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Ima Vima Reports

#1 User is offline   watcha 

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Posted 02 August 2005 - 01:17 PM

It has come to my attention that ACC has entered into a contractual relationship with Pegusas Health in a South Island pilot programme to peer review both Initial and Vocational Independence Medical Assessment reports.

All reports from the entire SI are sent to Pegasus Health, 10% are then selected at random to be peer reviewed, Pegasus Health acts as a clearing centre and sends the reviewed and unreviewed reports to ACC.

First thought is what a great idea, an independent authority that will ensure that all assessments meet a minimum standard resulting in consistancy right around the country.

There are fishhooks, of course, let's analyse the process a little more deeply.

ACC is insulated from adverse reporting, it can quite legitimately throw up its hands in horror and cry wolf at the havoc created by biased assessors.

The peer reviewers are none other than the usual crop of biased doctors who pick over the bones of the report and recommend changes; the original toady assessor may then make changes that will in all likelyhood adversely affect the claimant and the claimant is none the wiser that the final report that ends up in the case manager's hands may be quite different from the original draft.

The claimant is left out of the loop by being denied their right to receive a draft of the report and are thereby unable to check for accuracy and make corrections before it is sent out for distribution.

The unlawful practice has, either by design or accident - you be the judge - led to a second level of assessment; yet another end run around the law, claimants are getting screwed at every turn.

Could it be that the toadies have created a second income path for themselves? They are already paid to conduct assessments, now they are paid again to conduct a peer review, a third twist - one appers to be a BMA as well, nice little earner if you can get it. Assessors peer reviewing themselves - the stench of rotting flesh!

Furthermore, assessors are refusing give a draft copy of the assessment report to claimants, claiming that thier contract with ACC doesn't allow it. Does that mean that there is a new provider contract that we don't know about?

If this happens to you, remember that the Privacy Act 1993 and the Health Information Privacy Code 1994 applies to all parties, you must be given access to it to check for accuracy and make necessary corrections. Don't be put off.

And what of the one or two honest, unbiased IMA assessors - there are no known honest VIMA assessors - will they suffer as a result of shenanigans of the toady peer reviewers, probably. I wonder if the medical council is aware of the pressure put on assessors to toe the ACC party line!!
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#2 User is offline   magnacarta 

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Posted 02 August 2005 - 04:09 PM

Watcha, I not convinced this "peer review" process is legal pursuant to s.93, 94, 95 and 96 of the Act.

It's also bad faith. I can't imagine anyone in the health profession being happy with this revelation.

It's bad enough and deficient investigation by ACC that they are sending claimants to "occupational specialists for a "medical upate" because that is a clinical speciality and not a surgical or medical specialty.

These occupational physicians only fall within the vocational scope of occupational medicine and can only operate within that scope. That is the word of the NZ Medical Council.

An occupational physician has a competence in clinical medicine and rehabilitation.

It is also dangerous because a medical and surgical specialist will identify issues that an occupation specialist will not. I have specific evidence of that.
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#3 User is offline   jocko 

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Posted 10 August 2005 - 06:51 PM

Who owns Pegasus Health? Who are the directors? What are its functions?How much finance does it receive from ACC directly and indirectly? How many ex acc staff are employed/deployed by pegasus health?
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#4 User is offline   MG 

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Posted 12 August 2005 - 11:23 AM

They'll have adapted this from the lump sum/indepdendence allowance assessment process, where peeer reviewers are used to cut down on awards of financial compensation to people suffering permanent impairment. IMHO, this practice is illegal. I think a strong challenge could be made to the VIMA process but you'd have to get the original "draft" VIMA report before the peer reviewers get to it. This is just anoher cost-shifting exercise, where the ACC doctors get rich and injury victims suffer.
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#5 User is offline   doppelganger 

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Posted 25 February 2007 - 07:44 PM

here is the second report on IMA VIMA's off the ACC web site

http://www.acc.co.nz/wcm001/groups/externa...wim2_065184.pdf
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