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Occupational Medical Assessment Was what I experienced the norm?

#21 User is offline   ernie 

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Posted 03 December 2004 - 01:00 PM

The reason the IOA is before the IMA is so ACC don't have to pay to retrain people.

The IOA only identifies the types of work that may be appropriate for the claimant. Although the law doesn't say so, these people are all VIAP assessors and will apply the same test as for VIAP - that contained in section 108(2)(b) of the Act - of types work that may be appropriate "because of they match the skills that the claimant has gained through education, training or experience".

In instances when the IMA then identifies that none of these jobs are likely to be medically sustainable for the claimant, ACC then has no information upon which to identify jobs outside the claimant's education, training or experience that may be medically sustainable but for which ACC would have to provide retraining. So there's no retraining or minimal retraining, and rehabilitation designed solely to exit such claimants into a menial job - hence all the "car park attendants" and "gatekeepers".

So much for the obligation under section 70 "to assist in restoring the claimant's health, independence and participation to the maximum extent practicable".
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#22 User is offline   magnacarta 

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Posted 03 December 2004 - 01:12 PM

Spot on ernie - and who let's them get away with it - the judges!!!!
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#23 User is offline   jantol 

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Posted 05 December 2004 - 04:21 PM

Hi Jantol here ,I had to go for my IMA a few months ago now but I asked if I could tape the session as I forget what has been commented on, as I have a Brain Injury and in these situations who does remember, anyway ACC told me that they had to contact the assessor and ask him if it was OK, I was then told by ACC that so long as it was for my own use that it would be alright but I had to sign a form that they sent to me to this affect and send it back to the ACC office before the assessment, that was OK by me..
When I got to the IMA the Dr was quite upset by me wanting to tape as he said that I was supposed to bring the form with me, good job my husband was with me as I think I would have walked out, it made the start of the assessment very akward for me but he let me do the taping as he taped it himself as well.
My point is that the ACC told me wrong and could have caused me to walk out of the assessment but I would have been blamed by ACC for not attending wouldn't I? It all ended up OK and his assessment was a good one for me so alls well in the end. :)
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#24 User is offline   flowers 

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Posted 06 December 2004 - 05:46 PM

Hey Woggle I got one of those also in fact several from them and another crowd in the us.
I recon All they want is you to buy a copy of go to a convention where you may win a bit of silver.
Whatever go for it bro we may see a new poet laureate.
Cheers
Flwrznz.
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#25 User is offline   roamy 

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Posted 09 December 2004 - 05:59 PM

doppel, can you quote the legislation you refer to that prevents us from using the taping unless the other party agrees, cheers roamy
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#26 User is offline   tullys 

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Posted 22 January 2011 - 10:03 AM

View Postflowers, on 03 December 2004 - 12:28 PM, said:

Furthermore why is it mandatory to have the ioa before the ima.?
The answer is plain as the nose on your face. It is so they do not have to supply the medical/pysical limitations of the assessee to the ioa assessor so he cannot take them into accountand provide an out for their toadies so the can say they cannot take into account the clients limitations in their assessments. Where is the honesty in this.
By this tactic alone they show they are liars by omission and onle out to get the results they want not what the claimant requires and is entitled to under the acts.
ACC should be dismantled with predudice and all the board thrown in the can and the key destroyed like they destroy all our records that do not support their pogrom repeat pogrom.

recently underwent the restult of my occupational assessment. The Dr concerned did not want to listen to me or my husband , how pain was affecting my ability to work more than the two hours a day I currently do. He said , he just add to tick the boxes saying I can do several jobs.
My reply was if I could do them, I would be increasing my own job back to 30 hours a week. He just did not want to hear that.
As a result, letter from ACC, saying 3 months notice to stop rebatement. In meantime to see my surgeon again in March, still for more possible spnial surgery. Had back surgery in Dec o9. Still resulting in lumber pain.
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#27 User is offline   doppelganger 

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Posted 22 January 2011 - 10:59 AM

View Postroamy, on 09 December 2004 - 05:59 PM, said:

doppel, can you quote the legislation you refer to that prevents us from using the taping unless the other party agrees, cheers roamy



I said

Take a taperecorder and a witness. If the assessor objects that you use a recorder then itis his bad luck. tell him that the recording is for your and his protection and it is known that the ACC do payin excess of $7,000.00 to assessors.

that was in 2004 and the privacy Act is there to protect both us and the Assessor.

