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Deemed your injuries revoke cover on the claim for these injuries

#21 User is offline   INTER 

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Posted 07 May 2017 - 12:16 PM

before this get any more side tracked here is the acc response to acc18
We have deemed your injuries as covered. ( mail you out a letter ) This means that we have given you cover at the moment as we are passed the 21 days.

However, this still needs to be investigated and so I have passed on your medical notes and the additional diagnosis requests to our Branch medical advisor

to comment on whether we add cover permanently to this claim. If he agrees then yes we can look at what your entitlements would be....Home support, transport support etc.

Or if he says that no it should not be added to your claim then we will have to revoke cover on the claim for these two injuries.

acc 18 was for started with a lumbar sprain

acc 18 then went to lumbar sprain with confirmed lumbar spondyloiss = radiculpathy

acc18 then went to lumbar sprain with confirmed lumbar spondyloiss = radiculpathy foot drop

have cover for degenerative disc disease from the 80's ( so hopefully they carn't pull the due to old age card on Regarding New Cover )




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#22 User is offline   MINI 

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Posted 07 May 2017 - 01:15 PM

View PostINTER, on 07 May 2017 - 12:16 PM, said:

before this get any more side tracked here is the acc response to acc18
We have deemed your injuries as covered. ( mail you out a letter ) This means that we have given you cover at the moment as we are passed the 21 days.

However, this still needs to be investigated and so I have passed on your medical notes and the additional diagnosis requests to our Branch medical advisor

to comment on whether we add cover permanently to this claim. If he agrees then yes we can look at what your entitlements would be....Home support, transport support etc.

Or if he says that no it should not be added to your claim then we will have to revoke cover on the claim for these two injuries.

acc 18 was for started with a lumbar sprain

acc 18 then went to lumbar sprain with confirmed lumbar spondyloiss = radiculpathy

acc18 then went to lumbar sprain with confirmed lumbar spondyloiss = radiculpathy foot drop

have cover for degenerative disc disease from the 80's ( so hopefully they carn't pull the due to old age card on Regarding New Cover )


inter

it looks like I understood and answered your questions perfectly well.

you can see the rubbish anwering you in here collects.

Will you be wanting I/A/lump sum if they allow your cover, because it appears you will be entitled to it, for the new injuries.

It is obviously a tricky one to sort out because as you say they need a medical opinion, and are getting it from the branch medical advisor.

If I were you I would get my Xrays and pay to see a spinal/orthopedic doctor for a second opinion. Especially as ACC have given your 80's one cover.

I am having the same problems myself with my 1992 injury shoulders and neck.

I have now broken the humerous on the left and hand on the right. The hand has not healed, so is seen as not being permanent and stable. It has been difficult to mearsure the % of Whole Person Impairment when the left arm is made up of two injuries and the right one is not permanent and stable. They are sending me to an orthopaedic surgeon for the hand, and I think he considers my left arm is finished. I have a little news for him there. I do not consider it is a just assessment as it is far lower than the original shoulder one was/is. The broken arm is far worse than the shoulder was after being operated on and healed so what. So I have to see how calculations are done to get the figure the assessor did.

I hope you keep on supplying the information of your spine and what way they turn concerning the new injuries.

Good luck

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#23 User is offline   Alan Thomas 

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Posted 07 May 2017 - 06:36 PM

It seems that there are those who have considerable difficulty understanding the legislated criteria. The legislation is quite clear on this matter.

When a claim is made for cover for the purposes of calculating entitlements and ACC do not make a decision on that claim Within the legislated time criteria and automated decision is made as if ACC has made the decision.

When a deemed Decision of this type is made by legislation it means that the ACC has not made the decision.
As ACC have not made the decision legislation does not permit them to review the decision
.As the ACC are not permitted to review the decision it means they are not permitted to ask their medical assessor or internal Medical professional to review this matter.

The result is that the ACC are completely ensnared by this deemed decision made by legislation without any mechanism to have any authority of any sort whatsoever over this decision.

However, when it comes time for ACC to determine the level of entitlements they are perfectly within their rights to send a claimant to one of their independent medical assessors to determine the degree of incapacity or disability..


