Review two years overdue
Work to restore trust in ACC medical assessments has stalled more than two years after a review found a ‘‘myriad of problems’’ for claimants who challenged a decision.
ACC said a report on the work of a medical issues working party, which met four times in
2017, would not be available this year.
A spokesman said it may be provided ‘‘early’’ in 2019.
‘‘This is a really important and complex issue, and we have taken the time required to get things right.
‘‘We plan to release the report on the medical issues working group, as part of a wider report into the response to the Miriam Dean Report, early in the new year,’’ he said.
A Press inquiry this month revealed one ACC doctor earned
$8 million for assessments and had his opinion overturned in 24 district court cases.
A perceived lack of impartiality of medical assessments paid for by ACC was among the many problems Miriam Dean, QC, found during her inquiry into ACC’s dispute resolution process in 2016.
Dean made 20 recommendations that were accepted by the
‘‘This is a really important and complex issue, and we have taken the time required to get things right.’’ ACC spokesman
Government in September 2016, including establishing a working group to solve medical evidence issues.
Dean recommended the group have an independent chair and said the work to come up with solutions could be done in four to six months.
The Government appointed ACC to oversee the work and a meeting of ACC staff, medical college representatives and advocates met for the first time in December 2016.
ACC’s chief medical adviser, Peter Robinson, chaired four meetings between December 2016 and November 2017.
Topics discussed at the meetings included independence of medical experts’ opinions, costs of reports, and access to medical experts.
A decision to accept or decline
a claim is based on medical information provided in the claim.
Case managers can seek advice from ACC branch medical advisers about whether an external medical opinion is required. The branch manager helps frame questions to elicit the relevant information from external assessors.
ACC also uses a panel of 10 clinical medical advisers who decide by consensus whether an injury needing surgery has been caused by an accident and can be covered.
In the financial year to June, ACC made 802,099 payments totalling $131 million for medical assessments by external providers.
Barrister Warren Forster, who attended some of the meetings, said ACC was able to maintain control over medical assessment providers by contracting their services. There was currently no way to ensure their independence in the current system. Forster said an independent personal injury commission was the only way ACC could ensure medical assessments were available, fair and transparent.
The consequences of the current system for hundreds of thousands of individual claimants declined cover were ‘‘enormous’’.
‘‘These are the people that are being disadvantaged by this because it doesn’t matter what their GP, physio, surgeon says – the primary providers are ignored while ACC relies on its trusted assessors,’’ he said.
ACC Minister Iain LeesGalloway was approached for comment but did not respond by publishing deadline.