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Need some help going to review please *posted in members/archived forum sorry mods

#1 User is offline   AlexTheKid72 

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Posted 06 December 2017 - 10:58 AM

Hi community. A brief history :
April 2016 injured shoulder using pickaxe to widen trench in tar sealed road.
ACC compensated, a couple weeks off work, then light duties, then full time again in May.
When ACC rang for the sign-off I made it clear I still felt pain but was capable of returning to full duties.
Back to DR August, still experiencing pain. Ultrasound. Cortisone recommended.
November 2016 injured same shoulder again using heavy pry-bar to break overpour to remove boxing from a freshly poured footpath and remove boxing. DR was English 2nd language and put "lifting boxes" on AC45. Every conversation with ACC I advised that was not the case and it was an impact injury.
DR agreed that this was an aggrivation of April injury and put November injury on same claim number
Case Manager denies compensation suspecting degeneration, reviewing after MRI and specialist report.
Suggested I go on unemployment until healed or report in.
In one conversation she suggested it is very difficult to tie November injury back to April claim, and suggested starting with "I can't tell you this but .... " I go back to DR and relog injury on a new AC45. The DR did this, but said could not backdate to november, so new claim number for November injury began January.
MRI and report happened. No bone spurs or degeneration. Indication of a fractured collar-bone which specialist thought may be osteolysis starting or fracture. I think I fractured my collar bone in April, hairline down the bone not across, undisplaced, missed by x-ray and ultrasound.
Case manager then declined compensation because "I just had a sprain from lifting boxes".
AC45 information finally changed, another review of decision.
Final decline states : medical information does not support my current incapacity being related to injury in April and November.
Case manager hung up on me when I was trying to get an explaination.
It appears she used her advice to me to change number as an out, after degeneration and injury type was clarified.
She said "november is too far after the April injury for compensation, and January is too far after the November injury. So she has that November 23rd I applied for compensation for injury in April. And January I applied for compensation from November 22nd injury.

I have been unable to pay for physio, going from a working wage to a benefit has sent me into debt. I can barely keep up with the cost of living.
Specialist stated this type of injury can take 12 - 24 months to heal, but that he felt I should be capable of returning to work, and physiotherapy would rectify my injury without surgery.
Public Health finally picked me up for physio this week, 1 year after the injury.
In the past year I have had patches of feeling almost pain-free and been available for light duties, mixed with bad patches where I have been fully unable to work.

It feels like a very constructive "NO" to me, and has left me with the frustration of probably being 100% months ago IF I could access physio, instead I have had a painful 12 months loading up on anti-inflammatories and painkillers.

Who can I talk to to help prepare for my review? I am in Hamilton.
I have requested all telephone conversations and my file from ACC.

Greatly appreciate any advice to help me prepare for this fight.
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#2 User is offline   Alan Thomas 

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Posted 06 December 2017 - 02:34 PM

Alex the principal problem is the doctor not providing the ACC with adequate information. The reason the doctors don't provide adequate information is because the ACC don't want to have a complete picture of what is wrong in the first instance. From that point on the foundations of information that are necessary for a claim are continually eroded.

Has the same doctor continue to provide ongoing treatment and additional information to the ACC?

As there are a host of mistakes already it is quite important is that you have an independent assessment of your situation with a whole description) to the beginning of your first injury up until the present whereby everything is properly calibrated and documented. A complaint to the medical Council against the doctors involved might also be appropriate in your case.

Notwithstanding all of that the ACC's behaviour has been appalling and inexcusable.

Over the past few years the ACC has had a policy of rejecting every single shoulder claim so undoubtedly your case manager will be thinking they are following the corporate policy.

Over the years I have helped the large number of people and will continue to do so. You will see that the number of people quite actively support the ACCs behaviour when criticising me. It's a bit difficult to know what goes on in the heads of some people.
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#3 User is offline   greg 

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Posted 06 December 2017 - 03:16 PM

ACC will use these two events to confuse and delay and deny .
As a Dr. has claimed xyz. and another Dr has claimed zxy.