ACC are not allowed to challenge the original decision of cover but may only explore the degree of disability for purposes of entitlement..
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#24 User is offline   INTER 

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Posted 07 May 2017 - 07:30 PM

View PostBattleaxe, on 07 May 2017 - 07:00 PM, said:



Your treating specialist's opinion takes precedence over any of the opinions that the ACC may seek from their Branch Medical Advisors.

Submit a Privacy Act request right now to the ACC asking them for a copy of the Branch Medical Advisors "opinion/report". Tell your Branch Manager you also want a detailed list of all of the information that the Branch Medical Advisor referred to when considering your case. I was originally refused this information but I would suggest you insist on it because it is very important in terms of reviewing a decision made by your Case Manager. In addition, tell your Case Manager that you want to know the date on which he or she requested the Branch Medical Advisors "opinion/report', and, the date on which the Branch Medical Advisor wrote his or her "opinion/report'. Dates are important in the scheme of things. Tell your Case Manager too that you want the aforementioned information in writing.

If you do not have an Orthopaedic Surgeon treating you right now, you will need to find one who will assist and support you in the potential struggle that I foresee with the ACC based on what you have written at the forum.

Is it cervical, thoracic or lumbar spine issues you have?




lumbar spine issues for many Years going back to 1970's injury

few more over the years With another recently Bringing to fore a new lot of pain and symptoms

were worried about caunda equina orthopedic surgeon Said he no evidence of spinal cord being badly pressurized so says 9i dont see you having that ( Hence Nerve Issues )

so says nerve damage long term that technically never settled

Symptoms still persisted so had another mri done with a orthopaedic / musculoskeletal clinic at local hospital

Hence the new symptoms for acc18


ending foot drop etc.
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#25 User is offline   doppelganger 

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Posted 07 May 2017 - 07:58 PM

they can only investigate to see of the injuries should not have cover in other words they can revoke if you did not have the injuries or they are not due to the consequence of the original injury or accident. They can not stop your entitlements unless the injury is solely due to age and if they claim that you have age related degeneration it will come from a criminal activity from the person who wrote the document claiming your injuries are due to age.

Cover can be revoked under section 65 but very hard when no decision is made.
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#26 User is offline   Alan Thomas 

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Posted 08 May 2017 - 06:25 PM

Only a moron could be led to believe that the ACC has the legal authority to rescind or change in any way a deemed decision.. The legislation has the deemed decision section in it to take control away from the ACC.. How then in your wildest dreams do you imagine that the ACC can then contradict the legislated decision that was made against the ACC as a form of punishment against the ACC? You need to have your thinking adjusted.
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#27 User is offline   MINI 

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Posted 11 May 2017 - 01:39 PM

View PostAlan Thomas, on 08 May 2017 - 06:25 PM, said:

Only a moron could be led to believe that the ACC has the legal authority to rescind or change in any way a deemed decision.. The legislation has the deemed decision section in it to take control away from the ACC.. How then in your wildest dreams do you imagine that the ACC can then contradict the legislated decision that was made against the ACC as a form of punishment against the ACC? You need to have your thinking adjusted.


Because I know that the ACC can correct there mistake in the case of entitlements, but it cannot take off you any monies it has paid you or costs of medical given you while you have had cover, unless you have not been straight with them. So obviously if they are to put it right, they can.

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#28 User is offline   Alan Thomas 

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Posted 11 May 2017 - 05:03 PM

Deemed decision
Under s 58 of the Act, the Corporation’s failure to comply with time limits under s 56 or s 57 results in a deemed decision that the claimant has cover for the personal injury in respect of which the claim was made. However, under s 65, the Corporation can now revise such a decision. This is a change from the 1998 Act where the Corporation had no power to revise a deemed decision. See ACC v Grimes 27/3/03, Judge Beattie, DC Christchurch 94/02, Govind v ACC 11/11/02, Judge Beattie, DC Auckland 310/02 and Granich v ACC 22/5/03, Judge Cadenhead, DC Papakura 95/03.

See Musin v ACC 17/9/03, Judge Cadenhead, DC Wellington 229/03 for an example of the Corporation exercising their new power to revise a deemed decision.

