Review No.: 50056
Claim No.: 90214018
Application for Review by Alan Langdon
Under the Injury Prevention, Rehabilitation, and Compensation Act 2001 ("the Act")
Held at Auckland
Date of hearing 4 April 2007 (Concluded 14 May 2007)
Reviewer L A Clark
Present
No appearance by Mr Langdon. Ms Mechen for ACe.
Issue
Whether ACC correctly advised Mr Langdon that his Individual Rehabilitation Plan (IRP) was finalised.
Decision
The application is dismissed.
Costs Nil sought. Follow-up action None.
Review No.: 50056
Issue
The issue is whether ACC correctly advised Mr Langdon that his Individual Rehabilitation Plan (IRP) was finalised.
Outcome
The application is dismissed.
Reasons
Background
Mr Langdon has suffered numerous injuries over ilie years, dating back to 1997.
There are 48 in total recorded, with
some of these being duplicates and
others having been declined.
There are 31 claims
in the main, with
a number of these claims being for significant injuries.
Mr Langdon has also suffered substantial consequences from these injuries, including post traumatic stress disorder (PTSD) and ongoing chronic pain.
Only two claims remain open.
Both are handled by Henderson Branch.
ACC has acknowledged that there are historical issues over the management of Mr Langdon's claims and entitlements.
In an effort to try and reach some resolution, a full audit has been carried out on Mr Langdon's file.
Recommendations were made in October 2006. (It was a DRAFT REPORT not final recommendations)
Part of
the recommendation was recognising the historical issues, plus ongoing management and
rehabilitation of current claims.
Dr Price advised he had met with Mr Langdon on 13 December 2006, but that
Mr Langdon did not want to proceed with rehabilitation.
Dr Price advised ACC by telephone that the IRP gave a reasonable framework to undertake rehabilitation.
He did not identify any problems or issues with the draft IRP.
By January 2007, some three months after the draft IRP had been proposed, but agreement had still not been reached.
On 8 January 2007 ACC wrote to Mr Langdon advising that, as agreement could not be reached, the IRP was deemed to be finalised. Mr Langdon is seeking a review of that decision.
Review Proceedings
Mr Langdon's Case
There was no appearance by Mr Langdon I adjourned the hearing part heard and wrote to Mr Langdon, enclosing a copy of ACC's submissions. I advised that if he wished to respond to these he should let me have his written response by 16 April 2007.
ACC's Case
Ms Mechen's submissions are summarised:
- Under the legislation a claimant must be informed about the process of developing an IRP
A claimant must be given a reasonable amount of time to have input.
However if this time agreement cannot be reached ACC is able to fmalise the plan.
•
Following a tel)phone discussion with Mr Langdon an initial letter was sent to him explaining the development of an IRP.
A draft IRP was then sent a week later.
This draft was also sent to Mr Langdon's lawyer Mr Miller and his GP, Dr Price.
(Mr Miller was representing me for two appeals not any IRP negotiations)
All further correspondence was also copied to Dr Price and Mr Miller.
•
Dr Price confIrmed that he thought the IRP was a reasonable attempt to produce a framework for a way forward.
•
The IRP was reasonable and
ACC has worked hard to have all the parties participate in the development of the IRP.
•
With no agreement in sight ACC wrote to Mr Langdon finalising the IRP.
Review rights were given.
- ACC has complied with the Act in trying to address rehabilitation.
- It is appropriate that rehabilitation be contained in a plan.
- Over the three month period Mr Langdon did not provide any further details of alternative rehabilitation. Neither Dr Price nor Mr Miller advised that the plan was not suitable, or that they had issues with the proposals.
• The time period and actions of ACC were at all times reasonable.
Mr Langdon's Response
On 13 April 2007 I received written notes from Mr Langdon.
Mr Langdon said that the IRP injury list did not include the 1990 injury of chronic pain or posttraumatic stress disorder, nor traumatic brain injury.
He believes the list of injuries is incomplete and misleading, as an IRP requires correct and detailed information.
He said the reference to Dr Price is an insult: as specific questions were not put to him, and confirmation of the conversation ACC had with him had not been obtained.
Mr Langdon said that relying on a phone conversation regarding his rehabilitation plan was unacceptable.
He believed the IRP failed to address his transport to treatment needs, his mobility needs
and his failure by ACC to supply these.
He said the background does not detail what the 48 injuries were.
Mr Langdon said the IRP does not build on his previous IRP, and does not even mention any results or outcomes from the previous IRP interventions.
He believes that rehabilitation history was very important and failure to include those details was disturbing.
He said both he and his GP and him are willing to assist ACC with preparing an IRP that all can agree on and that contains all the details.
