ACC impairment Assessment - mental injury - PtSD

I have been writing some blog posts about my experiences and what I have learnt from going through the whole process from being assessed and treated for my mental injury of post-traumatic stress disorder, PTSD right through the review and court appeal hearing process for compensation. 

In this blog post, I want to focus on the assessment itself. The process is biased right form the start, as Accident Compensation Corporation, ACC, chose the assessor and they spend millions each year on doctors and lawyers to avoid paying out claimants for more complex and potentially expensive injuries.
​

Choosing a specialist

I didn't choose the assessor. ACC chose the specialist for my whole person assessment for compensation. I was told I could travel out of town to be assessed. As travelling is very tiring for me, to the point of being dangerous to drive and I can't drive everyday, I asked if I could have an accommodation of doing the assessment remotely. I was told I could do the assessment by telephone. This actually goes against ACC's own operational guidelines {1}, that say videoconferencing should be offered before phone calls.

TELEhealth ASSESSMENT

The assessment by phone call is called a 'telehealth assessment.' The assessor phoned me, seemed polite, introduced himself as 'a doctor.' I asked 'what kind of a doctor?' He replied, 'a psychiatrist.'

I am pretty sure he picked up on my disappointment, as I have had some pretty bad experiences with psychiatrists. Many in this profession are very arrogant, and jump to conclusions. I am pretty cynical after decades of being mucked around.

He bombarded me with a lot of questions, including asking which primary school I had gone to. I didn't know what the relevance of half the questions were.

As soon as the hour was up, he ended the phone call. I looked up his name, and was very dishearted to see that he had terrible reviews, for distorting reports. I obviously can't name him here but he is apparently one of ACC's 'hatchet job' assessors, in ACC's pockets. {2}
​

The Report

Just like some of the anonymous complaints about this psychiatrist, my report was indeed a mess. He had muddled dates, changed places, twisted my words and paraphrased me incorrectly to mean something different. He was very much trying to emphasise that I'd had bipolar mania since my 20s, which is not true.

I was diagnosed with depression since my 20s. Not diagnosed bipolar disorder until my 40s. The exaggerating the extent of the bipolar disorder would later be used against me. He also mentioned my son's childhood diagnoses (Aspergers, ADHD) a few times. This is deliberate, as ACC's own guidelines say to apportion to any traits that don't necessarily meet criteria for diagnosis {3}. This is to avoid paying out compensation.

He referred to 'hypersexuality' in my 20s, which is a falsehood. He implied that I had committed a crime 'was facing abduction charges' rather than hypothetical 'would face abduction charges under Hague Convention' as to reason why I am separated from my son. He also said I'd had a suicidal attempt. This is not true. I have had severe suicidal ideation many times. There is a difference. He also combined different parts from different aspects of my life, decades apart, into one sentence, to make it sound like I had bipolar disorder with mania and mixed episodes since my 20s. Other doctors confirm I had depression.

He also cherry-picked from a personality test done during my first assessment to be approved for treatment for PTSD. I have never had an Axis II diagnosis. He wrote under the Axis II 'some suggestions regarding a chronic abnormality of personality with longstanding difficulties with anxiety, dissociation, depersonalisation and trust'. I confirmed with another specialist that yes, he had speculated an unspecified personality disorder, yet listed PTSD symptoms. My psychologist who had treated me for 4 years for PTSD said I don't have a personality disorder.

I see no other reasons for doing this, than to try to discredit me, to have something else to potentially apportion to and to lower my scores. I am still trying to find out how much ACC paid him for this.

I have had a lot of medical procedures over the years, including three major surgeries for medical reasons. I had life-threatening complications which are documented in my medical records.

What he did, was suggest I was exaggerating. Yet, he ignored the parts from my initial assessment for treatment, that said I am very consistent and also genuine. 

He exaggerated my output, just saying that I paint, do a vlog, write, work, have a degree. With no context: breakdown at university, two medical withdrawals from university, take a very long time to do things. Can't work fulltime. On a minimum wage, low demand job. Why can't I have therapeutic hobbies?

He assessed me at threshold for compensation, then apportioned half to bipolar disorder to bring me below threshold compensation. The threshold for compensation is 10% and ACC had already told me they will typically assess PTSD between 10 to 20%. Under 10% then nothing. Note that another assessor assessed me at above 30%.

Being made out to be a liar is one of my biggest triggers. Also, the abuse of power. I felt angry when I read the report, which is the biggest pile of rubbish I have ever read from a doctor. Then, decompensated badly, so that was unable to work for some time.

In the terrible anonymous reviews, with very similar hackjob reports like mine, it turns out this man is in ACC's pockets and he specialises in those with sexual trauma.
​

Complaint

I typed a list of all the errors and falsehoods that I had noticed in his 9 page report. My list was 3 pages long. I called it 'statement of corrections' and gave it a date. I sent this to ACC and as well as to the Health and Disability Commissioner, HDC. ACC put it on my file but it was given very little attention, as the claimants own words have no weight legally.

I made a formal complaint to the Health and Disability Commissioner, who were next to useless, as they told me to deal directly with this psychiatrist. They had also told him that they require him to sort it out with me, and to send an amended report. The psychiatrist emailed me about his.

It was a frustrating process back and forth. He made some initial changes then sent an 'amended report' to ACC. I tried to persist with it, despite the stress and he reluctantly made some key changes about the claimed hypersexuality. He said he amended the report and sent me a version and said he sent a version to the HDC. I would later find out that he never sent this report to ACC. This would prove to be critical, as another psychiatrist assumed bipolar disorder was the explanation for decompensation, not PTSD (despite medical reports to the contrary).

He sent me some handwritten notes - his scrawly hand writing which he later used to write the train-wreck of a report, which also consisted of cut and pasted sections. It was very clear that he had paraphrased me incorrectly yet he stubbornly blamed communication issues on me.

He told me I can go to review if I am unhappy with his report. I would find that it is nearly impossible to shift his report, as he is deemed the 'expert'. Even when full of factual errors. He even clearly assessed me in at least one category, when I looked up the functional categories (which were surprisingly subjective) {4}. But only trained assessors are allowed to assess or challenge assessments.
​

To be continued

When I get the chance, I will write more about the bias, the review process and the court process. Including very generally what evidence I included and what was dismissed.
​

Footnotes

{1} ACC Impairment Assessment Services Operational Guidelines, December 2020, p9
'Some clients who have been approved for assessment via Telehealth may not have access to video capable devices. In this circumstance telephone consultations may be used for ACC Clients if videoconferencing is not possible.'

{2} ACC pays millons to send its hatchets, Stuff (2012)
https://www.stuff.co.nz/national/politics/7637014/ACC-pays-millions-to-send-its-hatchets
'ACC lawyers, advocates and claimant groups know those doctors as “hatchet men and women”, Mr Miller {lawyer againts ACC} said.
“They are not independent, as a substantial part of their income comes from ACC,” he said.'

​{3} ACC Impairment Assessment Services Operational Guidelines, December 2020, p20, under 9.3 Mental Injury, Apportioning:
'Any impairments due to non-covered conditions, non-covered symtoms or behaviours (even when these don't meet a diagnostic threshold) are apportioned.'

{4} 'The ACC User Handbook to AMA4' (2002) p36-40 "Rate the functional categories", "Rate the Overall Impairment"