See the assessor didn't tell you the legislation tully's

Go back to the beginning.

You are working 2 hours per day good on you.

Your IRP would be for you to remain in employment Clause 9 schedule 1 would mean that ACC had to issue a decision that the IRP will now proceed and all that they are going to do is carry out assessments to gather information to carry out a Vocational Independence assessment.

get a decent lawyer that knows thwe legislation and ACC policies and objectives. They will start proper legislation requirements and advise you how to get your entitlements. Tell all your freinds and also your employer the ACC are not following the legislation so Nick Smith can get the public to pritivise ACC. Very important as Nick is being paid behind close doors to make ACC look very bad.

You will need another assessment with an assessor that can tell the truth. He must put in the assessment ACC assessor did not listen or ask the correct questions. All he did was can you work 30 or more hours at other jobs with out asking why. hence why recomending claimants put the reason why in writing and do before the assessment.

A proper lawyer will guide you and your assessor in what to do just like ACC should have done before the assessment. Of cause all of that information should have been in the First occupational medical assessment.

You along with 10,000 kicked off the surgery entitlement need to fight on 2 fronts. Your entitlements and discredit Nick and his freinds.
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#28 User is offline   Moeroa 

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Posted 15 December 2012 - 12:09 PM

ernie said:

1102035629[/url]' post='11786']
The reason the IOA is before the IMA is so ACC don't have to pay to retrain people.

The IOA only identifies the types of work that may be appropriate for the claimant. Although the law doesn't say so, these people are all VIAP assessors and will apply the same test as for VIAP - that contained in section 108(2)(B) of the Act - of types work that may be appropriate "because of they match the skills that the claimant has gained through education, training or experience".

In instances when the IMA then identifies that none of these jobs are likely to be medically sustainable for the claimant, ACC then has no information upon which to identify jobs outside the claimant's education, training or experience that may be medically sustainable but for which ACC would have to provide retraining. So there's no retraining or minimal retraining, and rehabilitation designed solely to exit such claimants into a menial job - hence all the "car park attendants" and "gatekeepers".

So much for the obligation under section 70 "to assist in restoring the claimant's health, independence and participation to the maximum extent practicable".


BUMP
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#29 User is offline   unit1of2 

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Posted 16 December 2012 - 12:03 PM

IMHO ..I believe everyone should video & voice record all assessments.. and maybe it should be compulsory...
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#30 User is offline   Rosey 

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Posted 16 December 2012 - 12:34 PM

Quote

THE NEW ZEALANDMEDICAL JOURNAL Vol 115 No 1163 ISSN 1175 8716

Medical records

Daniel Kerr

Anecdotal evidence suggests that the majority of medical practitioners would refuse to examine someone who demanded that his or her consultation be tape-recorded. However, the decision of Judge A A P Willy in Jackson v ACC (AI 483/02) has held that there is “no rational basis” for such a refusal by a doctor.

The case of Jackson v ACC, arose in the accident compensation context, in which the applicable legislation requires a claimant to undergo assessment by a registered health professional when reasonably required to do so. The Corporation may decline to provide entitlements if a claimant unreasonably refuses or fails to comply with that obligation.

In Jackson v ACC the claimant and her advocate had attended a medical assessment with Dr R at ACC’s request, and had demanded that they be allowed to tape-record the assessment. Dr R explained that he would not allow the assessment to be recorded, and so the assessment did not take place. Another appointment was scheduled with Dr R, but for the same reason this did not proceed. An appointment with Dr K was scheduled, but prior to the assessment Dr K indicated that he would not accede to the claimant’s husband’s written request to tape-record the examination. Subsequently, ACC declined to provide the claimant’s entitlements on the basis that she had unreasonably refused to undergo assessment when reasonably required to do so by the Corporation.

