Anyone taken on ACC and won?

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10 years 7 months ago #29324 by kai
I posted up a while back I was waiting for a decision on surgery for my wrecked ankle. ACC decided not to fund the op. Consequently I am in constant pain and reduced mobility.
I have got a solicitor onto the case as there are horrendous errors in the case files they sent me. As well as a second opinion being sought on the wrong foot, there are 2 previous operations mentioned that I have never had. Along with many other errors. I think I counted 20.
I was wondering if anyone had taken a similar course of action.

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10 years 7 months ago #398665 by Chris-HB
An all-too-common example I'm afraid. There's a growing pile of evidence that ACC have adopted a "Say no and see if they dare to appeal" approach.

The classic is ACC attributing obvious acute musculo-skeletal injuries to "degeneration". I've had two patients in the last month who've told me near identical stories. It seems ACC are happy to get opinions from friendly (to them) semi-retired surgeons who will willingly attribute the cause to ageing/degeneration/.. Anything but the actual accident/event.

good luck
Chris-HB

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10 years 7 months ago #398672 by kate
Replied by kate on topic Anyone taken on ACC and won?
Have you seen Sideswipe today?

Web Goddess

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10 years 7 months ago #398677 by Clods
Replied by Clods on topic Anyone taken on ACC and won?
My husband took them to a tribunal, and wondered who paid them, as all the evidence was in his favour - ACC had no evidence to dispute what the Xrays and the doctor said, but still sided with ACC. Luckily our insurance paid for his operation, and supported him in appealing ACCs decision.

2 horses, 15 Chickens, 1 goat, 2 pigs, 1 cat

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10 years 7 months ago #398689 by kai
Replied by kai on topic Anyone taken on ACC and won?

Chris-HB;393713 wrote:

The classic is ACC attributing obvious acute musculo-skeletal injuries to "degeneration". I've had two patients in the last month who've told me near identical stories.

yup that is the line they are taking. I would like to know how ligaments and tendons can spontaneously tear/rupture/sever overnight by "degeneration".

Unfortunately I don't have insurance, and even though likely to have soon, it obviously would not cover this.

Ironically, the longer this goes on, the more it will cost ACC.

Interesting comment about them referring cases to surgeons near retirement age. I think I might check up on the guy giving a second opinion. If ACC can question my credentials (version of events), then I think I am entitled to question the reliability of their second opinion.

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10 years 7 months ago #398692 by kai
Replied by kai on topic Anyone taken on ACC and won?
hmm qualified as a surgeon in 1975, which would put him at around 60 if my calculations are correct, or possibly older. The theory of using surgeons near retirement age is plausible.

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10 years 7 months ago #398716 by JEF
Replied by JEF on topic Anyone taken on ACC and won?
the only issues Ive had with them was a massive delay for an answer , they said it was an 8 week wait for urgent surgery , I called the complaints dept on a friday and on monday they called and said it was sorted and the surgeon called me on wedsday to come in that afternoon . the other was they wouldnt cover my knee for surgery as it was wear and tear , i went thru my records and found a letter from my insurance company from 15 years ago saying they would never insure the knee due to an accident , so i explained to them that that long ago sthn cross knew this day would come and im sure the courts would se it the same way , they approved that within 2 weeks . most problems have an answer and you can win in most of these situations if your case is genuine

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10 years 7 months ago #398724 by kai
Replied by kai on topic Anyone taken on ACC and won?
JEF, I am trying to get hold of some records for some unrelated surgery I had 13 years ago, which ACC is saying because they don't know what it is, it obviously was related (I guess they employ psychic doctors).
I know my case is genuine. One day, ankle was normal, I bent the ankle backwards 90 degrees, (backwards not sideways - and yes think ow!) heard and felt things rip immediately ankle is swollen, painful and never healed. To my simple mind I see cause and effect. However with the bad luck I have had the past year, I am not holding my breath for ACC coming to the same conclusion.

