ACC's culture must change

A press release by Access Support Services

Over the last year there have been numerous negative media reports about the way ACC is managing claims, especially concerning sexual abuse victims and decisions declining surgery funding. Many organisations, including medical practitioners, counsellors and lawyers, have expressed the same concerns raised by Access Support Services over the last year.
The changes to ACC have come as a result of the Government’s directive for it to reduce costs. ACC claim these changes reflect a more rigorous application of the ACC legislation than in the past and the culture of ACC had to change.
It is difficult to argue against this if you accept what ACC claim at face value. However, it does stack up when you consider the statistics. For example, the number of review applications challenging ACC’s decisions have increased from about 6000 in 2008 to 9000 last year, a 50% increase. If, as ACC claim, it is applying the legislation more rigorously then one would expect an increase in the number of decisions upheld at review when in fact it has remained constant at 75% over the past 10 years. That means 1 in 4 decisions challenged through the review process are found to be wrong.
Access Support Services own success at overturning decisions is somewhat greater, an average of 75%, which is comparable with what other ACC specialists report. But in the area of decisions relating to surgery and sensitive claims Access Support Services success is somewhat greater than its average.
“In the last year about 90% of the surgery funding decisions we have handled have been overturned and I can only recall one review decision relating to a sensitive claim not being successful since 2006” claims David Wadsworth, Head of Access Support Services.
This does not necessarily reflect our expertise in these areas, although these have made up a significant proportion of our cases in the last year, it is more indicative of the way ACC goes about its decision-making process. Access Support Services finds ACC relies too heavily on its internal medical advisors without giving proper consideration to all the circumstances, including external medical specialist opinions and the requirements of the legislation.
“We consider ACC’s decision making process is fundamentally flawed and it does not meet basic legal principles” says Mr Wadsworth.
In fact, one ACC Appeal Judge has expressed his concerns as well. In a recent District Court decision Judge Beattie commented; “ I am not impressed by the nature of the evidence upon which the respondent acted to make its decision, and that advice was given, I find, without proper regard to the legal position of the appellant's entitlement to funding for treatment.”
In another appeal decision concerning ACC’s decision to decline funding surgery Judge Beattie commented; “This Court has now heard and considered a significant number of cases on appeal where the respondent's decision to decline to fund surgery is based essentially on the fact that the claimant's shoulder is displaying aspects of degeneration commensurate with age. The respondent is very quick to seize on that identified state of affairs and use it as a reason for declinature, and I find that the present case is such an example of that.”
Access Support Services considers the changes to ACC are less about rigorous application of the legislation and more to do with an arbitrary approach to decision-making. “ACC must change its culture or its ACC’s senior management, or both. This is not what the ACC scheme is suppose to be about and it is contrary the requirements of the legislation,” says Mr Wadsworth.

http://www.scoop.co.nz/stories/PO1012/S00126/accs-culture-must-change-advocate.htm

Shut down ACC's Sensitive Claims Unit

A press release from Access Support Services

Last year ACC’s Sensitive Claims Unit (SCU), based in Wellington, implemented its new clinical pathways for claimants suffering from the effects of sexual abuse. It also adopted the so-called “tough love” policy drafted by one of its senior officials, Phil Riley, who set out a strategy on how to exit claimants from the Scheme, including suspending entitlements.
The consequence of these two policies is that the SCU often requires rape victims to undergo multiple physiatrist assessments or risk having entitlements suspended or not provided at all. This heavy handed approach has a re-traumatising effect on victims of sexual abuse.
SCU’s approach is highlighted in a story on stuff.co.nz (8/11/10), where it reports ACC has unlawfully refused to implement a binding review decision directing the corporation to reinstate a rape victim’s entitlements.
“We believe SCU senior and technical staff have consistently demonstrated they are not up to the job, including its senior medical advisor Dr Peter Jansen,” says Mr Wadsworth. “Now it’s time for ACC to shutdown the dysfunctional unit.”
Over the last year Access Support Services has regularly expressed our concerns over the way the SCU manage sexual abuse claims. Now ACC’s claims management business manager Sue North is defending its refusal to implement a binding review decision.
“ACC’s senior management responsible for adopting Phil Riley’s tough love strategy and implementing the new clinical pathways need to take a good hard look at themselves, even if they are under enormous political pressure from the National-led Government,” says Mr Wadsworth.“This is not what the ACC scheme is suppose to be about.”

http://www.scoop.co.nz/stories/PO1011/S00087/shutdown-accs-sensitive-claims-unit.htm