The Court held that the claimant was entitled to demand to tape-record her medical assessments, and that her demand did not amount to an unreasonable refusal to undergo assessment. The failure of the assessments to proceed was attributed not to the claimant’s demand to make a recording, but to the doctor’s refusal to allow her to do so.

Although the case arose in the accident compensation context and its statutory regime, Judge Willy expressed the view that it may have repercussions for doctors beyond their ACC work.

In his judgment, Judge Willy considered the reasons given by medical practitioners for refusing to allow consultations to be tape-recorded. The first was that to tape- record the proceedings would alter the tenor of the examination, which was meant to be an independent medical assessment and not a taped legal assessment.

Judge Willy expressed the view that the fact that what is said at the examination will, or might, be used in evidence in legal proceedings is a tenuous basis for a doctor to refuse to examine a patient. He said that there can be no objection to ensuring that what is said is accurately recorded and not subject to any avoidable misunderstandings. He further pointed out that any privilege or privacy that attaches to the doctor–patient relationship is for the patient, and not for the doctor, to enforce or waive.

NZMJ 11 October 2002, Vol 115 No 1163 Page 1 of 4 URL: http://www.nzma.org....al/115-163/205/ © NZMA

With respect, Judge Willy failed to appreciate that a tape recording by no means guarantees accuracy. There is potential for a tape recording to be edited or presented in such a way as to distort what actually took place or was said, and a doctor who allows a tape recording to be made has no control over what is done with it and to whom copies of it are subsequently given. Furthermore, an aural recording does not detect body language, gestures or facial expressions, all of which can drastically alter the meaning of the verbal statements they accompany.

Judge Willy stated that, although it obviously comes as a surprise to some practitioners to have their utterances and those of patients recorded, it is commonplace in other related callings. He referred to the fact that a verbatim record is kept in most courts, and that the police record interviews with suspects.

However, any comparison between medical consultations and court proceedings or police interviews is surely mistaken. Medicine and law enforcement are not so similar as to constitute “related callings”. Moreover, the verbatim records taken in courts and police interviews are kept secure, are used for limited purposes, and access to them is restricted.

As the Judge himself accepted, the doctor–patient relationship is a very special one, in which there is a need for absolute frankness concerning what are frequently very intimate matters. It is suggested that a request to tape-record a consultation has the potential to undermine the doctor–patient relationship by calling into question the doctor’s independence and integrity. It may be suggestive of a degree of mistrust and an adversarial approach to the consultation.

On the other hand, the fact that recording is commonplace in callings that are more closely related to medicine, such as psychology, counselling and social work, suggests that the use of tape-recording need not necessarily undermine the doctor–patient relationship. It does also have the potential to enhance the relationship by promoting patient understanding and recall of the consultation, thereby fostering trust.

Judge Willy stated that a request to tape-record is not an aspersion on integrity, but merely a reflection of fallibility. With respect to the Judge, this statement oversimplifies matters and does not recognise that the purpose of a written medical report is not primarily to provide a detailed account of what took place in a consultation but to set out the doctor’s observations, diagnoses and any suggestions for further treatment. A tape recording may help to reveal the exact questions put by the doctor and the answers given by the patient, but the fact that the patient makes a tape recording will not result in the provision of an infallible medical assessment or eliminate the possibility of errors in the interpretation of symptoms and the diagnosis of conditions.

Judge Willy concluded that none of the objections to the tape-recording of examinations have any merit. So what are the implications for doctors of this somewhat contentious conclusion? Are they prevented from refusing to examine somebody who demands to record the consultation?

The Judge accepted that there is no principle requiring a doctor to give an expert medical opinion simply because he or she is asked to do so. The Hippocratic Oath requires a doctor to treat and prevent illness to the best of the doctor’s ability, but nothing in the oath touches upon the provision of expert medical opinion.

