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Acc Revises A Decision this may be done with out them making a decision

#1 User is offline   doppelganger 

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Posted 17 December 2006 - 06:02 PM

The Corporation revising there decisions.

There is two sections under the current Act in which the corporation must use depending when the orginial decision was made.

Section 65.
65.Corporation may revise decisions—


(1)If the Corporation considers it made a decision in error, it may revise the decision at any time, whatever the reason for the error.

(2)The Corporation may revise a decision deemed by section 58 to have been made in respect of any claim for cover, but may not recover from the claimant any payments made by it, in respect of the claim, before the date of the revision unless the claimant has made statements or provided information to the Corporation that are, in the opinion of the Corporation, intentionally misleading.

(3)A revision may—

(
a) amend the original decision; or

(B) revoke the original decision and substitute a new decision
.

(4) Every amendment to a decision, and every substituted decision, is a fresh decision.

[(5) Sections 19 to 23 of the Crown Entities Act 2004 do not limit this section.]

Cf 1998 No 114 s 73(1)-(3)

But were it is made under the previous Act the decision is made under section 390.

Revision of decisions under former Acts

390.Corporation may revise decisions—


(1)The Corporation may revise any decision specified in subsection (2) if it appears to the Corporation that the decision was made in error, whatever the reason for the error.

(2)The decisions are the following decisions made before the commencement of this Act:

(a)decisions made by the Corporation (including decisions about premiums):

(b)decisions not made by the Corporation, but made in respect of claims that the Corporation is responsible for managing
.

(3)In revising a decision, the Corporation must apply the Act that applied at the time when the decision being revised was made.

(4)The Corporation may revise a decision that, by operation of section 66(1) of the Accident Insurance Act 1998, it has accepted a claim.

(5)However, if the Corporation issues a decision in reliance on subsection (4), the Corporation may not recover from the claimant any payments made by it, in respect of the claim, before the date of the revision unless the claimant made statements or provided information that are, in the opinion of the Corporation, fraudulent or intentionally misleading.

(6)A revision may—

(a)amend the original decision; or

(b)revoke the original decision and substitute a new decision.

(7)Every amendment to a decision, and every substituted decision, is a fresh decision.

(8)Part 5 applies to every fresh decision made under this section.

Cf 1998 No 114 s 452


And if the decision goes to review section 145 (2) applies

(2) However, on the review of a decision revised by the Corporation under section 65(1), the Corporation must establish that the decision revised under that subsection was made in error.


This makes the Act very transparent if used. The corporation may amend any previous decision it makes. In doing so it not only issues a new decision but needs to inform you why the previous decision is wrong.

This comes very handy when it comes to IRP's rehabilitation has been requested and accepted by the corporation. They want a new IRP because the old one doesn't suit. Bad luck Case Manager unless you use either section 65 or 390 to show that there was an error.

What happens when you have been on medication for years. The ACC decides to remove that medication claiming that you don't need it. The Dr says you do. The ACC has made a decision saying that the original decision has an error. This is why medication is no longer supplied for that injury.

It is up to the ACC to show and prove the error.

Keep an eye on the ACC and what they are doing with there file on you. Be active and constructive in the management of your claim. Most staff just don't know the Act but have no idea were to look for the entitlements.
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#2 User is offline   Gloria Mitchell 

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Posted 17 December 2006 - 11:40 PM

When I asked for a revision of the decision to exit me, the Branch Manager replied finally telling me that he upheld the original decision that had been made and therefore this was not a reviewble decision but simply the upholding of the original decision.

Thing is, section 390 was not applied in the revision of the decision as the Accident/injury is established under the 1982 Act. The cover has never been withdrawn or revised or declined and the exiting was done using the 1998 Act.....being quoted in the declination letter. The treatment costs have not been declined, the only thing declined was the earnings related compensation and then the surgery was later declined. They could not decline the cover because the documentation was complete and unquestionable, there were three lots of surgery on the knee, however they misused the legislation and stated my problems were wholly and substantially now, that of degeneration. That is misuse of legislation in this claim with an injury by accident date in 1986.

