ACC is spending millions of dollars flying doctors around New Zealand to assess long-term clients who have already been assessed by other doctors.© 2012 Fairfax NZ News
The policy has been slammed by John Miller - one of the country's top lawyers specialising in ACC legislation - who said the so-called “independence” of some assessors was a sham.
ACC lawyers, advocates and claimant groups know those doctors as “hatchet men and women”, Mr Miller said.
“They are not independent, as a substantial part of their income comes from ACC,” he said.
ACC figures reveal the corporation pays millions of dollars a year to a group of “independent assessors”, often flying them to towns or cities where other doctors with suitable qualifications already practise. In some cases the ACC assessors are flown from the South Island to North Island cities.
At least $3 million was spent last year on airfares and assessment fees for a group of less than 12 doctors.
Mr Miller said medical professionals had expressed serious concerns to him about the issue. Because some assessors earned virtually all their income from ACC it was “inevitable” they would tend to “provide reports ACC wants".
“The old saying of ‘he who pays the piper calls the tune' definitely applies with ACC assessors. The use of such assessors actually damages and diminishes ACC's reputation,” Mr Miller said. “ACC knows the assessors who have particular fixed medical views, for example on degeneration . . . and they keep sending injured claimants to be assessed by those assessors as they know they will receive reports they want.”
Mr Miller said ACC advocates know when clients are sent for assessments by “the same usual suspects ... there will be an adverse outcome for the injured claimant”.
ACC has seen a drop in the number of cases it is winning as claimants fight assessments. The corporation won 77 per cent of cases challenged by clients in 2009 but in the year to date that figure has dropped to 56 per cent.
Mr Miller said his firm had experienced cases where independent assessors such as occupational therapists for seriously injured clients refused to provide reports “for us in ACC disputes".
“They fear that it will affect their livelihood from ACC contracts,” he said.
“It confirms in people's minds it is an organisation more concerned with removing claimants from ACC assistance this way rather than being concerned with properly rehabilitating injured claimants off the scheme.”
Mr Miller said the solution would be for ACC to start using a group of trusted assessors who could “be used by both sides."
ACC's claims management acting general manager Phil Riley said ACC chose appropriate providers, but if clients did not want to see them because of genuine concerns, a choice of two alternative providers was offered. If clients chose not to see a local assessor, ACC could arrange for a specialist from another area to travel to their location.
"For practicality purposes, we try to send specialists to other areas when there are a number of clients to see in that area. This is why ACC flies specialist medical professionals to other regions, to hold ‘day clinics' for ACC clients."
ACC paid specialists at market rates, Mr Riley said.
ACC Minister Judith Collins said changes she made to ACC's board include new priorities for the corporation to ensure entitlements were delivered transparently. She said ACC must follow a fair process for assessments and provide best practice and lawful services to preserve public trust.
However ACC would not be a soft touch for people trying to take advantage of it, Ms Collins said.
http://www.stuff.co.nz/national/politics/7637014/ACC-pays-millions-to-send-its-hatchets
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