Short & Long Term Disability Cases We’ve Won for Our Clients Against Sedgwick

An installed sales coordinator in North Carolina had Short Term Disability benefits approved for treating major depressive disorder, panic disorder, anxiety disorder, and insomnia, then Sedgwick terminated payments just four weeks later, citing an internal nurse review that claimed the medical records supported a return to work.

With income interrupted and deadlines approaching, Fields Law Firm acted quickly to stabilize the claim and clarify next steps. The Fields team reviewed the medical and occupational evidence, obtained updated records, and secured additional physician support to strengthen the administrative appeal. Because a different carrier administered the Long Term Disability coverage, Fields Law Firm also prepared and submitted a Long Term Disability application to support continuity of benefits. After the appeal record was fully developed and Long Term Disability benefits were approved, Sedgwick reversed course and paid the Short Term Disability benefits that had been denied.

An associate manager in New York developed multiple medical conditions that made it impractical to perform the core duties of the role, including severe back issues following failed back surgery and fusion surgery, persistent pain that limited sitting tolerance, and additional symptoms affecting daily function. Long Term Disability benefits were initially approved under the “own occupation” definition of disability. When the policy definition shifted to “any occupation,” Sedgwick terminated benefits, despite ongoing limitations that continued to interfere with sustained work capacity.

Fields Law Firm conducted a detailed review of the claim file and prepared a comprehensive appeal. The Fields attorneys organized and explained the supporting medical evidence, secured narrative reports from treating physicians documenting functional restrictions, and identified gaps in the insurer’s evaluation showing the review was not fair or complete. After the appeal was submitted, Sedgwick reinstated Long Term Disability benefits going forward.

A retail sales associate in Missouri had to stop working after severe complications from a staph infection and ongoing, debilitating migraines that limited day-to-day functioning. After Sedgwick denied the short term disability claim, the client turned to Fields Law for an organized appeal strategy supported by comprehensive medical records and clear documentation of work restrictions.

Fields Law submitted an initial appeal that resulted in approval for several months of benefits. When the insurer later denied the remaining months based on an unsupported claim that the client had returned to work, Fields Law Firm filed a second, detailed appeal to correct the record and reinforce the evidence. That follow-up appeal led to approval of the remaining short term disability months, along with continued Long Term Disability benefits.