How to Fill Out and Submit the Sedgwick Direct Deposit Form

The Sedgwick direct deposit form switches your benefit payments from mailed paper checks to electronic transfers into your bank account. You can complete it online through the mySedgwick (viaOne) portal, or fill out the paper authorization and send it by fax to (855) 800-5116 or by mail to Sedgwick, PO Box 14648, Lexington, KY 40512.¹ After a short verification window, future payments arrive electronically.

What to Have Ready Before You Start

Pull these together first so you can finish the form in one sitting:

Your Sedgwick claim number, which appears on correspondence from your claims examiner and inside the mySedgwick portal.
Your bank’s nine-digit routing number, printed at the bottom left of a personal check. If you don’t have checks, your bank’s app or a quick call will give you the number.²
Your account number, which is the second set of digits along the bottom of a check.
A voided check or a bank verification letter on official letterhead listing the routing number, account number, and account holder name. A letter is the right substitute if you’re using a savings account or don’t have paper checks.
Your Social Security number, which the form asks for as an identifier.¹

How to Fill Out the Form

The paper form is one page. At the top, check the box that matches what you’re doing: establishing new direct deposit, changing existing bank information, or canceling electronic payments to go back to paper checks.¹

Enter your first and last name exactly as they read on the bank account. A mismatch between the name on the form and the name at the bank can cause the transfer to bounce. Fill in your Social Security number and your Sedgwick claim number in the fields provided.

In the banking section, write the name of your financial institution, the routing number, and the account number. Check every digit. A single transposed number sends the payment to the wrong account or triggers a rejection. Mark whether the account is checking or savings; the ACH network uses different transaction codes for each.

Sign and date at the bottom. Your signature authorizes Sedgwick to deposit funds into that account and, if a payment ever needs correcting, to debit the account to recover an overpayment. No one else can sign for you unless they hold a valid power of attorney.

How to Submit It

Through the mySedgwick Portal

Log in to mySedgwick, open the Summary tab, and find the Actions section. Choose “Manage direct deposit,” then select “Electronic” and enter your bank details on screen.³ The online route is the fastest because your information enters the system without waiting on mail or fax queues. Enter your details once and let it process; repeatedly opening the direct deposit settings page can restart the verification period.

By Fax

Fax the completed form along with your voided check or bank letter to (855) 800-5116.¹ Keep the transmission confirmation as proof of delivery.

By Mail

Send the form and voided check or bank letter to:

Sedgwick
PO Box 14648
Lexington, KY 40512¹

Use a trackable mailing method so you can confirm arrival. Pick one submission channel and stop there. The form advises against duplicates, which can create confusion in the processing queue.

What Happens After You Submit

Sedgwick verifies your bank details before sending real money. The standard method is a prenote, a zero-dollar test transaction routed through the Automated Clearing House network to confirm the account exists and can accept deposits. Under NACHA operating rules, the originator must wait at least three banking days after the prenote before sending a live payment. Sedgwick’s full verification cycle often runs closer to one or two full payment periods once internal processing is layered on top.

Expect at least one more paper check while the setup is being confirmed. If the prenote comes back rejected, your claims examiner will contact you to correct the account details, and the clock restarts. The mySedgwick portal shows the payment method on your claim; when it flips from “Check” to “EFT,” your next benefit will arrive electronically.

ACH transactions don’t settle on Federal Reserve holidays.⁴ If a payment or a verification prenote lands on a holiday or the weekend right before one, the deposit moves to the next business day. Long holiday weekends can push both prenotes and live payments back a day.

Changing or Canceling Later

To update your bank account, submit a new form with the “change” box checked, or use the same “Manage direct deposit” option in the portal.³ A new prenote runs against the updated account, so keep the old account open until the first deposit lands in the new one.

To stop electronic payments entirely, check the “cancel” box and submit the form by fax or mail. Your authorization stays active until Sedgwick has reasonable time to act on the cancellation, so send it well before your next expected payment date.¹ Once processed, payments revert to mailed paper checks.

Keeping Your Information Safe

Sedgwick’s privacy policy states that the company collects bank account numbers and account details to fulfill its service requirements, with technical and organizational safeguards against unauthorized access or disclosure.⁵ On your end, don’t email the completed form. Email isn’t encrypted by default, and an attachment with your SSN and full bank details is a serious identity theft exposure. Use the portal, fax, or mail. If you fax from a shared machine, take the original with you as soon as the transmission finishes.

1
Arizona State Retirement System. ASRS Long Term Disability Direct Deposit Authorization Form
2
Social Security Administration. Where Can I Find My Account Information?
3
EB Landing. mySedgwick 5.0 Guide for Claimants
4
Federal Reserve Financial Services. Federal Reserve System Holiday Schedule
5
Sedgwick. Global Privacy Policy