Rape victim: ACC cut my lifeline

An article from the Sunday Star Times by Tim Hume

Last month, an Auckland mother died after her claim for ACC-funded counselling was rejected under ACC's new 'clinical pathway' for sensitive claimants. But many existing ACC clients claim they are also having their counselling for sexual abuse terminated. One multiple rape survivor tells Tim Hume how having her therapy discontinued has pushed her to the brink, and why she is speaking out to call for changes to the way abuse victims are treated.
The worst part is the nightmares. "Getting raped every single night when I go to sleep. I can only sleep for 45 minutes before I wake up screaming," says Danielle Martin. "I've got a hammer in my bed. If I knew it was going to be like that every night for the next 30 years, I'd kill myself."
The 32-year-old was first raped when she was 16. The attack happened at Red Beach, north of Auckland. Her attacker was known to her and she says he had a serious drug problem. As she ran from the scene, he chased her to the side of the road and laid into her with his boots.
A private-school girl who had been going through a tearaway stage after becoming estranged from her family, Martin took refuge in a caravan park. A few weeks later, her attacker tracked her down, tied her up and held her hostage for 38 hours, subjecting her to all kinds of indignities. "He cut up or destroyed everything I owned: clothes, photos. He was burning me with knives."
Martin eventually escaped by pleading to be allowed to do her park-cleaning duties, then running to the home of the managers, but not before the man had made a cut on her throat and threatened to kill her and her family if she told anyone.
She didn't, trying instead to forget and move on with her life, and eventually got a job at a bar in Auckland's Viaduct. But after a staff party one night, when she was 18, she was drugged and raped by one of the regulars. She remembers only brief flashes of what took place, but the attack left her with lasting physical injuries.
Her trauma went untreated and unacknowledged, and the subsequent years were filled with depression, addiction, nightmares and self-harm until she finally sought help from a counsellor. In October 2000, her claim as a rape survivor – a "sensitive claimant" – was accepted by ACC, entitling her to heavily subsidised counselling.
At first, the counselling had limited success. She went through about 20 counsellors and psychiatrists without feeling comfortable divulging or addressing the trauma at the core of her issues.
"I never felt safe or made that connection," she says. Life was hard, sometimes unbearable. As a result of the attacks, she had chronic post-traumatic stress disorder and major depression, conditions which constituted a disability and made it extremely difficult to leave the home, use public transport, or maintain social links.
But in the past two years she established a connection with a regular counsellor and a psychiatrist, who allowed her to finally "get into the grit" of her trauma. She made what her psychiatrist called "slow but significant progress" and began to study for a counselling degree.
This was all reversed in October when, out of the blue, Martin received a call from her ACC case manager telling her that her twice-weekly sessions with her counsellor were to come to an end.
In November came a letter: "We're pleased to tell you we've approved your decision for a final 20 sessions. Please note there will be no further counselling sessions approved."
Martin was devastated. "I've been suicidal as a direct result of this."
ACC senior medical adviser Dr Peter Jansen said that while Martin and her psychiatrist might have felt she was making progress with her present regime, the opinion of ACC's experts was that "the long-term counselling has created a dependency that has been counter-productive".
He said Martin had already had 280 ACC-funded counselling sessions. One of ACC's expert assessors, through an assessment which included a review of her case history, determined she would be better off at Segar House, a mental health treatment centre operated and funded by the Auckland District Health Board.
"We want the right care so that people recover from their injury."
Martin, who has had trust issues and finds it difficult leaving the security of home, felt she was incapable of undertaking the programme at Segar House, which has a group therapy component and would involve revisiting the trauma of her rapes with new counsellors.
Her psychiatrist agreed and wrote in a letter to ACC last month: "Since having funding for this intervention discontinued, she has in fact deteriorated significantly – is currently in fact more severely unwell than when first seen but is not accessing any care or follow-up other than that provided by her GP."
Martin said she had been "revictimised" by ACC, which had taken away her lifeline. "I don't have anybody I can talk to about this," she says. She has been calling mental health crisis helplines just about every day but they are not equipped to properly help.
During a recent call, after she woke up hyperventilating from a nightmare, she was advised to take a walk around the block.
"Rape is the ultimate form of powerlessness, the ultimate form of having your choices taken away. And I've been kept in the dark and given no options," she says.
"Therapy helped. My quality of life was improving, my prospects, my ability to be cohesive with other people and my chances of being a productive member of society. I've gone from having some semblance of a normal life ... [to being] a rape victim with worsening symptoms and no help."
Since her counselling was discontinued, Martin has made her blog publicly accessible and has been tweeting about the ordeal, including messages to the prime minister's account. (She received no reply).
"If I'm dead next week, I need this documented," she says. "I've done the right thing. I've been really honest with my treatment providers. I've worked really hard, I've stepped out of my comfort zone to get well. I can still potentially have a really good future. But they're not going to do the right thing unless they're shamed into it."
David Wadsworth of Access Support Services, who is advocating on Martin's behalf, said her case was symptomatic of ACC's "assault on sensitive claimants". "If ACC can get out of any funding of sensitive claims claimants, they'll do it by hook or by crook, as I see it. And they're really the most vulnerable group."
The corporation's new "clinical pathway", which required new clients to be diagnosed with "a significant mental injury" before their applications for sexual abuse counselling could be accepted, had seen the number of sensitive claims approved drop from 472 in the first two months of last year to just 32 in the same period this year. Last month, an Auckland mother died four days after her claim for counselling was rejected.
Meanwhile, many longer-term sensitive claimants were being subjected to reassessments of their treatment regime, which saw them pushed off ACC-funded counselling into DHB-funded programmes.
"They're leaving the claimant high and dry. Four months down the track the person hasn't had any counselling. It's caused a lot of damage to them. They're essentially being retraumatised," Wadsworth said.
Jansen said perceptions that ACC was turfing long-term claimants off counselling regimes to cut costs were incorrect. However, until recently, ACC had been funding treatment for many people who weren't covered by the legislation or weren't getting appropriate treatment.
"If the community is concerned that people are exiting from ACC, my concern would be that they exit because they are recovered."
For regional Rape Crisis help line numbers visit www.rapecrisis.org.nz.

