I apologise in advance for the length of this post & also any grammatical / spelling errors. My wordsmith is away!
The other day I decided to see what delights awaited me for the month of March, my calendar, burst into life with a reminder of my D-day’
What is D-day? Well, it is the day when my lawyer (& my partner) fights for justice, once again.
In New Zealand, when someone has an accident, regardless of who is at fault, the injured person is automatically placed under the care of ACC – Accident Compensation Corporation. A government operated organization that assumes responsibility for medical treatment / rehab relating to the accident. They are also required to pay 80% of your income at the time of the accident. I have since discovered ACC has only one objective & that is to remove claimants from their schedule as quickly as possible. I will go into their functionality further into this post.
The first 12 months, following my ski accident, I knew very little of what was going on behind my confused, clumsy & complex existence. If it wasn’t for the support of my partner, GP (who also happens to be a trained brain surgeon) & a very good friend (I shall call NW) I would have, unquestionably been railroaded into submission, then squashed & buried me along with hundreds of others. These 3 people were/are my advocates & my voice when it comes to ‘playing’ the ACC game.
Allow me to give you some further insight to the reason I find myself back in the disputes court.
It was roughly 18 months after my accident when ACC decided was no longer eligible to be a claimant. This decision was based on 3 out of 7 or 8 (I saw so many!) ‘specialists’ I went to see (under instruction from ACC) for examinations & tests (more tests than any healthy functioning brain could deal with). With the exception of an Occupational Therapist & 2 or 3 neuro specialists, all other appointments I was forced to attend were about ‘testing’ my cognitive function & digging into my past to see if they could pin my ‘presentation’ on a childhood trauma! There was no appropriate treatment or rehab provided for me – AT ALL, even though the neuro specialists (the ones that knew their stuff & disagreed with ACC’s decision) identified I was indeed the recipient of a TBI.
So, 18 months down the track, no real rehab other than physio for my neck injury & other related issues (balance, hip alignment, shoulder & arm problems), which again was abruptly halted by ACC. I found myself to be discarded by the very organisation that purports to help individuals regain their lives after an accident! This meant I would receive no treatment / rehab (not that I benefited before) or financial support, I was thrown ‘under the bus’ without a second thought, all because 3 psychologists had ZERO understanding of the effects trauma has to the brain. As far they were concerned the symptoms I presented were that of a car crash victim hitting a lamppost at 140kms/hr! As this hadn’t happened to me, their only explanation was that I was a malingerer, however, cleverly written so as not to use the word! If it wasn’t for the afore mentioned people barracking for me, I would have given up and probably done something unthinkable.
My partner made contact with a lawyer, one that specializes in fitting ACC (there’s a lot of outraged people!). The lawyer said we absolutely had a case, whether we would win? 50/50 was our best hope. The disputes court we were told is highly unpredictable, since there is no Judge & jury, just an ‘independent’ mediator to pass a verdict. I was not so keen to pursue, un-surprisingly! But despite the stress, impact on my health & cost, I gave the green light. It took 5 maybe 6 months for my case to be heard, all throughout that time, my progress & health took a battering. The hearing came & went, my lawyer was outstanding & my partner managed to get a few words out in my defense. All that remained was the decision, I remembered thinking what if the dispute official believes these clueless specialists & their malevolent reports. Where would that leave me? A month later & a phone call from my lawyer, he announced we had won albeit somewhat ambiguous in the ruling. Still a win is a win & a huge wave of relief swept over all of us I think. Without doubt, it helped this little chicken believe she wasn’t crazy.
The ruling stated that ACC had to take back my case & resume rehab/treatment & payments. The ruling also stated ACC was required to define the treatment plans for varying levels of brain injury & subsequent mental health issues, ACC also had the right to appeal. That was September 2011.
December 2011, three months on, no appeal from ACC & zero treatment, only the weekly payments. Then out of the blue I am told my claim has been rejected, they offered no new evidence to quantify my discharge, just a letter informing me of their decision! It was back on the roller coaster for me, whilst my partner engaged the services of the lawyer once again. He informed us, that this is a common tactic used by ACC, they discard you, knowing that 80% of the claimants will not fight, because they cannot afford to &/or they do not have the support & strength to do so. I am extremely lucky that I have a strong & supportive partner & some savings from those payments.
I await the day of my hearing with trepidation; I can only hope the hearing goes in my favour & the ruling be more finite & without ambiguity. All I have ever wanted from this organization was understanding, rehab & therapy to help me deal with my injury which would then hopefully help with my healing. Not a lot to ask for seeing as this is the basis of their very existence! I am where I am today (rehab wise) because of my own hard work & perseverance.
A few snippets of ACC reality :
1/. ACC are duty bond to give medical care & rehabilitation to the accident claimant, whereby they are able to return to work. ACC also have to pay 80% of the claimants salary / income (at the time of the accident), again, until they are fit to return to work.
Instead of paying 80% why not reduce the percentage given to the claimant & put towards their rehab & re-training where necessary. It appears this is too complex for the government, so 80% of your income it is or nothing!
2/. Once in the system you are allocated a case manager who overseas your treatment & rehab through regular contact & visits.
In the 2 years I have been in the system, I have had 1 meeting with my case manager! There have been emails between case manager & my partner, none pertaining to my progress.
3/. Treatment & Rehab Plans, these are arbitrary & confusing at best. A pointless exercise as it is rarely followed through. The medical professionals you’re required to see for assessment & treatment are, in the main, either clueless &/or operating under the strict guidelines of ACC & their requirements to expedite you from the system. Visible injuries such as broken bones tend not to be contentious.
4/. ACC will argue & again use medical professionals to support their preposterous claims. Prime example would be – your injury is pre-existing, the accident has merely aggravated it, ergo you are not covered.
5/. Every taxpayer pays an ACC levy. There is also a levy applied to vehicle licenses. Student & beneficiaries are exempt.
This is from their home page. The Accident Compensation Corporation (ACC) provides comprehensive, no-fault personal injury cover for all New Zealand residents and visitors. Yeah right! Comprehensive? my arse.
ACC has been & continues to be mismanaged; the levels of corruption may gradually be reducing but the system as a whole continues to be defrauded by the devious & lazy bastards devoid of a conscience. This system is in dire need of an overhaul & by that I do not mean turn it into another form of social welfare.
I appreciate there are many countries (probably far more than I realise) that do not have an accident compensation system or indeed any health care assistance, unless, maybe, there is a personal insurance option or legal avenues that can be pursued. But, when there is a system in place, it absolutely without favour needs to work for everyone.
The once go-getting, A+ personality, confident, successful, ambitious & spontaneous woman that I was, no longer exists. Each day is a struggle of some kind, I may put on a brave face, even cloak with humor, but this bump to the head did more damage than any non-TBI person could ever know. Imagine being trapped inside yourself, a stranger in your own brain! As each day, week, month, year goes by, I can only trust that my abilities will improve & pain will lessen. What a fabulous person I will be, enlightened & triumphant!!
I shall sign off now & thank you, if you reached the end of my rather long rant! A gold star is awarded to you 🙂