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10 years 7 months ago #398778 by spoook
Replied by spoook on topic Anyone taken on ACC and won?
Mmmmm, something to think on :confused:............
Someone I know has just been refuse surgery on his knee by ACC as it is classed as "degeneration". They may look at it in 10 years.

By then, he will be far less productive in his work, if he can work at all. How does he earn a living without being a bludge on our already over burdoned system.

He has had to buy a support that cost over $500 to enable him to walk.... out of his own pocket too.

Might just follow this through a bit more.:confused:

There are no bad questions only those that are not asked.
"You are responsible, forever, for what you have tamed"

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10 years 7 months ago #398783 by Clods
Replied by Clods on topic Anyone taken on ACC and won?
Yes, ACC seem to be saying anything knee-related is degeneration, not matter what it is, and if it was an obvious accient that caused it - its degeneration that made it weak in the first place... Its part of their cost saving ploy, only all the extra time taken on appeals and more appeals and arbitration, must negate any savings they would have made.

2 horses, 15 Chickens, 1 goat, 2 pigs, 1 cat

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10 years 7 months ago #398786 by kai
Replied by kai on topic Anyone taken on ACC and won?
spoook if it is a genuine degeneration, or tbh even if it isn't, it doesn't matter either way, he should get referred into the medical system. It will take longer, but it should get seen to.

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10 years 7 months ago #398874 by The Kats Place
they aproved my knee op no questions asked and while I did have an accident there was also some deteration and the lovely surgeon did my vercose veins whilst he was at it at no cost to me.

Asking about taking ACC on and winning, yes my son did over a back injury, ACC lost and had to back pay thousands and reinstate his benifits. Again there was all sorts of mistakes in there history/paperwork.

I used to deal with ACC a lot in my job and we saw a lot of RSI patients. ACC had a 'tame' specialist and his reports were always the same no matter who the patients was, he would say they hated their job, had money worries, were unhappy in their relationship and had unsatifing sex lives - and didn't have RSI at all. Oh and he never did a physical exam of the patient and several time asked his questions over the phone.

kats
Live your life in such a way that it will be easy for people to say nice things at your funeral [;)]

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10 years 7 months ago #398879 by DiDi
Replied by DiDi on topic Anyone taken on ACC and won?
Escuse me if I am wrong but I thought I read only a couple of months ago that those who had been refused surgery could now apply again.

This was when Nick the nutty fruit cake suddenly discovered that they had money after all. How anyone could vote for the Nats after the ACC fiasco is beyond me but go back and quote me about the reopening of the books and see what happens.

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10 years 7 months ago #398989 by arnie.m
Mr BIL had a long term problem with joints due to to League injuries that ACC said were normal wear & tear, he went back himself and obtained all the reports, wrote the calim himself and stuck to the FACTS. Went to court himself (could not afford a lawyer) and won easily. ACC only relied on their previous reports which he proved wrong as to facts (dates etc).

The judge was most impressed with his work, as my BIL said "I could not work so had plenty of time."

Diary everything as it happens and keep the reports, you are entitled to the reports.

arnie
88 Valley
Nelson

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10 years 7 months ago #399005 by Organix

arnie.m;394062 wrote: Mr BIL had a long term problem with joints due to to League injuries that ACC said were normal wear & tear, he went back himself and obtained all the reports, wrote the calim himself and stuck to the FACTS. Went to court himself (could not afford a lawyer) and won easily. ACC only relied on their previous reports which he proved wrong as to facts (dates etc).

The judge was most impressed with his work, as my BIL said "I could not work so had plenty of time."

Diary everything as it happens and keep the reports, you are entitled to the reports.

Excellent advice :) When dealing with organisations such as ACC where administration and record keeping is relegated to unmotivated paper shufflers your detailed diary entries can run rings around them and will stand up in court.

I've used similar diary records to great advantage in our spray drift incident and in marital property apportionment :cool: And I am very selective which emails I delete for the same reason.

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NZ & AU distributor of Eco Wood Treatment stains and Bambu Dru bamboo fabrics and clothing

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