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aCC PTSD compensation Sensitive Claims

26/1/2022

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I have been through a stressful process of being assessed for impairment for post-traumatic stress disorder (PTSD) for the purposes of lump sum payment as compensation. For what is called sensitive claims (includes sexual abuse trauma etc) with ACC in New Zealand.

This can only be done after having therapy to treat the PTSD as much as possible. A lot of people pull out of the process. 
Picture
Nuclear. Doodle in felt pen on paper, processing anger when triggered.
The process has taken nearly a year, and has been very triggering and stressful. I am diagnosed with bipolar 1 disorder and PTSD. I experience them tangled together. Mental health services deal with bipolar and ACC deal with PTSD in New Zealand. Treated like separate entities. Bipolar is not covered by ACC and it was hard to get therapy in the first place as blame was put on bipolar. 

I have had PTSD most of my life. I have the avoidance and shutdown presentation, which means I usually shut down when triggered, which also includes usually shutting down intense emotion, so I seem calm. Bipolar developed in early adulthood. I am diagnosed with bipolar 1 disorder and I have experienced the full mood spectrum (mania, hypomania, depression, mixed features).

A trauma psychologist advocated strongly for ACC to pay for my therapy. It was a long wait before they finally accepted my claim for PTSD (which goes back to historical sexual abuse trauma). I have been in therapy for two years.

I am still in therapy but not much is expected to change now. My psychologist, a trauma expert agrees that bipolar and PTSD are tangled together for me. PTSD can mimic bipolar and they can set each other off. I was advised that I could start a compensation process. ACC required my GP to fill out a form.

ACC advised me that they do no payout for below 10% whole body impairment and that PTSD is usually assessed at around 10-20%. With a one time payout of approximately NZ $3,000 to $9,000 (which isn't very much). For comparison, a fulltime minimum wage job in New Zealand is $41,600 and I could have earned nearly double that if I had been able to continue being a teacher.

ACC chose a psychiatrist to do a phone assessment. The psychiatrist asked lots of questions and read reports from my psychologist. He determined me at 10% whole body impairment, then apportioned half to bipolar and also suggested autism, also not covered (bringing my son's childhood diagnosis into it). There were a lot of errors and contradictions in the report, so I challenged it.

​I've had an adult autism assessment and the conclusion was traits only, better explained by bipolar 1, PTSD, mild social anxiety disorder.

The process of assessment for compensation was so stressful, that I had a massive mood crash and had to quit one of my part time jobs as I wasn't coping.

ACC gave me the option of two companies that could 'independently' review. They talked to me on the phone and advised me that I could have another assessment done but I would have to pay for some of it if it exceeded the amount provided and find someone of my own choice, but it had to be a trained assessor and doctor.

It was difficult searching for someone to do  it. I felt it had to be another psychiatrist to challenge the first psychiatrist, because in the medical world, psychiatrists tend to be ranked higher than GPs. Also, I felt discouraged that it was so expensive. I did however manage to find an independent psychiatrist that was prepared to do it before the deadline. It would be more than $600 that I would have to pay over the amount allocated. This was a lot of money to me, as I am on a low income.

The second psychiatrist did a video call. He looked at the report from the first psychologist and also the psychologist reports. His assessment came back as 32% whole body impairment, apportioning half to bipolar. This put me at 16% for PTSD, well above the threshold for a lump sum payout.

I had another call with ACC. They said that since the figures of 10% and 32% whole body impairment were so different, they would have to send it to peer review to decide which report is correct.

I was supposed to hear back in February but I got an email today with the report which sided with the first psychiatrist. I was very triggered reading it. The decision was not in my favour. My heart was racing and I was angry (rare for me). I did the above improvised doodle, Nuclear when venting anger and frustration at the whole thing.

Basically, the peer reviewer, a third psychiatrist, without even talking to me, said that he felt the second psychiatrist was too generous. He said apportionment didn't have to be half and half and even if it were 32% whole body impairment, it could still be 5% PTSD and the rest bipolar.

There is no way of them knowing what percentage. They just don't want to pay out with any excuse.

The third psychiatrist agreed with the first psychiatrist that I managed to:
- get a degree (which I can no longer use as I have significant short-term memory impairments, plus I had a breakdown from distress which was directly connected to PTSD flashbacks)
- work (I can't work full-time and I do a minimum wage job rather than what I was trained in)
- teach (I only lasted a year teaching, over 20 years ago, while on antidepressants before burning out)
- write a book (I self-published Pet Purpose: Your Unspoken Voice - a very challenging project that took me years with cognitive impairments).
- because I've painted (as DIY therapy)
- because I've made videos on You Tube (raw and unedited, as mental health advocacy).

Therefore, he decided that it must be mostly bipolar that I have impairment by, which isn't covered. He decided also that the deterioration in my mental health with cyberbullying was mostly bipolar. Remember, he had never talked to me.

The frustrating thing is that they would have spent more on the cost of psychiatrists (estimated over $2,000 each) and support staff to fight me than to have paid me out. It's not a lot of money, but I tried on principle, to take on the system, to see if I would be dismissed. I was. Being dismissed is one of my biggest triggers. They will get out of it any way they can. It's disheartening. Abuse of power is one of my biggest triggers. 

Some of the video explains. When I was calmer. The video previous to this one, was when I was still triggered and venting.
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    Xanthe Wyse

    Xanthe finds creative expression including writing and painting to be therapeutic and helps her to manage her diagnoses of bipolar disorder and post-traumatic stress disorder (PTSD).

    Creative projects give Xanthe a sense of meaning and purpose despite the challenges.

    Comments are welcome but no personal attacks nor attacks on others.

    Xanthe's opinions and personal experiences are no substitute for independent professional advice.

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