Can you find any 'Read code's within any paperwork ACC. has sent you.?

Request all documents ACC have ;

try this ;
https://accforum.org...ecific-process/
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#4 User is offline   AlexTheKid72 

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Posted 06 December 2017 - 04:31 PM

I have just sent the request for file today. I also applied for review to be deferred date was 10 Jan and no time to prepare.
The ac45 issue is rectified.
For me the big failing is acc denying expecting degeneration.
Then tryin sprain after MRI came back with none.
Damnit accident events updated can't use that for a no it's an impact injury.
Haha the claim numbers they advised me to change.
Surely this is a constructive denial of compensation.
Why state degeneration if injury/claim dates are the reason for a no?
I am seeing my gp and getting a concise timeline of all visits Monday.

Thank you for the responses.
I am broke can anyone suggest a pro bono advocate in Hamilton?

Just read email from Fairways. They're happy to extend review date, but ACC have to agree. Hope that goes well tomorrow, or likely I'll be going into review unprepared.
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#5 User is offline   doppelganger 

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Posted 07 December 2017 - 09:12 PM

View PostAlexTheKid72, on 06 December 2017 - 04:31 PM, said:

I have just sent the request for file today. I also applied for review to be deferred date was 10 Jan and no time to prepare.
The ac45 issue is rectified.
For me the big failing is acc denying expecting degeneration.
Then tryin sprain after MRI came back with none.
Damnit accident events updated can't use that for a no it's an impact injury.
Haha the claim numbers they advised me to change.
Surely this is a constructive denial of compensation.
Why state degeneration if injury/claim dates are the reason for a no?
I am seeing my gp and getting a concise timeline of all visits Monday.

Thank you for the responses.
I am broke can anyone suggest a pro bono advocate in Hamilton?

Just read email from Fairways. They're happy to extend review date, but ACC have to agree. Hope that goes well tomorrow, or likely I'll be going into review unprepared.


Take a note of section 26 (2) amd 20 (2) (g)

(2) Personal injury does not include personal injury caused wholly or substantially
by a gradual process, disease, or infection unless it is personal injury of a
kind described in section 20(2)(e) to (h).

(g) personal injury caused by a gradual process, disease, or infection consequential
on personal injury suffered by the person for which the person
has cover:

Not the sections that ACC are using and that is subsection 26 (4)

(4) Personal injury does not include—
(a) personal injury caused wholly or substantially by the ageing process; or
(B) personal injury to teeth or dentures caused by the natural use of those
teeth or dentures.
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#6 User is offline   AlexTheKid72 

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Posted 07 December 2017 - 09:54 PM

In April there was a specific event. I lost my footing mid-swing and over-extended, the pick-axe struck the road on an angle, the impact was violent. In November i miss-hit the concrete I was trying to break away, and bang my shoulder was hell again. There was a definite individual strike my shoulder let go.
The April AC45 was written correctly by my GP. However the November one wasn't. According to the review team that has been updated. I guess I'll see when I receive my file.

There was no sign of degeneration.
How did ACC come to the conclusion despite the specialist report stating this type of injury can take 12-24 months to heal, that I needed 0 time off work?
Note they compensated me in April, I have no issue with that. I was back to full duties by May, after some physio, a little time off, and a little time on light duties.
The Claim Decision that says no relates entirely to compensation from November 23rd onwards. I believe the case manager presented my file as me requesting compensation on 23rd Nov because I hurt myself in April, and that I asked for compensation in January because I hurt myself in November.

