Sedgwick Claims Management Services, Inc. has made it a business practice to defy California workers’ compensation laws, and public entities like the County of Los Angeles have enabled it.

This time, taxpayers paid the price when Sedgwick stiffed a provider on the legally required reimbursement for an Independent Bill Review (IBR) filing fee.

Fed up with Sedgwick’s long history of stiffing our clients for the IBR filing fee, daisyCollect fought back. After Sedgwick ignored yet another order to pay the fee, daisyCollect enlisted legal counsel to force the Third-Party Administrator (TPA) to comply—ultimately recovering the $180 fee, penalties, and attorney fees.

It’s important to be clear: Sedgwick acts on behalf of the County of Los Angeles, and it’s the County—not Sedgwick—that foots the bill for this TPA’s lousy behavior. Each time Sedgwick wrongfully denies payment or delays reimbursement, it is ultimately California taxpayers who will absorb the costs.

If this is Sedgwick’s conduct toward medical professionals, what are they doing to injured workers?

County of Los Angeles Complicit–Taxpayers Left Holding the Bag

In March 2024, daisyCollect submitted a clean, compliant bill for CPT 99358 and 99359, supported by complete documentation. Rather than paying, Sedgwick falsely claimed the documentation didn’t justify billing for prolonged services.

After denying the provider’s Second Review appeal, Sedgwick left daisyCollect no choice but to pay the $180 IBR filing fee (which increased to $195 in 2025) and initiate IBR.

Maximus, the state’s IBR reviewer, made the decision easily. Maximus ordered Sedgwick to pay the disputed bill and the IBR filing fee. But when payment arrived, the fee reimbursement was missing.

Sedgwick: Repeated Failure to Reimburse IBR Filing Fee

Instead of obeying the law, Sedgwick forced the doctor to engage in a legal battle to collect the IBR filing fee. In April 2025—more than a year after the initial bill, eight months after the IBR ruling, and 211 days after payment was due—the County of Los Angeles finally issued a check for the fee and associated penalties.

This isn’t new behavior for Sedgwick. The TPA routinely fails to pay the IBR filing fee—in fact, for a different payment dispute, Sedgwick currently holds the record for the longest-overdue IBR fee reimbursement to a daisyCollect client: 1,655 days. That’s over 4.5 years of ignoring the law.

California Labor Code Section 4603.6 states (emphasis ours):

“If any additional payment is found owing from the employer to the medical provider, the employer [or their claims administrator] shall reimburse the provider for the fee in addition to the amount found owing.”

In addition to the check below, California taxpayers paid for the hourly attorney fees that were also awarded—making the decision to stiff this doctor a poor one, indeed.

CA DWC Enables the Abuse

What makes Sedgwick’s misconduct possible? The near-total absence of enforcement by the California Division of Workers’ Compensation (CA DWC).

The CA DWC has the authority—and the obligation—to ensure that claims administrators follow the law. Yet despite mountains of evidence and repeated violations, the CA DWC remains silent.

By failing to penalize Sedgwick or any other administrator for ignoring IBR laws, the CA DWC has created a de facto green light for this behavior. In practice, claims administrators have learned they can flout the law with impunity, knowing the state won’t intervene. The message to providers is clear: If you want to get paid everything that you’re owed, hire a lawyer.

Under the CA DWC, Sedgwick wins, public employers avoid accountability, and taxpayers are left holding the bag when doctors (and injured workers) are forced to hire attorneys to enforce workers’ comp laws.

When it comes to protecting our provider clients, daisyCollect is always up for a fight. Click below to learn more:

LEARN MORE: DAISYCOLLECT