Ms Mechen's final submissions are summarised:
- Chronic pain is not an injury itself, but a consequence of an injury.
- The injury of February 1990 is recorded on the IRP as pain in lumbar spine; lumbar sprain.
- It is correctly recorded.
- The issue of chronic pain is well recognised as part of Mr Langdon's claims being a result of injury. He is entitled to treatment and rehabilitation in respect of chronic pain .
- PTSD has been recognised as a result of Mr Langdon's injuries, and is part of his file as a consequence of injury.
- It is noted more than once that Mr Langdon has suffered concussion and other injuries to his head.
- His injuries are correctly recorded on his IRP
- Mr Langdon has a claims history that shows 48 claims.
- However a number of these are duplicates or cover the same injury but have been extended.
- When you compare the list with those injuries outlined on the IRP none of the injuries suffered have been left off.
- It is a true representation of the injuries the applicant has suffered.
- The IRP outlines broadly rehabilitation interventions to be explored with Mr Langdon and his GP having input at all stages.
- Any entitlements that flow from the commencement of an intervention will occur.
- If they do not, Mr Langdon can request a decision from ACC, which, if not satisfactory, can be reviewed.
- For example, if it was determined that Mr Langdon would attend pain management. then ACC would cover his transport to and from that treatment/rehabilitation.
- Because that point is not necessarily included in the IRP does not mean it does not apply or will not happen.
- These are the types of issues that can be worked through as each intervention is explored.
- Dr Price was given a copy of the plan for his input but has not voiced any objections.
- However if he had any issues they could be explored as the IRP provides for Dr Price's constant input into treatment and rehabilitation.
- Mr Langdon has stated that the IRP does not mention Ann Scragg's report.
- The IRP is a document that outlines rehabilitation.
- The file has details of the report and the histoty surrounding it.
- The IRP is not a claim file that contains a running record of the interactions between the applicant and the respondent.
- That is for the file.
- Due to the conflict between the parties in the past, ACC in drafting the IRP, was attempting to start afresh on treatment and rehabilitation needs.
- Previous IRP's were often in dispute.
- While the IRP does not contain all previous interventions, the file still contains the histoy of the claim.
- The IRP's are part of the history.
- ACC is attempting to get treatment and rehabilitation underway.
- After considerable time ACC finalised the plan as it was unable to get agreement.
Mr Langdon provided further submissions,
the content of which was difficult for me to follow, as they were inserted into other ACC documents and correspondence.
But, in essence, he believed that the 'conflict' he has or has had with ACC in the past was not sufficient reason to abandon protocol, procedure or policy.
He believes
he is physically unable to 'start afresh' with rehabilitation.
The hearing concluded on 14 May 2007.
Decision Details
Relevant Legislation
Individual Rehabilitation Plans (IRP's) are dealt with under Clauses"7 through 10 of Schedule One to the Injury Prevention, Rehabilitation and Compensation Act 2001.
Under Clause 8 of Schedule 1, ACC has the ability to finalise an Individual Rehabilitation Plan (IRP) 'if, after a reasonable time, the claimant declines to agree to the plan.'
Analysis
In response to Mr Langdon's numerous concerns,
I have conducted a careful scrutiny of Mr Langdon's files.
From the evidence before me, I am satisfied that ACC has done all that it can be legally and reasonably required to do so, before finalising his IRP.
While Mr Miller was acting for Mr Langdon, he was advised of the process every step of the
way, as was Mr Langdon.
In addition, I confirm that Mr Langdon's GP,
Dr Price was also invited to participate in the process.
As Ms Mechen has submitted, the chronic pain and PTSD that Mr Langdon suffers from are consequences of
other covered injuries.
Entitlements to treatment and rehabilitation
flow as a result.
These are correctly recorded on his IRP.
Any entitlements that flow from the commencement of an intervention will occur.
As Ms Mechen has confirmed,
if they do not, Mr Langdon can obtain a decision from ACC, which, if not satisfactory, can be reviewed.
Mr Langdon should not be concerned that
he has signed away any of his 'rights.'
These rights are preserved.
He should also be aware that an IRP is not set in concrete.
It is fluid,
( like diarhea) with any changes to that IRP, reflecting a person's changing needs,
depending on their current circumstances, agreement by ACC and the results of any assessments.
Conclusion
Therefore, for the above reasons, I find that ACC's decision to finalise Mr Langdon's IRP was made on a correct basis. The application for review is dismissed.
Costs Nil sought.
Review No.: 50056
L A Clark Reviewer
Date: 23 May 2007
Appeal Rights
All parties have the right of appeal to the District Court. For further particulars, please see the accompanying letter.
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Alan Thomas, on May 26 2007, 11:57 AM, said:
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