I have just read an email from ACC.
They have no records of any telephone conversations .....
*I have now completed a search in ACC’s call recording system for any calls to or from your phone numbers to or from Kim Harris. I have not been able to locate any calls, which means that if there were any calls recorded the recordings no longer exist.*
Also no record of me stating that I still feel pain but I am confident I am good enough for full duties and happy to be signed off.
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#7 User is offline   AlexTheKid72 

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Posted 08 December 2017 - 08:31 AM

Quick question : If ACC do not think my current incapacity to work is related to the injury I had at work, do they have to state what the medical evidence is showing them to the contrary? IE what they think is causing the problem that allows them to reach the conclusion that it has nothing to do with the injury?

I have had no issues with my shoulder prior to the April injury.
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#8 User is offline   greg 

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Posted 08 December 2017 - 08:57 AM

Try this site as is based in Cambridge , may offer some local knowledge, re Advocates ?

http://accforum.nz/f...general-forums/
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#9 User is offline   Alan Thomas 

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Posted 08 December 2017 - 10:06 AM

Alex I would suggest that you use the search function on this site. The site has a very large level of contributions from good and well-meaning people despite the fact that friends of the ACC have attacked the site including Greg and the one he has suggested you go to who has been banned from this site for missbehaviour

The following URLs might help you out. I know that there is a woman who does review hearings for people and will work for the government funded rate which means you won't have to pay anything. You might find that a number of others will do the same.

https://accforum.org...h&fromMainBar=1
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#10 User is offline   Alan Thomas 

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Posted 08 December 2017 - 10:08 AM

Alex it seems to me that the principal problem you are having is the lack of clarity in the documentation produced by the medical profession with the result that ACC have applied the "beauty is in the eye of the beholder" principle and cherry picked what information they want to reconfigure the story their way. It will be necessary for you to get all your medical documentation from the various medical professionals and take that to your current general practitioner or someone better in order that they produce for you a report describing the whole situation. Expect to pay about $200 or so from your general practitioner but if your general practitioner send you through to a specialist you might be ending up paying 600-$1000.
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#11 User is offline   doppelganger 

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Posted 08 December 2017 - 03:17 PM

View PostAlexTheKid72, on 07 December 2017 - 09:54 PM, said:

In April there was a specific event. I lost my footing mid-swing and over-extended, the pick-axe struck the road on an angle, the impact was violent. In November i miss-hit the concrete I was trying to break away, and bang my shoulder was hell again. There was a definite individual strike my shoulder let go.
The April AC45 was written correctly by my GP. However the November one wasn't. According to the review team that has been updated. I guess I'll see when I receive my file.

There was no sign of degeneration.
How did ACC come to the conclusion despite the specialist report stating this type of injury can take 12-24 months to heal, that I needed 0 time off work?
Note they compensated me in April, I have no issue with that. I was back to full duties by May, after some physio, a little time off, and a little time on light duties.
The Claim Decision that says no relates entirely to compensation from November 23rd onwards. I believe the case manager presented my file as me requesting compensation on 23rd Nov because I hurt myself in April, and that I asked for compensation in January because I hurt myself in November.

I have just read an email from ACC.
They have no records of any telephone conversations .....
*I have now completed a search in ACC’s call recording system for any calls to or from your phone numbers to or from Kim Harris. I have not been able to locate any calls, which means that if there were any calls recorded the recordings no longer exist.*
Also no record of me stating that I still feel pain but I am confident I am good enough for full duties and happy to be signed off.


Be careful what you say as the medical term for degeneration is that something is not normal (an injury is not normal)

Age Related Degeneration on the other hand is completely normal
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#12 User is offline   Alan Thomas 

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Posted 08 December 2017 - 04:36 PM

Alex what you need to remember is that neither the ACC nor the claimant has an entitlement to have any kind of an opinion regarding the degree of injury and incapacity. Legislation requires both parties to refer to those who have the relevant qualification and experience to have an opinion. Everyone else is irrelevant.

