Howard's End: ACC’s Deeds Do Not Match Words
ACC claimants remain unconvinced with assurances from Minister Ruth Dyson that recent legislative changes and a number of other initiatives will ensure that assessments of claimants will be fair and independent. Claimants say the words of ACC do not match the deeds. Maree Howard writes.
Imagine if your boss approached you and said that due to your failure to do something which he alone subjectively decided you should do, your pay would to be stopped for up to three months unless you complied with his wishes.
Does the word panic come to mind? After all, you could lose your house if your mortgage payments couldn't be met.
Would you be angry with the injustice of it all?
That situation is one in which any claimant can find themselves when an ACC case manager or branch manager subjectively decides to flex their muscles or engage in petty power games. Too many ACC employees are relying on that flaw in the system to over-ride medically unfit for work certificates and force claimants to do things against their will.
An ACC employee can make a decision to suspend or decline weekly compensation on nothing more than their interpretation of the ACC legislation or what they consider might, or might not, be reasonable.
The claimant files for a review of that decision which is sent to the ACC Review Unit in Wellington who, it seems, does not actually conduct a review of the decision.
No, the review application is sent back to the employee who made the decision in the first place. As one claimant put it - it's like allowing the rat to make their own poison. The original decision-maker becomes both accuser and judge.
If the decision is then made to proceed to a formal hearing it ends up at the ACC owned company Disputes Resolution Services Ltd. It seems that any review application which involves $300 or more must go to a hearing.
A hearing can take weeks or months to be held. Meanwhile, the claimant is left with nothing and wondering when the bailiff might call. There is not a damn thing you can do about it.
Imagine the stress and anxiety you would be under, and the injustice you would feel, when all along you have a totally unfit for work certificate from your doctor.
If the reviewer decides that the ACC employee is right then it's off to appeal in the District Court - another few months with nothing except maybe bankruptcy.
Scoop has seen decisions of reviewers with subjective comments in them without any supporting evidence which border on defamation - and would likely be held to be so should the decision document become a matter of public record on appeal to the District Court.
It remains unclear whether reviewers have any immunity or not, or whether the function they undertake is judicial in nature. ACC seems to call reviewers a "tribunal" but the Ombudsmen's Office doesn't agree. So what are they? - nobody knows!
This is the sword every ACC claimant stands under - a sword held-up by nothing more than a piece of fragile cotton woven together with a subjective or vindictive thought of an ACC employee.
While Scoop has copies of the ACC, "processes and procedures," which are crying out to be enforced at branch level, there doesn't seem to be anyone who actually taps the ACC offender on the shoulder and says enough already, you are on an official warning - or sacked. Put simply there appears to be systemic failure or default in the checks and balances.
But then, to force an already vulnerable and injured human-being to the anxiety of a review hearing because it is more than $300, and know they will likely be unable to afford a lawyer to defend themselves because their compensation has been suspended, must be an ultimate act of terror against a human-being in a so-called democracy.
Over the weekend Scoop was told about an alleged particularly nasty and vicious ACC case manager.
This individual refused, despite a medical specialist's request, to provide a corrective shoe following an operation on the ankle of an injured claimant.
The result - the pins in his ankle popped because one leg was shorter than the other and infection set-in. His leg recently had to be amputated below the knee.
Worse, the limb-clinic said that he will need to be in a wheelchair for some time while his artificial leg settles into the stump. He applied for a wheel-chair ramp to be installed over the steps of his home, only to be allegedly told by this ACC case manager that he could only have a temporary ramp made of plywood and if that wasn't satisfactory he could remain confined to his lounge chair when he couldn't walk.
The fact that he lives in Christchurch which can be frosty, didn't seem to matter to much to this case manager.
Apparently, the specialists are furious and are considering taking personal court action against the case manager.
This same case manager discovered a mention of Seaview Psychiatric Hospital on another claimants file and immediately jumped to the conclusion that he had been a psychiatrict in-patient.
The case manager wrote to the Hospital demanding information and threatening the hospital with penalties if they didn't supply the clinical notes.
In fact, the claimant had only worked at the hospital some years ago and the case manager would have known that had he read the file properly.
Do these claimants remain bitter? You bet they do, because this case manager remains working at the main ACC Christchurch office.
Another claimant with a different case manager was dumped on the say-so of an ACC appointed doctor when another doctor with better qualifications took a different view.
The reviewer discounted the doctor with the higher qualifications and accepted the opinion of the one appointed by ACC. That is also off to appeal in the District Court. Meanwhile, this claimant has just had another operation for his injury and is recovering and yet ACC still says he can work.
This claimant has $8,000 on his credit card and has been advised that his house will go up for mortgage sale in four weeks if he cannot make the payments.
ACC employees all too often seem to depart from reality.
Scoop has stories from claimants across the country about problems they continue to experience with ACC case managers and branch managers.
One Auckland claimant has launched his own investigations with a view to bringing private prosecutions on criminal charges against compliant ACC doctors and ACC employees. He consistently makes allegations of fraud and behaviour amounting to gaining a pecuniary advantage when "suspect" reports about claimants are written for ACC.
If you were a Corporation, you promised to do something, you took money to do it, advertised that you were doing it, and then didn't provide it across the board as you promised - what might that be called?
The Commerce Commission is alleged to have told one claimant that ACC is not an organisation it is targeting under the Fair Trading Act and will not investigate. Likewise, the Serious Fraud Office isn't concerned enough to even make an investigation.
Scoop reported some time ago that the Auditor-General was conducting a study into ACC case management and the disputes resolution processes. Scoop had already been in touch with the Medical Council and they are finally distributing draft guidelines for doctors. Scoop also earlier reported about the Ombudsman's concerns and now the Minister is finally to meet with them.
But, quite frankly, that is not good enough. No study, meetings or talks will satisfy the public interest when they are to be held behind closed doors. The public pays $2 billion each year for the services which many injured people are not getting.
Despite the words of ACC and its Minister, 1500 claimants are targeted to be, "exited from the ACC scheme,” this financial year according to the Sunday Star Times this past weekend. Scoop has earlier reported that ACC refers to long-term claimants as "stock"
What has happened is that ACC has managed to gather around itself miraculous healers who cure injured people and make them fit for all manner of wondrous occupations with one stroke of their mighty pen. Perhaps ACC should be offering to sell that expertise as an export commodity. The world will snap it up - if it's true and they can prove it.
Alice in Wonderland would be proud - and so would Hitler, his medical experimenter, Dr Mengele, and his employees who transported people to their deaths in cattle-stock trucks.
It's way past time for ACC, its Minister and the Government to have the cold hard wind of a full, open and transparent public inquiry put-up their collective backsides. The public interest, and the public purse, demands nothing less.