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ACC Wrongly Rejecting Claims, MPs Say

Fuseworks Media
Fuseworks Media
Jim Anderton
Jim Anderton

Wellington, Feb 18 NZPA - Accident victims who applied to ACC for surgery have been turned down on the grounds that their injuries were the result of "prior conditions" or "a gradual process", Opposition MPs said in Parliament today.

Progressive Party leader Jim Anderton said that in the first six months of last year nearly double the number of people applying for elective surgery were declined, compared with the same period in 2008.

ACC Minister Nick Smith said the corporation was "quite properly being more thorough" in ensuring levy payers funded surgery that was the result of an accident, rather than of ageing or a degenerative process.

"This reflects that elective surgery costs have more than doubled over the last five years to $260 million," he said. "That is out of step with accident trends."

Mr Anderton said his electorate office, and those of other Christchurch MPs, were being inundated with people complaining they had been rejected by ACC because of non-existent prior conditions.

"Is this a pattern emerging across the country from a government determined to cut accident compensation entitlements at any cost?" he asked.

Dr Smith said more than 80 percent of claims for elective surgery were being approved, and this year ACC would fund over 50,000 operations.

"I am watching closely the results of reviews, and if a trend emerges of medical evidence overturning the decisions of ACC, I am prepared to re-look at this issue," he said.

"The evidence to date shows that those review decisions are upholding the decisions of ACC."

Labour's health spokeswoman, Ruth Dyson, tabled four documents detailing rejected applications. The documents did not identify the applicants.

The documents were:

* Woman in late 50s -- fell when going downstairs and grabbed the stair rail to stop falling right down. Immediate pain and unable to use arm -- surgery declined due to gradual process despite MRI not being clear due to haemorrhage in the shoulder as a result of the injury. Applied for review.

* 60-year-old -- fell in garden and shoulder took impact -- had to leave her job two months after the accident as she could no longer work. ACC declined due to gradual process condition. Applied for review.

* Elderly woman slipped on ice and to save her hip took full impact on her elbow. ACC declined as surgery needed for gradual process condition. She had surgery privately as she had lost the use of her arm -- specialist explained to ACC that her nerve had become trapped and post surgery she is back to normal and despite this they will not cover cost of operation. Been to review and awaiting decision.

* 39-year-old -- fell off motorbike and twisted knee in the fall. Sent her papers to Auckland specialist who says injury by gradual process. Despite needing surgery for tear that would have meant one week off work recuperating, she has not worked since date of injury August 09. Applied for review.

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