It is also to be remembered that the effect of a deemed decision may be limited.
For example in a claim for an entitlement such as a motor vehicle a delay by the Corporation results in a deemed decision that there is such an entitlement but the extent of that entitlement still has to be determined. See Buis v ACC 5/9/03, Judge Cadenhead, DC Wellington 222/03, citing Crawford v ACC 12/6/02, Judge Beattie, DC Dunedin 161/02 and Cooper v ACC 13/9/02, Hansen J, HC Dunedin AP9/02 in support. See also Govind v ACC 29/11/04, Judge Cadenhead, DC Wellington 372/04 and H v ACC 11/10/06, Judge Ongley, DC Wellington 246/06. See also IP146.02.
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#29 User is offline   Alan Thomas 

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Posted 11 May 2017 - 05:11 PM

View PostBattleaxe, on 11 May 2017 - 05:07 PM, said:



Paragraph 1 is a virtual copy of what I have posted previously at this topic Alan. But I was accused of providing "misleading information". Your post serves to confirm this isn't the case at all and in fact I was 100% correct in the information that I provided.



Not quite.. This subject needs to be explored a little bit further than the superficial.
In order to understand the access ACC has two revisit a decision we need to understand what that really means in relation to deemed decisions. Obviously the ACC cannot under any circumstances simply revoke a deemed decision because they feel like it. Neither can they simply revisit the information they already have after the automated legislated process making a deemed decision out of the information already before the ACC. If you read the judgements I have provided you will realise that the ACC were required to acquire new and fresh different information whereby they could conceivably make a new and fresh decision based on new and fresh information discovered subsequent to the information available at the time of the deemed decision. Otherwise what force for what purpose would be deemed decisions have? In order to comprehend legislation you first have to understand it as it relates to the big picture and the spirit of the act.

I say again that the ACC do not have the power to simply disregard a deemed decision because they feel like it. They need new information.
Information is not something generated from within the ACC such as a branch medical adviser simply looking at the information that he could have looked at prior to the expiry of the deadline resulting in the deemed decision. Don't be so stupid.
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#30 User is offline   Alan Thomas 

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Posted 11 May 2017 - 07:12 PM

My observations in blue

View PostBattleaxe, on 11 May 2017 - 06:17 PM, said:

FACT: Section 65 of the AC Act provides that the ACC may revise a decision at any time as long as it considers IT MADE A DECISION IN ERROR. There can be ANY REASON for the error.


A deemed decision cannot under any circumstances be considered by the ACC to be a decision in error. Such a notion would be repugnant to the integrity of the legislation as the notion of ACC tampering with such decisions in the manner you described strikes at the heart of the deeming process.



FACT: Section 65 of the AC Act further provides that the ACC may revise a decision DEEMED BY SECTION 58 to have been made in respect of any claim for cover.
This is only in regards to circumstances when new information comes to light. ACC may not under any circumstance set aside a deemed decision based only on the information that existed at the time of the deemed decision. That opportunity for the ACC has gone.
FACT: It is a well know tactic of the ACC to revoke deemed - accept cover - decisions and replace them with a new decision declining cover. I was personally told this by a renowned ACC Solicitor and also by a reputable ACC advocate.
The reason why we have the deeming process provided within legislation is to prevent the ACC from tampering with the legislated criteria and compelling the ACC to make decisions in a timely fashion in accordance with that legislation.
I and no-one else that I know of at this forum has written a post in this topic and on this subject saying that the ACC has the power to simply disregard a deemed decision, much less "because they feel like it". This is rudimentary knowledge of the AC Act and how the ACC operates Alan.
Simply because the ACC know that they can get away with that in as much as invalids are to disabled to stand up against such disgraceful behaviour and there are not adequate legal professionals to act on behalf such claimants is the reason why you are observing gross misconduct of the ACC which required the abduction of such legislation in the first place. Incompetence outside of the ACC is not justification of the ACCs misbehaviour.