http://www.stuff.co.nz/national/3702810/Rape-victim-ACC-cut-my-lifeline/

ACC looking to revoke historic sexual abuse claims

Press release from Access Support Services

Access Support Services understands ACC are looking at stopping all entitlements to claimants who lodged sexual abuse claims under former Acts if the actual abuse occurred prior to the introduction of the ACC scheme in 1974. If this is the case then hundreds, if not thousands, of claimants suffering from a mental illness caused by sexual abuse will be exited from the ACC scheme.
“We already have one client affected by this policy and we understand ACC is currently reviewing other similar claims” said Mr Wadsworth, Head of Access Support Services.
It appears this new strategy to reduce liability is because ACC legislation prior to 1992 did not define the date of injury and ACC look likely to attempt to revoke cover for a significant number of people who have sensitive claims under the previous Acts.
“Access Support Services considers this policy change is wrong in law and its advocates will vigorously challenge any decision ACC makes to revoke cover for this group of claimants” said Mr Wadsworth. “If ACC do implement this new attack on claimants suffering from sexual abuse then, in my opinion, it will have blood on its hands.”
Access Support Services asks the Government intervene and put an end to what could end up being a grievous error in judgement by ACC’s management.
Access Support Services provides ACC claimants with a nationwide advocacy service.

http://www.scoop.co.nz/stories/AK1001/S00262.htm

ACC – only 127 sexual abuse claims

Press release from Access Support Services

On Monday, TV 3’s 60 Minutes programme exposed 500 cases of alleged abuse, including sexual abuse, at children’s homes run by the former Department of Social Welfare. The lawyer representing these complainants said she felt it was just the tip of the iceberg. In the 2007/08 year ACC accepted 127 claims for personal injury caused by sexual abuse. In the same year the NZ Police received 3,700 sexual abuse complaints and Rape Crisis dealt with about ten times this number of enquiries.
So why are so few sexual abuse claims being lodged with ACC and how many of these types of claims should there be?
“That is a very difficult to determine but I would have it expected it to be at least ten times this amount” says Mr Wadsworth, Principal of Access Support Services. “What we do know is 127 sexual abuse claims in a year isn’t consistent with the number of victims other organisations deal with.”
Last month ACC revealed it would no longer fund the Auckland Sexual Abuse Help-Line. This month ACC released information to Access Support Services that its funding this year for injury prevention in relation to sexual abuse is forecasted to be a paltry $27,500.
“It appears the lack of adequate funding is effectively suppressing the number of injury claims ACC receives for sexual abuse” comments Mr Wadsworth. “In my opinion, ACC is failing to fulfil its statutory obligations and, by default, failing the most vulnerable in society.”
Access Support Services wants the Government and ACC to increase funding to front-line organisations such as help-lines and Rape Crisis. In addition to this, ACC should fund a nationwide awareness campaign along the lines of the recent “It’s Not OK” anti-violence campaign.
“It is time for ACC to step up to the plate and be counted,” says Mr Wadsworth. “ACC needs to show it has the same courage as the three victims showed by appearing on the 60 Minutes programme.”
Ref: Injury Statistics for Sensitive Claims
(Access Support Services is a private organisation providing advocacy services for ACC claimants.)

http://www.scoop.co.nz/stories/PO0907/S00206.htm

ACC should continue funding of sexual abuse help-line

Press release from Access Support Services

It has been reported ACC intends discontinuing its funding for the Auckland sexual abuse help-line. The reason ACC has given is that it is outside its legislative responsibility.
Access Support Services considers ACC has a clear responsibility to fund such initiatives. One of the expressed purposes of the Injury Prevention, Rehabilitation, and Compensation Act 2001 is “establishing as a primary function of the Corporation the promotion of measures to reduce the incidence and severity of personal injury” (ref: Section 3 of the IPRCA 2001).
Personal injury caused by sexual abuse are some of the most complex and difficult treat injury claims Access Support Services deals with and usually comes at a significant cost to ACC by way of administration and providing entitlements, such as lump sum compensation, treatment and weekly compensation. “ACC should be doing more in this area, not less,” says Mr Wadsworth, Principal of Access Support Services.
“It is extremely disappointing the people at ACC’s Corporate Head Office cannot see the woods for the trees,” Mr Wadsworth said. “I will be looking into this matter further. In the meantime, we call upon Dr Smith and the ACC Board to take the necessary action to ensure ACC is meeting its responsibilities under the legislation.”

http://www.accesssupport.co.nz/press-release-27may09.html