NZMJ 11 October 2002, Vol 115 No 1163 Page 2 of 4 URL: http://www.nzma.org....al/115-163/205/ © NZMA

In Jackson v ACC, the claimant’s lawyer claimed that she had a “right” to tape-record her medical assessment. However, it is suggested that a patient cannot have an absolute right to do whatever he or she pleases. As the Court of Appeal held in R v B [1995] 2 NZLR 172, 178, “individual freedoms are necessarily limited by membership of society and by the rights of others and the interests of the community”.

Surely a patient’s right or entitlement to request a tape recording must be balanced against, and possibly restricted by, a doctor’s right or entitlement to regulate the way in which an assessment is carried out, including the environment in which it is conducted. Such a right or entitlement facilitates a thorough, independent and objective assessment of a patient. The balancing of each party’s rights and entitlements requires discussion and negotiation on both sides, rather than inflexible demands.

Contrary to the Judge’s indications that the case may have far-reaching implications for the medical profession, it is suggested that it should be restricted to its particular facts. Judge Willy did not make a determination that doctors cannot refuse to examine people who demand to tape-record their assessments, but that the claimant’s demand to make a recording did not amount to an unreasonable refusal to undergo assessment in terms of the accident compensation legislation. While the Court held that the claimant was entitled to ask for a tape-recorded examination, it also accepted that the doctor was entitled to decide in what lawful way the medical examination would be conducted. Despite Judge Willy’s criticism, the doctor was thus entitled to say that he would not examine the claimant if she insisted on having a tape recording of the procedure.

Although the decision in Jackson v ACC does not restrict the ability of doctors to refuse to examine someone who demands to tape-record the consultation, it does have potentially far-reaching implications for the Accident Compensation Corporation and practitioners who provide services to the Corporation.

If, for instance, the Corporation believes that a claimant is no longer suffering from the effects of a personal injury for which he or she has cover, it will usually be necessary to obtain an opinion from a medical practitioner to confirm this. If the claimant demands to tape-record the medical practitioner’s assessment, but the doctor does not accede to that demand, the assessment cannot proceed and the Corporation must continue to provide entitlements indefinitely because the claimant cannot be said to have unreasonably refused to undergo assessment.

In deciding to examine a person for the purposes of giving an opinion, the Judge did accept that the doctor may prescribe the terms of that examination, such as the date, time and place, the type of examination required, whether any bodily samples are necessary, whether or not a nurse needs to be present, etc. He said that an examinee who took exception to such ordinary requirements and declined to attend an examination on such terms would, in the ordinary way, be said to be refusing to submit to an examination in terms of the relevant legislation.

Surely a claimant who demands to record an assessment is acting at least as unreasonably as someone who demands to undergo a medical examination at a date, time or place other than that specified by the doctor. If, as Judge Willy says, a doctor may prescribe the terms of an examination for the purposes of giving an opinion, then

NZMJ 11 October 2002, Vol 115 No 1163 Page 3 of 4 URL: http://www.nzma.org....al/115-163/205/ © NZMA

why should those terms not include the manner, if any, in which the assessment is recorded?

Finally, Judge Willy expressed the view that the existence of an accurate tape recording of a medical interview may obviate the necessity for a claimant to insist on having an advocate present at a medical assessment. He said that if the case had depended on the question of a right to have advocates or lawyers present at a medical examination, the outcome may well have been different. The Judge, somewhat ironically, stressed that medical practitioners who are asked to perform assessments by ACC are experienced and impartial, and have no pecuniary or other interest in the outcome beyond their fee. While a patient might feel more comfortable in having present a family member or friend for moral support, he doubted that there would be many circumstances in which it would be reasonable to insist on having one’s lawyer or advocate present at such an assessment.

If attending a medical consultation with one’s lawyer or advocate amounts to an unreasonable challenge to the doctor’s expertise, integrity or impartiality, then it is difficult to see how a demand to tape-record the consultation does not also unreasonably call into question the doctor’s impartiality and integrity.

In summary, the decision of Judge Willy in Jackson v ACC heavily criticises doctors for refusing to allow recordings to be made of their assessments and finds no rational basis for such a refusal. The Court does not, however, ultimately hold that doctors are prevented from refusing to allow tape recordings to be made. The decision seems more likely to cause problems for ACC than for doctors, but may impact on doctors’ practices indirectly.

