Review Process to challenge aCC assessment

I have been writing about my experiences with Accident Compensation Corporation, ACC. ACC paid for my therapy for my mental injury of post-traumatic stress disorder, PTSD. When I then applied for the pittance of lump sum compensation, ACC fought me all the way to court. In this blog post, I want to outline what the review process involved. This outline is not a substitute for legal advice and is to the best of my memory.
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Challenging an impairment Assessment

I had what is called a 'whole person impairment' (WPI) assessment with a psychiatrist chosen by ACC. So it was biased from the start. The report was full of errors and even falsehoods. I made a complaint to the Health and Disability Commissioner and I was told I had to deal with him direct. The psychiatrist was very stubborn and only made some changes and said that I can go to review. I outlined what the assessment involved and the kind of distortions in his report in another blog post. I would later learn that the first report is nearly impossible to shift. This psychiatrist did not even update ACC with the changes he said he made to the report. I saw anonymous complaints online that other people had similar issues with this psychiatrist, who is reportedly in ACC's pockets. The claim of 'independent' is rubbish when most or all of a clinician's income is from ACC.
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Going to Review

I had the choice of two review organisations. I am not going to say here which one I used and I cannot advise whether one is better than the other. I had to apply for review with 28 days of receiving the report if I recall correctly (it is pretty quick). It is also a legal process. I was bumbling through this with no legal knowledge. It involved completing a form requesting a review.

I have since learned that one of the specialists in law against ACC decisions will only take on cases that they respresented at review, to the next potential stage of the District Court. This is simply because of the high volume of cases plus it is more likely to have success at the review stage than the court stage.

Legal REpresentation

I was eligible for legal aid, yet practically could not get it. My mental injury comes under 'sensitive claims'. Sensitive claims is for injuries caused by criminal acts, whether criminally prosecuted or not.

Theoretically, legal aid can be a low cost in some cases but it is not free. Bear in mind, the potential payout may be low and may be swallowed up in legal fees. Some applicants hire an advocate, which is not a trained lawyer. Be careful with this, as some contracts have resulted in all payouts being paid over to the advocate (totally ripping a vulnerable person off).

​A lawyer is not required for the review stage. I represented myself.
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Review hearing conference calls

There were two telephone conference calls, each lasting less than an hour. Each conference call was with the reviewer (someone with a law degree who makes the final decision), a representative from ACC (a review specialist) and myself.

The first call was to establish what the issue was (I disagreed with ACC's decision because of the errors and falsehoods in the report). The second call was the actual hearing itself, made around 3 months after the first.

During the first call, I was informed that I could have a second impairment assessment, this time with a psychiatrist of my choosing. ACC would pay for some of the bill (at the time, it was around NZ $1090). If I could not get the assessent, then I would not be able to successfully appeal.

Finding a psychiatrist

Trying to find a psychiatrist was very difficult. As it depended on:
1. someone who was trained to do impairment assessments (ACC's way - bias again)
2. wasn't too expensive, as I had to pay for any extra over the allocated amount
3. didn't have a terrible reputation
4. could do the assessment in time before the hearing

It was very stressful emailing psychiatrists. I was shocked to learn to learn that some were quoting way more than the potential compensation payout (starting at a bit over NZ $3000 at the time). Many said they were too busy anyway, booked out months and advance. Some rip off ones quoted something like NZ $8,000. Utterly ridiculous.

I managed to find a psychiatrist who was willing to do it in time before the hearing. He had his own practise, so he wasn't fully in ACC's pockets. He looked nice (yes he looked pleasant in his pic). Had good reviews. And the price was more reasonable than others. It was still a lot for me on a low income but I decided to go ahead.
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Assessed for review

This psychiatrist assessed me by video call (whereas ACC's chosen psychiatrist assessed me by phone call. I would later learn this went against ACC's guidelines, as he should have offered me video call).

Both assessments were done by 'telehealth' as I was unable to travel to them because of the stress, distance and expense.

I had a bit of anxiety going in, as the video link went to junk mail and I couldn't find it at first.

The psychiatrist was polite and the assessment was a bit rushed as I didn't get the link in time. However, this psychiatrist asssessed well in my favour (over 30% whole person impairment) which still meant I was well above the 10% threshold when he halved it for non-covered bipolar disorder.

He wrote that the difference in the two assessments was my own self-assessment. Also, he did not directly challenge the first psychiatrist's report. This would be something that would be legally used against me at both review and court.

After doing this report, this second pyschiatrist bailed and would not assist me further. I have since learned that this is common, as the clinicians don't want to get involved with legal matters, as it might affect them (especially if they make money from ACC work).
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The review hearing

This phone call was horrendously stressful. ACC's representative was gaslighting me constantly, which was triggering. ACC refused to accept the second assessment as it was so different from the first.

I felt the reviewer was calm and reasonable during the process.

I was told that an option was for both reports to go to a peer reviewer (chosen by ACC - bias again).

It was a horrendously stressful and triggering conference call. I actually have the recording as I requested it with transcripts. I have the shutdown presentation of PTSD and the emotion only comes out when I am extremely stressed. The emotion (the intensity of the pain) was in my voice yet I did my best to be rational with my arguments. I would later learn that my own words have no value legally.

ACC's representative was fiercly against paying out compensation but then to my surprise agreed to pay out what I had paid for the second psychiatrist. No matter what the outcome. So that I 'would not be out of pocket'.

If I were to do this process again, I would not rely on just the psychiatrist's report but also try supply any other relevant medical reports for the reviewer.

ACC's representative said they would supply the peer reviewer my list of what was wrong with the report to the peer reviewer. Note that any written corrections sit on a file separately. Both the original report and the amended report also are in the file, easily confused. The further amended report was never given to ACC.

peer reviewer

The peer reviewer (psychiatrist) chose the first psychiatrist's report with the distortions. He also made assumptions that the difference between the reports must be bipolar disorder, not PTSD. He even admitted that the assessments are subjective.
He listed silly reasons out of context, such as:
1. that I have a degree (first report did not mention that it took me two extra years after two medical withdrawals). 
2. that I wrote a book (yes, I self-published a book that took me years to write and edit, with difficulty)
3. that I paint (why can't I have hobbies and paint as therapy?)
4. that I had worked as a teacher (no context that didn't last long, couldn't cope with the stress).
The profile for this psychiatrist said he specialises in ACC work. So he's in ACC's pockets too. It's easy money for these psychiatrists, making the bulk of their income from ACC. Throwing their medical ethics out the window in the process.
Not long after, I emailed him to ask if he'd received my 'statement of corrections' along with the two reports. He said he couldn't remember and had already discarded them. He told me to ask ACC what they had sent. ACC could not prove that they had sent it. But when I did an information request, I found out the decision was made on a report that was only partially amended.
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Independent reviewer decision

I will set this out in another blog post, a summary in general of what was in the review decision (Spoiler: he went against me, yet awarded me costs). The reviewer had said he still had the final say, no matter what the peer reviewer psychiatrist report said.