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How some ACC assessments predetermine outcomes

BIG ACC NEWS JAN 2003

How some ACC assessments predetermine outcomes for claimants

By Dave Crampton

Assessors contracted by ACC are not providing claimants with a fair assessment of their injury and vocational ability, thus limiting the assistance provided by the Corporation.

In order to determine most vocational rehabilitation needs, claimants are required to be assessed by an occupational assessor who identifies any work the claimant can undertake for 35 hours a week. This is followed by a medical assessment to see if the claimant is fit to do any of the jobs identified by the vocational assessor. Claimants, in some cases, are told that such assessments “are meetings that are purely discussions” – but in many cases are in fact attempts to arrange early and illegal exits from the scheme. Thus some needy claimants get no rehabilitation and no resultant compensation.

Those that are assessed as requiring rehabilitation are supposed to have their rehabilitation plans amended and be sent a copy. They are often not. If the content of the plan is disputed a review hearing is lodged with ACC subsidiary Disputes Resolution Services, who tend to rubber stamp the decision. Therefore lawyers are avoiding reviewing such decisions and are going straight to appeal at the District Court where they have a greater chance of success as rehabilitation plans are not adequately updated post assessment.

Some claimants are told they will be sent on “work preparation programmes”. Many case managers have work preparation plans all mapped out before any initial assessments of their claimants have even commenced. This smacks of pre-determination to get claimants off ACC as fast as possible. It also means that case managers do not have faith in the outworking of their own assessment processes.

Whether the claimant is actually fit for work is irrelevant. What is relevant is how long a claimant should be on ACC. This attitude not only contravenes the sprit of the ACC Act, it contravenes the letter of it as well – not to mention the views of the ACC Minister. It also means that ACC is unable to arrange assessments for vocational independence, as the vocational rehabilitation assessments end up being de facto vocational independence assessments- ideally required only after completion of a legal rehabilitation plan.

Rehabilitation plans that comply with legislation are difficult to find, meaning most vocational assessments for independence are conducted within a dubious legal framework. ACC needs to arrange an independent internal investigation on these matters instead of leaving it to the Audit Office.

Scoop has spoken to one claimant who was forced to sign three rehabilitation plans last year alone, the latest on 4 November under duress. He is going through his third “initial” round of assessments. This claimant’s plan was signed in addition to a rehabilitation plan through Aon Insurance in the days of ACC privatisation. The claimant, from Christchurch, told Scoop that his Catalyst case manager informed him that it was Catalyst’s policy to replace all private insurer rehabilitation plans with Catalyst ones. That’s false, as ACC legislation stipulates that rehabilitation plans must be updated, not rewritten from scratch.

Yet in some cases where other insurers have arranged the plans, ACC has ignored them and started the process from scratch when it retained the function as the sole provider of compensation entitlements through accidents.

The corporation restarts the process by ramming through a signed rehabilitation plan – irrespective of whether the claimant agrees to or has input in the plan - and gets the a claimant assessed to do certain jobs for 35 hours a week. The case manager then arranges the medical assessment in the hope that identified tasks are medically achievable, and, if so, compensation is cut.

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