Also, Alan, I and no-one else that I know of at this forum has written a post in this topic and on this subject saying that or even implying "information is something generated from within the ACC such as a branch medical adviser(sic) simply looking at the information that he could have looked at prior t the expiry of the deadline resulting in the deemed decision. If you had bothered to read what I had written in this topic and on this subject, you would have noticed that I stated in one of my posts to Inter; "Your treating specialist's opinion takes precedence over any of the opinions that the ACC may seek from their Branch Medical Advisors"and "If you do not have an Orthopaedic Surgeon treating you right now, you will need to find onewho will assist and support you in the potential struggle that I foresee withthe ACC based on what you have written at the forum." DON'T YOU DARE CALL ME "STUPID" AGAIN ALAN THOMAS!!!! I am not "stupid" and you write bald-faced lies like this about me without there being legal consequences for you.
Legislation does not permit the ACC to generate its own information.. All information without exception must be acquired by independent authorities having no connection with the ACC such as medical assessors or even the claimant's own treatment providers.. In-house medical assessors certainly are not independent of the ACC as they are employees/agents or contractors.ACC staff are required by legislation to be obedient to the independent and qualified information of the highest level and would be committing insurance fraud if they were to disregard such information in favour of in-house doctors or even their own intuitive or common sense understanding and in particular any such understanding from unqualified members of the public providing the ACC information by way of private investigators et cetera. When you make stupid and irresponsible comment that has no basis in law and could mislead those who read this site obviously it is necessary to identify you as being stupid. I would suggest that you look at the dictionary meaning of the word. <div><span style="font-size: 9pt;"><br></span></div>


To assist the readers of the site familiarise themselves with both the legislation and relevant judicial decisions I suggest following reading

Revised decisions
Section 65 of the Act allows the Corporation to revise its own decisions. In Wood v ACC 7/5/03, Judge Cadenhead, DC Papakura 80/03 it was made clear that this power could only be used to revise the Corporation’s own decisions and could not be used to circumvent decisions that had been the outcome of the review and appeal process. The decisions of the reviewer or the District Court could not be revised by s 65. The cases of Mitchell v ARCIC 5/11/97, Judge Beattie, DC Palmerston North 220/97 and Eason v ARCIC 26/9/97, Judge Beattie, DC Auckland 202/97 were referred to with approval as stating the law on revised decisions. See also Elliston v ACC 30/9/03, Judge Cadenhead, DC Wellington 241/03.

However, in ACC v Versey 19/3/04, Judge Beattie, DC Wellington 66/04 it was held that a reviewer’s decision that there was cover could be revoked by the Corporation. When analysed it was not the reviewer’s decision that there was cover that was being revoked. The reviewer’s decision was simply that there was a deemed decision, as the Corporation had failed to action the claim in the stipulated time. That was not a grant of cover by the reviewer but a grant of cover by operation of the statute.

The issue of the Corporation not revising decisions even when new medical evidence is presented was raised in Reden-Oldfield v ACC 8/12/05, Lang J, HC Whangarei CIV2005-485-185. The Court held that the Corporation has the ability, if it so wishes, to review a claimant’s case at any time based on new evidence that comes to light. He considered that the Corporation should give consideration to referring the new evidence to medical practitioners who were appropriately qualified to comment on the matters that were germane to the appellant’s case.


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#31 User is offline   Alan Thomas 

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Posted 12 May 2017 - 12:32 PM

View PostBattleaxe, on 11 May 2017 - 10:40 PM, said:


An intelligent verbal abuser that portrays a know it all attitude but somehow couldn't win at court. How many appeals was it again that the Judge threw out Alan?


Do you think that there is anything wrong with the Cases I have described in conjunction with the interpretation of legislation?

If the court cases I have quoted an interpretation of war is also correct then what do you think is happening to cause me to lose my court case to gain my entitlements back on the basis of the ACC claiming to possess information that I was working though not being able to describe a single work task activity at any material time and then accusing me of planning to blow up the ACC based on the drunken recollections of Douglas weal whom they had also accused of committing fraud with the result that no evidence of any sort have ever gone before the court of the standard necessary for making any decisions whatsoever in opposition to the highly qualified medical profession.
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#32 User is offline   MINI 

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Posted 12 May 2017 - 01:00 PM

View PostINTER, on 06 May 2017 - 10:24 PM, said:

I Said TO ACC regarding my deemed Acc18 cover as cover has been Granted, IM Sure Acc Is Meant to determine My entitlements as a covered claim

Acc SAY


ACC Say These are injuries that after this length of time would have resolved so this is why we are getting a medical opinion .


So it is your job to prove that your injuries could not have and have not resolved, for the reasons you quote.

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#33 User is offline   He who pays the piper 

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Posted 12 May 2017 - 01:59 PM

A message for INTER.

ACC know that you will have limited financial resources to obtain a credible medical opinion and the problem you have out there now days is that many of these specialists have been in some shape or form been bought off by ACC where that specialist knows they can make more money out of ACC [bowing to their needs & pressures] than to a one-off person who is being cheated by ACC.