I asked for the decision to be revisited and investigated and re-issued taking newly discovered old evidence which had not been disclosed....an xray report from the time of the iinjury stating..."no fracture or any other skeletal abnormality." into account. It was in effect a re-issuing of an earlier decision. any decision issued or re-issued becomes surely a fresh decision which does indeed carry with it, the right of review/appeal.

For me to be told it is unreviewable is surely incorrect. It was an administrative decision to uphold the original decision....is this not reviewable?

Gloria.
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#3 User is offline   DARRELLGEMMA 

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Posted 07 February 2007 - 07:14 AM

View PostGloria Mitchell, on Dec 18 2006, 12:40 AM, said:

When I asked for a revision of the decision to exit me, the Branch Manager replied finally telling me that he upheld the original decision that had been made and therefore this was not a reviewble decision but simply the upholding of the original decision.

Thing is, section 390 was not applied in the revision of the decision as the Accident/injury is established under the 1982 Act. The cover has never been withdrawn or revised or declined and the exiting was done using the 1998 Act.....being quoted in the declination letter. The treatment costs have not been declined, the only thing declined was the earnings related compensation and then the surgery was later declined. They could not decline the cover because the documentation was complete and unquestionable, there were three lots of surgery on the knee, however they misused the legislation and stated my problems were wholly and substantially now, that of degeneration. That is misuse of legislation in this claim with an injury by accident date in 1986.

I asked for the decision to be revisited and investigated and re-issued taking newly discovered old evidence which had not been disclosed....an xray report from the time of the iinjury stating..."no fracture or any other skeletal abnormality." into account. It was in effect a re-issuing of an earlier decision. any decision issued or re-issued becomes surely a fresh decision which does indeed carry with it, the right of review/appeal.

For me to be told it is unreviewable is surely incorrect. It was an administrative decision to uphold the original decision....is this not reviewable?

Gloria.

If acc revises a decision all decison letters must contain review rights. They cannot revisit a decision a decision that false & misleading sounds like you need legal advice as to whether these wankers can get away with blue murder.
Regards.
Darrell Pearce.
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#4 User is offline   Warren Forster 

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Posted 07 February 2007 - 12:48 PM

s. 65 or s. 117, and the relationship between them

The effect of s.145 (2) is profound because every decision on cover must be made through s. 65.

This effectively switches the onus of proof at review to the Corporation:

i.e. The Corporation has to prove that the decision to grant cover was made in error.

This means that it is very difficult for the Corporation to revoke it's cover decisions.

You may recall that a few years ago, s. 117 was expanded. The Corporation has accepted that s.65 limits them, so this "revocation" of cover has been closed as an exit strategy, and instead s. 117 is used.

Many of the Case Management tools used by the Corporation haven't been amended and still use the s.65 concepts developed pre 2001 Act. This means that cases exist where the case manager, following the "tools" supplied to them, exit a claimant using s. 65.


Unfortunately for the Corporation, Pathway notes reveal that the Corporation still make s.65 decisions. This is found on the early pages of Pathways under "Cover Status History".

This shows how in many cases, cover was declined, then after review or after Legal Advice, cover was reapplied and the Corporation's decision was changed to "we didn't decline cover, we suspended entitlements".

Of course, this makes for interesting readings of Transcripts of hearings.

Cheers

Warren
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#5 Guest_I love chocolate_*

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Posted 14 February 2007 - 11:54 AM

QUOTE "... this makes interesting readings of Transcripts of hearings"

There were 6 review hearings in 2 hours the other day. Usually when transcrips are asked for the reply is "the equipment malfunctioned" but this time DRSL is charging $420 per transcript because they have to get them typed. That's $2520 for 2 hours of hearings = $1260 per hour for typing.

We have also been told another time that we only get transcripts if the matter is going to court. What if we want to read the transcript before we decide whether to take the matter to court or not.

How much are transcripts supposed to cost?