If claimants adopt the practice of demanding to tape-record assessments so as to avoid having their entitlements suspended, ACC may seek a legislative solution to the problem. However, given the emphasis on claimants’ rights in the new Injury Prevention, Rehabilitation, and Compensation Act 2001, such legislative amendment may be difficult to progress politically.

It is not inconceivable that in order to avoid claimants indefinitely avoiding suspension of their entitlements, the Corporation may be tempted to engage only medical practitioners who are happy to allow claimants to record their assessments. Given that most practitioners seem uncomfortable with having their assessments recorded, it is difficult to predict what may transpire.

Given that tape-recording will not undermine the doctor–patient relationship in all cases, and may in fact be used to enhance it in some circumstances, it may be that a balance can be struck whereby medical consultations can be recorded pursuant to a mutually acceptable agreement between doctor and patient. Such agreement may include matters such as the purposes for which the consultation is recorded, the security and custody of the tape, the uses to which it might be put, and questions of privacy.

Author information: Daniel Kerr, Solicitor, KPMG Legal, Wellington Correspondence: Daniel Kerr, P O Box 10 246, Wellington. Fax: (04) 472 2291;

email: [email protected]

NZMJ 11 October 2002, Vol 115 No 1163 Page 4 of 4 URL: http://www.nzma.org....al/115-163/205/ © NZMA






Quote

IN THE HIGH COURT OF NEW ZEALAND WELLINGTON REGISTRYIN THE MATTER OF

BETWEEN AND

Hearing: 16 May 2012

CIV-2012-485-381 [2012] NZHC 1038

an intended appeal pursuant to s 162 of the Accident Compensation Act 2001

BRUCE FARQUHAR Appellant

ACCIDENT COMPENSATION CORPORATION Respondent

Appearances: A C Beck for the appellant I G Hunt for the respondent

Judgment: 16 May 2012

JUDGMENT OF CLIFFORD J

[1] Mr Farquhar is granted special leave to appeal on the question of whether or not, in the circumstances of his case – having regard in particular to any relevant transitional provisions, the Corporation was entitled as a matter of law to require him to undergo an updated Initial Occupational Assessment in the manner that it did in its letter of 27 August 2009, given that Mr Farquhar had previously been the subject of an Initial Occupational Assessment in December 2004.

[2] As I indicated at this morning’s hearing, leave is reserved if any issues arise for the Corporation or Mr Farquhar from my formulation of the legal question for which special leave is granted. Any such application is to be made by 5.00pm Friday 25 May 2012.

“Clifford J”

FARQUHAR V ACCIDENT COMPENSATION CORPORATION HC WN CIV-2012-485-381 [16 May 2012]

Solicitors: Gault Mitchell, Wellington for the appellant – [email protected] (Counsel: A Beck – [email protected]) Young Hunter, Christchurch for the respondent – [email protected]




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#31 User is offline   Campy 

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Posted 16 December 2012 - 02:47 PM

unit1of2 said:

1355616230[/url]' post='144035']
IMHO ..I believe everyone should video & voice record all assessments.. and maybe it should be compulsory...


MG said:

1350436433[/url]' post='140177']<br style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469); ">ACC was wrong to demand that Bruce Farquhar underwent an "updated" IOA, when he had not acquired any new skills, training or experience since an earlier IOA, according to Justice Collins, in a High Court judgment just released. Readers of this site will be aware that Collins was ACC's board chair until his replacement by the much-loved Sir John Judge, after the Tories won power in 2008. According to Collins J, all ACC needed to do in order to stop Mr Farquhar from vocationally rehabilitating himself by retraining as a lawyer (which is what it wanted to do)was to required him to undergo a more specific assessment, under the provisions of section 72(1) of the ACA, from one of its "independent" [sic] occupational assessors, directed at whether it was cost-effective for ACC to pay weekly compensation (and possibly VR expenses) to Mr F while he studied law at University. The answer, almost certainly, would have been "no" (or else the assessor would not have been paid for any further assessments of claimants) but, instead, ACC chose the wrong procedural steps, leading to the decision from Collins J. Followers of ACC jurisprudence (court decisions) will realise that the law, almost never, addresses substantive issues (in this case: why hadn't ACC provided Mr F with any vocational rehabilitation, as defined in in the ACA, in almost 20 years of him receiving weekly compensation from it? The answer, of course: it was too busy throwing money at assessors to tell it that Mr F didn't need any vocational rehabilitation, or entitlements, etc) but, instead, focuses obsessively on microscopic issues of procedure or form. This judicial obtuseness is by no means confined to Collins J, who is a very clever man who knows all about ACC's activities, but is endemic to the legal system and is one of the main reasons why the phrase "justice according to law" is an oxymoron.<br style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469); ">
<br style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469); "><br style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469); ">
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#32 User is offline   Ask Annette 

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Posted 16 December 2012 - 03:28 PM

NO! None of what you report is 'normal' polite or correct procedure. I strongly suggest you report the assessor immediately to the ACC Relationship Manager. Or Health and Disability commissioner, or both. I was asked to 'take my clothes off' by both the 5th Occupational Medical Assessor and the 2nd Impairment Assessor recently, and I declined. Previously I was told to 'take all my clothes off and lie on the table, oh, you can put that cotton gown on' I said NO. He ran out to my supporters saying ... I didn't touch her! I regret that I did not report Dr Courtney Kenny. I told both Siobhan Gavaghan and Rosy Fenwicke (whom ACC flys to Auckland at our expense from Wellington monthly] that only ACC assessors demand I remove my clothing, not one of my GP's or treatment providers have requested same, and that I find it deeply offensive. This makes me so angry. We are not paying $800+ for them to get their 'jollies' during this stressful and invasive time. All the physical examinations for ACC follow the same pattern with variations. The assessors could try reading our files!

View Postaphinity, on 21 September 2004 - 01:42 AM, said:

Just wondering if anyone can tell me the normal procedure "or what is the norm" during an Occupational Medical Assessment appointment I recently attended.

I really became quite uncomfortable during this.

I am an early 30's woman with an undiagnosed injury to my lower back, nothing nasty showing up in MRI's etc, but terrible terrible pain in back and leg. Injured myself earlier this year, and due to the condition I am in find sitting and standing for longer than 15 mins excruciating and impossible to bear, and have been off work.


I was to attend a medical assessment advised by ACC.

Please tell me, is it normal to not be told what to expect when inquiring to ACC about the nature of the visit? Ananswered questions like How long do these take, what will be happening...the usual things I wanted to know.

Is it normal, to be told to remove your clothing to your underwear, with no change cublicle or privacy to undress, no "gown" to put over you, no "nurse", NO Warning of a physical exam where inner cheek buttocks examined, asked to squat in your undies in front of a repulsive OVERWEIGHT creepy "doctor", turn and bend over and suchlike?????

Boy, I felt so degraded, the pain of all this movement was immense...the travel alone to get there was an hour which didn't help matters...... even more, I had my boyfriend there as support, but it was awful doing all this in front of him.

I was not prepared for all this, let alone for an "up close & personal" inspection.

I choose my own doctor by how comfortable they make me feel, and if happy, am ok about undergoing the usual physicals that make up a womans life at the docs.

I was not comfortable with this man from the minute I stepped into his office.

I hated the way he looked at me..... eeewwwww if you know what I mean.
I want to complain, but do not know who to..

I really feel degraded, humiliated, and to make matters worse, the pain I have is "all in my head". My chiro chuckled at this comment.

I don't know what to do, or even if my rights have been abused here.

Please help..... and please tell me if I have

This assessor, is also, I have found, on the Not Nice list of ACC names on this site.

If you can help me, or wish to discuss by email, please let me know. I would so appreciate opinions on this. It was demoralising, and to me, downright rude.
I had more respect shown during childbirth.

Cheers, and "awesome" site here...thank you for its help already.

A

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