That's what ACC relies on.

They will sap your pocket dry. They will sap your energy dry.
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#34 User is offline   Alan Thomas 

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Posted 12 May 2017 - 04:24 PM

View PostMINI, on 12 May 2017 - 01:00 PM, said:

So it is your job to prove that your injuries could not have and have not resolved, for the reasons you quote.

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That is done by the medical certificates ACC18
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#35 User is offline   greg 

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Posted 12 May 2017 - 05:56 PM

View PostAlan Thomas, on 12 May 2017 - 04:24 PM, said:

That is done by the medical certificates ACC18


That sounds about right;

The Document is called "Medical Certificate ACC18"

ACC45/Claim No.B744===.

Patient Details ===

Injury Details ===


Fitness for work.

The Dr. states 'Fully unfit for work"

from === to


I do realise some DR's ARC18 forms format can be different but they all still all have this info..

Complications/Assistance required ?.

The Dr. states 'Fully unfit for work"
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#36 User is offline   INTER 

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Posted 12 May 2017 - 06:24 PM

No update as of yet : but through them a curve-ball in the mean time:

before you try to revoke cover,
I I Believe, YOU Can Not revoke My Cover ? under section's 56 ,57 , 58 , 65 of the 2001 Acc act, First off no decision was made in error.

2 Acc had the 21 days into which it could have had into regards to look into circumstances, when new / old information comes to Hand / Light etc.

3 ACC may not set aside a deemed decision based on the information that existed at the time of the deemed decision. ( they had 21 days to do this in fact ovr 2 mths )

4 That opportunity for the ACC has now gone : Hence why they had to issue a deemed cover decision. ( can't shut the gate after the horse has bolted )

5 well in this/my case it Really was well over the require Legislative Day's that deemed cover applied to as i were ( over 21 days & over 2 months )

The Corporation must take the following Above steps as soon as practicable, and no later than 2 months, after the claim is lodged:


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#37 User is offline   greg 

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Posted 12 May 2017 - 08:33 PM

View PostINTER, on 12 May 2017 - 06:24 PM, said:

No update as of yet : but through them a curve-ball in the mean time:

before you try to revoke cover,
I I Believe, YOU Can Not revoke My Cover ? under section's 56 ,57 , 58 , 65 of the 2001 Acc act, First off no decision was made in error.

2 Acc had the 21 days into which it could have had into regards to look into circumstances, when new / old information comes to Hand / Light etc.

3 ACC may not set aside a deemed decision based on the information that existed at the time of the deemed decision. ( they had 21 days to do this in fact ovr 2 mths )

4 That opportunity for the ACC has now gone : Hence why they had to issue a deemed cover decision. ( can't shut the gate after the horse has bolted )

5 well in this/my case it Really was well over the require Legislative Day's that deemed cover applied to as i were ( over 21 days & over 2 months )

The Corporation must take the following Above steps as soon as practicable, and no later than 2 months, after the claim is lodged:




You have earlier claims with ACC. Is this a new injury or just an old one re-injured.?
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#38 User is offline   INTER 

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Posted 12 May 2017 - 08:53 PM

Debatable new because of the old

or unsettled old

only thing that will change is the bullshit acc will try to apply either -way :
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#39 User is offline   He who pays the piper 

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Posted 13 May 2017 - 08:10 AM

Just remember that ACC have got $33 billion of our money to fight you on this.

They've got any number of dodgy doctors and dodgy specialists who will write up a report that says anything they require of them.

And also don't forget that if you take your case to FAIRWAY RESOLUTIONS the REVIEWER there is under huge pressure to support ACC's position.

Short version, you are fighting a DINOSAUR with no heart and not a straight bone in it's body.

But you owe it to yourself to fight them if you truly believe you have a legitimate claim.

Good luck.
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#40 User is offline   tommy 

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Posted 15 May 2017 - 09:20 PM

tommy was lead to believe as in a lawfull view , that if if a claimant had a motorbike , boat , and was in an injury status as in a claimant to the corporation , as in not being able to fullfill their abilities to their intended purposes , ie an opposed to an able bodied ownership and usage , there was no issues , coorrect tommy if tommy is wrong , and also if one can recite the legislation
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