So what ACC does is persuade the medical professionals to make reports that lack definition so that they can be open to interpretation. What you need to do is get a total summary from a medical professional that describes the degree of injury and incapacity and explicit terminology that cannot be interpreted in any other way than what the author of the report has intended. This way tthe ACC, reviewers district court judges and suchlike will have to submit to the authority of the medical report as they do not have the authority to have a different opinion.
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#13 User is offline   tommy 

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Posted 08 December 2017 - 05:22 PM

request doctors notes , and also then request infos to date as in a latest or earlier file report in acc files
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#14 User is offline   tommy 

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Posted 08 December 2017 - 05:35 PM

informations are crucial as in evidence , seek and retain as in a claimant presenting their case if required
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#15 User is offline   MINI 

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Posted 10 December 2017 - 01:18 PM

View Postdoppelganger, on 08 December 2017 - 03:17 PM, said:

Be careful what you say as the medical term for degeneration is that something is not normal (an injury is not normal)

Age Related Degeneration on the other hand is completely normal


doppelganger

Do you know if a spinal injury of only one or two disc with a root injury can only be caused by a injury when all the rest are claimed as being OK.

Any input appreciated.

Mini
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#16 User is offline   doppelganger 

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Posted 11 December 2017 - 03:49 PM

I can not say if this is correct answer, but medical documents say that once one disc is injury the adjacent disc are more likely also become injured because of the original injury
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#17 User is offline   greg 

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Posted 11 December 2017 - 05:32 PM

View PostMINI, on 10 December 2017 - 01:18 PM, said:

doppelganger

Do you know if a spinal injury of only one or two disc with a root injury can only be caused by a injury when all the rest are claimed as being OK.

Any input appreciated.

Mini


From my world ; a previous X-ray showed no 'ruptured disc, torn disc, slipped disc, collapsed disc, disc protrusion' during a work medical. The
X-ray was of the chest checking for lung damage . This image was again used when back damage occurred
and cover granted.
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#18 User is offline   tommy 

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Posted 11 December 2017 - 08:28 PM

when a claimant is put to close scrutiny as in assessors reports . and if the claimaant has only x, ray images , then new imaging as in ct , or mri , scans may give new evidence , but as at whoms expense
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#19 User is offline   MINI 

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Posted 13 December 2017 - 11:42 AM

View Posttommy, on 11 December 2017 - 08:28 PM, said:

when a claimant is put to close scrutiny as in assessors reports . and if the claimaant has only x, ray images , then new imaging as in ct , or mri , scans may give new evidence , but as at whoms expense


Thanks for all the replies. It is heartening that a few are prepared to give their opinions. I have had Mri for my L1 and L2 root lesion. For many years is has been seen as being medical, but that has since been written up by the appropriate specialists as a misdiagnosis, and been called medical issue for 25 years and not covered by ACC. Except they have lost the relevant docos that say if this injury could or could not be part of my original injury all those years ago.

Doppleganger: That appears to have happened to mine, as I say it is L1/L2 on the MRI scan.

Gregg: It sounds like your back was in pretty good condition. Even my own GP is starting to say degeneration, however, it was only three years ago that he said he wouldn't believe those bones were of someone my age. Now I just have to get that doco off my file.

Does anyone know how the 25 years of misdiagnosis is claimed. Ie procedure, prossess of claim etc?

Cheers Mini
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#20 User is offline   Alan Thomas 

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Posted 13 December 2017 - 12:11 PM

View Posttommy, on 08 December 2017 - 05:22 PM, said:

request doctors notes , and also then request infos to date as in a latest or earlier file report in acc files


Unfortunately Tommy once you go into the realms of a judicial remedy such as a review hearing doctors notes and other information are quite meaningless for purposes of assisting a reviewer making a decision based on the legislated criteria of information. Legislation requires medical reporting to determine that there has been injury and that injury has caused disability and incapacity. Attempting to influence a reviewer or a judge by way of surrounding material is not very helpful and it is helping a reviewer to add best roll the dice or at worst not upset his masters.
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