and advise on how to correct this error. 4. 5. Payment for March 27 2024 IOD to June 16 2024 6. Reemburst all my 50%,75% , 100% sick, holiday pay and vacation from march 27, 2024 to December 31, 2024 as I am deemed IOD
Date Range of Issue(s) *
3/27/2024 to 1/22/2025
Description of Pay Issue(s) *
* I was still today not paid the remaining 50% balance owed to me, as referenced in payroll email early January for mid December paycheck only paying me 50% of my pay and deducted 80 hours of my 75% sick. $3,000. The current paycheck also shows no reimbursement. Please advise on how to resolve this immediately, as I am on a fixed income while off IOD and it has been over a month now. And still no reemburst for this error
1. Pension Reimbursement:
* My pension payments as of the pay period ending 3/23/24 totaled $3,746.27 before I went off IOD on 3/25/24.
* On the pay period ending 11/16/24, the pension payments reflected $12,732.49. I was charged $589.30 during this time.
* I received a reimbursement of $2,134.62 on pay period ending 10/19/24, but I am still owed $11,187.20. Please clarify when this will be resolved.
2. Medicare Overpayment:
* While off IOD, I should be exempt from Medicare payments. However, the following amounts were deducted:
* $616.01 on pay period ending 3/23/24
* $2,172.30 on pay period ending 11/27/24
* Total overpayment: $1,556.29. Please confirm the process for reimbursement of this amount.
3. Voluntary Health Pension Contributions:
* I noticed significant discrepancies in deductions for “Voluntary Health Pension” while off IOD:
* $624.53 on pay period ending 3/23/24
* $1,049.84 on pay period ending 11/30/24
* I should only be paying $89.97 per pay period. As of pay period ending 11/30/24, I have been overcharged a total of $2,579.33. Kindly review and advise on how to correct this error.
4. All my holidays from last year not paid to me as I was off IOD and docked for 2 hours every holiday
5. Payment for March 27 2024 IOD to June 16 2024 of IOD because I used all my sick/vacation which I have not received back
6. Reemburst all my 50%,75% , 100% sick, holiday pay and vacation from march 27, 2024 to December 31, 2024 as I am deemed IOD

January 28, 2025 at 2:43 pm
Cade Gaspar 315748 23C Basal Cell Skin Cancer Bryan Veloz None 150

I filled out the Workers’ Compensation Form DWC-1 on March 29, 2024 for the need for Mohs surgery for skin cancer on my head. I had this surgery done in the past without any issues when the City was using AIMS. After waiting for months and going back and forth with Sedgwick, they denied my claim. Which is something I didn’t think would ever happen since cancer is presumptive and my other skin cancer claim was approved through AIMS. I was told that Segewick sent an appeal to the workmans comp appeals board and would have to wait for them to create a panel. That was on 07/23/2024. After waiting another month without hearing anything about the appeal, I decided to get the surgery done on my own on 08/29/2024, not wanting the cancer to grow any more. As of today, I have still not heard anything from Sedgwick since 07/23/2024. I had to use 96 hours of SK time and spend $770.63 out of my pocket for this surgery.

January 28, 2025 at 8:03 pm
ARMANDO CARRANZA 51073 114 B Heart Barbara Palser Broessel, Dane 180

City denied 2023 and 2024 heart claim. Hired lawyer, claim approved summer of 2024. City refuses to pay benefits. Trail set with 35% penalty requested. No city employee is getting benefit’s converted, alleged Workday issue.

February 1, 2025 at 4:12 pm
Raymond Rodriguez 381885 48B Covid No body contacted me Kevin Davis 6

This happened back in 2022 I got Covid at work and took a pcr test that was provided by the union. I was too sick to drive to an urgent care and my family isolated from me because of their health issues. I was off QZ MLU approved my QZ time but 4 months later workers comp denied my claim and took 140 hrs of sick time away from me and never returned my QZ time.

February 2, 2025 at 8:17 pm
Michael Cunningham 105864 Hru Back Multiple. Changed throughout Captain changed. Throughout 320

Horrible process. Dept was no help. Adjuster was horrible. Lawyering up was the only thing that helped the process, which is still unresolved.

February 2, 2025 at 8:17 pm
Thomas Andrews 374454 DT81 Cubical Tunnel Syndrome/ torn tendons in elbow Unknown Captain Crossen 340

Surgery was denied countless times due to work comp needing a ‘peer review’ (face to face) with the surgeon requesting the operation.

I’d receive notices after each request saying they were unable to get ahold of the surgeon for the peer review, therefore treatment was denied. Follow up visits were every 5 weeks. The surgeon assured me peer to peer reviews are simple, that he does them all the time, but was frustrated on my behalf because he was never contacted by their team. He looked up the physician denying the surgery and found that they held a general license in 5 different states, no specialty in orthopedics. He wrote a formal request and reached out, stating he needed to speak with a surgeon @ his level or higher, as he was confident someone with his training would see this as an absolute necessity.

I went through 6 different adjusters, was doing ALL of the leg work. I was sending emails daily and getting replies from work comp stating I was going out of my chain of command and needed to leave certain requests and communication to my adjuster.

I contacted my front office @ the time for advice. Pain every day, weakness and atrophy down my arm and no luck with treatment. I was getting acupuncture weekly out of pocket off the record. I was going to cancel the claim and burn my own time to get it handled. I was beyond fed up.

Captain Crossen had me come to MLU to straighten it all out. He emailed a gentleman named Tyrone Spears who oversees all workers’ compensation programs for all city departments. From what I understand, he can override denials. Captain Crossen told me it is extremely rare for them to reach out to Mr. Spears, but they’d give it a shot. Surgery was approved within a week.

Post surgery, I received a letter stating PT was denied because Sedgwick did not approve the operation. It took far too long to get PT because of this. I then received packets stating financial coverage was in question because of this operation that Sedgwick did not approve. All has been worked out, but it has left a terrible taste in my mouth.

Unless I have no option (unconscious at work transported with life threatened emergencies) I will be handling all injuries on my own. Unfortunately, using my own time and finances is more efficient than going through any process affiliated with the City.

February 2, 2025 at 9:14 pm
Adrian Puga 510284 35C currently in light duty Torn meniscus Jose Banuelos Hernández Capt Faulkner 60

First month of waiting to get an MRI because Concentra would not approve it. There has been delays on getting referrals to my chosen doctor now that I have been seen by him we are waiting for the approval for schedule surgery.

February 4, 2025 at 7:46 pm
Adrian Puga 510284 35C currently in light duty Torn meniscus Jose Banuelos Hernández Capt Faulkner 60

First month of waiting to get an MRI because Concentra would not approve it. There has been delays on getting referrals to my chosen doctor now that I have been seen by him we are waiting for the approval for schedule surgery.

February 5, 2025 at 5:59 am