Do ACC always get a copy of the transcript or reviewers notes or anything other than the decision after hearings without asking jsut as standard practice?
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#6 User is offline   Warren Forster 

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Posted 14 February 2007 - 01:07 PM

The paper files is allegedly transfered to DRSL.

DRSL staff have read only access of the electronic file on Pathways.

Reviewers then conduct the review.

DRSL records the hearing. (However recently, they have stated that they do not have to record the hearing.)

The Contract between ACC and DRSL sets out that DRSL must record each hearing and place the original tape or CD in storgae.

When you lodge a Notice Of Appeal in the District Court, the Corporation writes to DRSL and asks them to prepare the Appeal for them.

What then happens is unclear however it would appear that in controversial cases, the "Record of Hearing" held by DRSL may be put through an audio process.

Anyone who has ever wondered why "several inaudible words" come up at important times can put this down to this process.

At this stage, the files are sent to transcribers all over New Zealand, transcribed, declared as true an accurate by the parties who weren't even there, and then released to ACC by DRSL.

My advice is to lodge your notice of appeal with the district court immediately, it costs nothing and nothing is lost by doing so. Then this means DRSL will have to give everything to you for free.

Cheers

Warren




View PostI love chocolate, on Feb 14 2007, 12:54 PM, said:

QUOTE "... this makes interesting readings of Transcripts of hearings"

There were 6 review hearings in 2 hours the other day. Usually when transcrips are asked for the reply is "the equipment malfunctioned" but this time DRSL is charging $420 per transcript because they have to get them typed. That's $2520 for 2 hours of hearings = $1260 per hour for typing.

We have also been told another time that we only get transcripts if the matter is going to court. What if we want to read the transcript before we decide whether to take the matter to court or not.

How much are transcripts supposed to cost?

Do ACC always get a copy of the transcript or reviewers notes or anything other than the decision after hearings without asking jsut as standard practice?

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#7 User is offline   DARRELLGEMMA 

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Posted 14 February 2007 - 07:30 PM

View PostI love chocolate, on Feb 14 2007, 12:54 PM, said:

QUOTE "... this makes interesting readings of Transcripts of hearings"

There were 6 review hearings in 2 hours the other day. Usually when transcrips are asked for the reply is "the equipment malfunctioned" but this time DRSL is charging $420 per transcript because they have to get them typed. That's $2520 for 2 hours of hearings = $1260 per hour for typing.

We have also been told another time that we only get transcripts if the matter is going to court. What if we want to read the transcript before we decide whether to take the matter to court or not.

How much are transcripts supposed to cost?

Do ACC always get a copy of the transcript or reviewers notes or anything other than the decision after hearings without asking jsut as standard practice?

Transcripts should not cost anything if the case goes to the district court. I would contact drsl & ask them does it cost anything for a transcript because i have 3 transcripts & they cost me nothing.
Regards.
Darrell Pearce.
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#8 Guest_Percy_*

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Posted 14 February 2007 - 10:06 PM

Just goes to prove that you shouldALWAYS TAKE YOUR OWN RECORDINGS, WHETHER IN SECRET ORON THE TABLE OR BOTH.
I have a Treatment Provider friend who was charged $1000 for a tape recording (copy) of an Investigators interrogation!!!!!!!!!!!!!!!!!!!!
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#9 User is offline   stockfeed 

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Posted 15 February 2007 - 03:25 PM

View Postdoppelganger, on Dec 17 2006, 07:02 PM, said:

The Corporation revising there decisions.

There is two sections under the current Act in which the corporation must use depending when the orginial decision was made.

Section 65.
65.Corporation may revise decisions—


(1)If the Corporation considers it made a decision in error, it may revise the decision at any time, whatever the reason for the error.

(2)The Corporation may revise a decision deemed by section 58 to have been made in respect of any claim for cover, but may not recover from the claimant any payments made by it, in respect of the claim, before the date of the revision unless the claimant has made statements or provided information to the Corporation that are, in the opinion of the Corporation, intentionally misleading.

(3)A revision may—

(
a) amend the original decision; or

(B) revoke the original decision and substitute a new decision
.

