Third-Party Administrator (TPA) Sedgwick Claims Management Services authorized treatment for an injured FedEx employee — and then refused to pay for it. Worse, Sedgwick won't explain why, in direct violation of state law and regulations.

Injured workers depend on providers. Providers depend on getting paid. And California law is unambiguous: under California Division of Workers' Compensation (CA DWC) regulations, the mandatory Explanation of Review (EOR) that a payer sends in response to a provider's bill must include a clear explanation of any payment denial or reduction.

Sedgwick authorized the treatment. Sedgwick denied the bill. And Sedgwick will not say why.

Denying payment for the treatment it had approved, Sedgwick sent the provider an electronic Explanation of Review (e-EOR) that omitted a reason for the denial. When the provider reached out to Sedgwick's bill review vendor, Genex, to request a paper EOR listing the reasons for the payment denial, Genex directed the provider to contact Sedgwick's dedicated FedEx claim unit directly — dedicated, apparently, to not answering the phone.

FedEx should be concerned. A provider treated one of its injured employees, then submitted a compliant bill that included Sedgwick's authorization for the treatment. What did the provider get back? A payment denial with no explanation, a bill review vendor that couldn't produce the mandated denial documentation, and a dedicated phone line that nobody answers.

This sequence of events is very on-brand for Sedgwick, and none of this should surprise anyone paying attention.

On daisyBill's Claims Administrator Directory, Sedgwick earns a D for EDI compliance — dead last among major TPAs and insurers.

As of October 2025, daisyBill has filed over 305,000 audit complaints with the CA DWC reporting Sedgwick's systemic violations in workers' compensation claims handling — and the violations keep coming.

FedEx must answer one question: Is Sedgwick delivering the same D-grade service to its injured workers?

Sedgwick's Disregard of the Rules

Step by step, this is how Sedgwick treated a provider who treated an injured FedEx employee:

1. Sedgwick authorized treatment for the injured FedEx employee as medically necessary.
2. The provider rendered the authorized treatment and submitted a compliant e-bill to Sedgwick, with all required supporting documentation and the authorization.
3. Sedgwick sent an e-EOR denying payment for treatment it had itself authorized, without providing the required explanation for the denial under state regulations. The provider has no idea why Sedgwick won't pay for the care it approved.
4. The provider contacted Genex, Sedgwick's bill review vendor. While California requires an e-EOR in response to an e-bill, a paper EOR with denial reasoning could at least shed some light on the issue. However, Genex couldn't provide one. Instead, Genex told the provider to contact Sedgwick's dedicated claim unit that handles FedEx claims.
5. The provider called Sedgwick's dedicated FedEx claim unit — a line seemingly as dedicated to FedEx workers as Sedgwick itself.
6. The phone rang.
7. And rang.
8. And rang.
9. The provider left a voicemail with Sedgwick. It’s been almost two weeks, and there has been no response as of this writing.
10. The provider submitted a Second Review appeal to Sedgwick, disputing the denial.

Despite having no clue why Sedgwick refused payment for treatment it authorized, and therefore no particular counterargument, the provider's only recourse is to submit a Second Review appeal and see if Sedgwick will reconsider its denial.

This payment appeal is a needless procedural battle fought in the dark by the provider. Given Sedgwick's well-documented history of incorrectly denying these appeals as duplicate bills, we are not optimistic.

FedEx Is Not Alone

After Sedgwick took over claims for the New York Metropolitan Transportation Authority, the Transport Workers Union called Sedgwick a "menace to workers" after it failed thousands of injured transit workers. JetBlue flight attendants passed a unanimous resolution accusing Sedgwick of treating injured workers with abuse, disrespect, and mistreatment. Workers at multiple major employers have publicly urged their companies to stop doing business with Sedgwick.

Sedgwick is the largest TPA in the nation, handling a massive volume of claims for major employers across the country — and its performance data are publicly available for any employer willing to look.

On daisyBill's Claims Administrator Directory, Sedgwick earns a D for EDI payment compliance — dead last among major claims administrators, a grade that has not improved despite hundreds of thousands of audit complaints filed with the CA DWC. Gallagher Bassett earns a B. State Compensation Insurance Fund earns an A. CorVel earns an A-. FedEx chose the D.

The data suggest that Sedgwick’s pattern of violations is no coincidence. Sedgwick is owned by private equity, and its valuation has nearly doubled to $13 billion while providers go unpaid, injured workers go untreated, and audit complaints pile up unanswered. Sedgwick once boasted that its Utilization Review nurses blocked 54% of treatment requests from injured workers' physicians — before quietly deleting that page from its website. Every employer that contracts with Sedgwick is signing off on that model.

Sedgwick's well-established patterns of violations make workers' comp a riskier financial proposition for providers, discouraging them from treating injured workers and further eroding these employees’ access to care.

FedEx markets itself as an employer that takes care of its people. It operates one of the largest workforces in the country, and those workers get hurt on the job. When they do, they deserve a TPA that follows the law — one that pays providers correctly for authorized treatment, clearly explains its payment decisions, and answers the phone. Sedgwick does none of these things. That's not just Sedgwick's failure. It's FedEx's failure, too. FedEx chose Sedgwick. The D grade was there for anyone to see. The question is whether FedEx cares enough to demand better.

daisyBill tracks 835 compliance for every major California workers' comp claims administrator, including Sedgwick. See how Sedgwick and other TPAs are performing (including average days to pay) in our Claims Administrator Directory:

BILL BETTER: DAISYBILL