(4) Every amendment to a decision, and every substituted decision, is a fresh decision.

[(5) Sections 19 to 23 of the Crown Entities Act 2004 do not limit this section.]

Cf 1998 No 114 s 73(1)-(3)

But were it is made under the previous Act the decision is made under section 390.

Revision of decisions under former Acts

390.Corporation may revise decisions—


(1)The Corporation may revise any decision specified in subsection (2) if it appears to the Corporation that the decision was made in error, whatever the reason for the error.

(2)The decisions are the following decisions made before the commencement of this Act:

(a)decisions made by the Corporation (including decisions about premiums):

(b)decisions not made by the Corporation, but made in respect of claims that the Corporation is responsible for managing
.

(3)In revising a decision, the Corporation must apply the Act that applied at the time when the decision being revised was made.

(4)The Corporation may revise a decision that, by operation of section 66(1) of the Accident Insurance Act 1998, it has accepted a claim.

(5)However, if the Corporation issues a decision in reliance on subsection (4), the Corporation may not recover from the claimant any payments made by it, in respect of the claim, before the date of the revision unless the claimant made statements or provided information that are, in the opinion of the Corporation, fraudulent or intentionally misleading.

(6)A revision may—

(a)amend the original decision; or

(b)revoke the original decision and substitute a new decision.

(7)Every amendment to a decision, and every substituted decision, is a fresh decision.

(8)Part 5 applies to every fresh decision made under this section.

Cf 1998 No 114 s 452


And if the decision goes to review section 145 (2) applies

(2) However, on the review of a decision revised by the Corporation under section 65(1), the Corporation must establish that the decision revised under that subsection was made in error.


This makes the Act very transparent if used. The corporation may amend any previous decision it makes. In doing so it not only issues a new decision but needs to inform you why the previous decision is wrong.

This comes very handy when it comes to IRP's rehabilitation has been requested and accepted by the corporation. They want a new IRP because the old one doesn't suit. Bad luck Case Manager unless you use either section 65 or 390 to show that there was an error.

What happens when you have been on medication for years. The ACC decides to remove that medication claiming that you don't need it. The Dr says you do. The ACC has made a decision saying that the original decision has an error. This is why medication is no longer supplied for that injury.

It is up to the ACC to show and prove the error.

Keep an eye on the ACC and what they are doing with there file on you. Be active and constructive in the management of your claim. Most staff just don't know the Act but have no idea were to look for the entitlements.



Reviewing decisions: How often does this happen and what are the statistics for sucess for the claimants?
Thanks Stockfeed
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#10 User is offline   Alan Thomas 

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Posted 15 February 2007 - 05:40 PM

With me each year!
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#11 User is offline   doppelganger 

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Posted 15 February 2007 - 09:29 PM

We don't here of any that use this section in obyaining there entitlements.

as ACC must prove that they made a mistake and ACC never make a mistake ACC are never going to say that they are wrong.
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#12 User is offline   stockfeed 

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Posted 16 February 2007 - 08:53 AM

View Postdoppelganger, on Feb 15 2007, 10:29 PM, said:

We don't here of any that use this section in obyaining there entitlements.

as ACC must prove that they made a mistake and ACC never make a mistake ACC are never going to say that they are wrong.



Hi Team
This site is absolutely essential and helpful to people like me. My decision has now gone to review, ineteresting.........just before we were due in court, Probably routine and a stalling tactic as far as I can see. so the corp can look for any loopholes I presume. Oops...sorry for that..that's just me being cynical What I would like to add, and it's probably been said before is: keep ypur paper work, envelopes as well. Try and make all contact with cm's by email not telephone.
Does any one know of acc spies on this site?
Thankyou again.
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#13 User is offline   Spacecadet 

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  Posted 16 February 2007 - 09:38 AM

View Poststockfeed, on Feb 16 2007, 09:53 AM, said:


Does any one know of acc spies on this site?
Thankyou again.



You can rest assured in the fact that, from the figures of those accessing and reading this site, that it is a favorite amongst ACC staff.
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