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Fraud Investigation Help

#1 User is offline   cmarx 

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Posted 08 March 2004 - 12:00 PM

Hello all,new member with a worry.


Last october my friend and I purchased a cheap beach batch with plans to upgrade with paint and paper.We made a start and upon realising that as a longterm claimant I was obliged to notify ACC of my intentions we ceased. I discussed this with my doctor and he agreed that provided I set limitations,no more than 3 hours a day,no ceilings,no lifting etc I should notify ACC in writing.I did this through my representitive and resumed my project Since notifing ACC I have become aware of an ACC investigation into my activities.
My representitive has since notified me that ACC are still working on their investigation and will invite me to an interview in due course.He has advised me to opt for a written set of questions which I can answer as statutary declarations.
My question is, because this is my own property,I have had no financial reward,I have followed my doctors advice and I have notified ACC,although a little later than I should have, do I have anything to worry about.

Thanks all,Chris
PS, I am a long term claimant,7 years, with multiple spinal problems. C
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#2 User is offline   accvictim 

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Posted 08 March 2004 - 03:06 PM

well how are you going to do a redecorating job without ,Bending, Lifting, Ladders,
cielings, etc,, are you just gonna stand there with the paint tin so your friend can dip the brush,, get real, if you`ve a serious spinal injury, you would never consider such a job, and I can see why ACC has put the snoops on you.
If your able to do up the batch at the beach, your able to work.
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#3 User is offline   cmarx 

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Posted 08 March 2004 - 03:45 PM

Thanxs accvictim, just what I wanted to hear.I've no doubt you'll be arranging my re-training,pain relief,sleep issues etc and when you've got that all sorted you'll return to your former life as an expert in the mechanics of spinal injuries in heavy manual workers.
Get a life fella and if you've anything constructive to say, thanks, but otherwise don't bother
Chris
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#4 User is offline   BillyBob 

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Posted 08 March 2004 - 04:03 PM

I think it boils down to what exactly you are doing to your batch.

If you are able to do small amounts at a time i see no problem with it although acc will try and state that you are able to work as a decorator etc.

ACC's investigators in my opinion are a bunch of morons and will do anything they can to keep themselves in a job.
The best way to go is to not offer any information and answer their questions with as few words as possible.
There is no harm in being honest and telling you have been doing some renovation work however make sure you tell them this is being monitored by your gp.
As acc are rather reluctant to offer rehab we all need to do something to keep us relatively sane and light work such as wallpapering would do this as long as it isnt agravating your injury.

a list of questions from acc would be a good idea although i doubt they will do that as they will want to trip you up at any chance they get.

my advice is be very wary and am speaking from experience.

cheers
billybob
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#5 User is offline   fairgo 

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Posted 08 March 2004 - 04:09 PM

I guess my advice would be decide exactly what it is you will be doing and how well you are able to handle that given that you have spinal problems... will you be working every day for 3 hours or would it be once a week? What tasks do you envisage doing? Have you actually done these tasks since you developed spinal problems? How realistic is it for you to do this work and finally if you are able to do a couple of hours a day would you be willing to also do it for pay?
I can understand you wanting to do something with your days but is this a realistic option........... I am not trying to rain on your parade at all as I have a back injury myself, just curious.
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#6 User is offline   accvictim 

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Posted 08 March 2004 - 05:51 PM

Hey Chris, no need to get snotty,, I`m just looking at the situation the way ACC would see it, to give you an idea, not advice.
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#7 User is offline   Easyrider 

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Posted 08 March 2004 - 07:45 PM

Hi Chris, I suggest you run a dairy, and put down what you do each day and for how long. It can be brought up later should the ACC try and hound you.
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#8 User is offline   admin 

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Posted 08 March 2004 - 07:54 PM

Easyrider, on Mar 8 2004, 08:45 PM, said:

Hi Chris, I suggest you run a dairy, and put down what you do each day and for how long. It can be brought up later should the ACC try and hound you.

Get up at 4am...milk cows - I hope you meant 'diary' on that one :) Kinda puts things in perspective when you think most uninjured persons would be able to do something like farm work / manual labouring - but in the case of cmarx it could even be even dangerous to do so. Good idea on the diary though, make it a 'proposed' one though.

-Admin
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#9 User is offline   jocko 

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Posted 08 March 2004 - 10:15 PM

I hope accvictim did not put you off cmarx. It blew me out a bit. But as was said it is of course the corporations version, definitely not ours. Ummmm, if working on your bach within your pain tolerance is not good for you. Then ACC should get its new book on how to deal with back pain and shove it up its authors jacksy.
There was a sunday night documentary some years ago on the ACCs, at the time, new fraud unit. Showing investigators with cameras that could film you 1.5 kilometres away and some footage of people allegedly ripping off the system. (It is illegal for private investigators to use film evidence, by the way) I telephoned my case manager in the morning and asked if she had seen it. She said "No, but I heard it was very good!" I informed her. " Well we have just completed pouring an eleven by seven metre concrete pad here over the week end, there were five of us working on it and we all have disabilities, it is the only way we can get anything done. If you people think I am going to sit around on my arse all day you have another think coming and I am going to do as much for myself as I possibly can!"
At that the poor little pscycologically profiled thing went in to catatonic shock and started writing and telephoning my doctor. Demanding I be certified fit for selective work. When I saw my doctor he said "What on earth did you tell her that for? now I have to put you fit for light or selective work!" I grinned through the pain and said "No, you have to put me down as unfit for any work." He said "But you have just poured a 7x11 metre foundation??" I replied "Thats what I bloody well mean, I'm knackered." He woke up and said "Of course!!" His physical examination revealed the inflamation and tenderness in the lumbar sacral disc and quite gross swelling of my previously crushed ankle. Naturally, he shut the demented little dear up with a short nasty letter. The way I look at it cmarx, is the same way Sir Michael Faye regarded the BNZ. "It's my f.....g back and I'll do what I like with it!" We have a file note from a very respected and elderly doctor referring to a case manager who had complained of a person on ERC having paint on their clothes that goes. "Are they trained to be arseholes? I tell people to get out, do some exercise, try a bit of quiet whitebaiting or the like and they persecute them if they try?" You have done the right thing by informing them of your physical activities. Any fool can see these will be severely limited with your injuries and the social rehabilitative powers of what you are doing are what should be looked at and the enjoyment of participation you will obviously receive. Tell them you will be doing as much as you can within your pain tolerance and if they give you any grief. You will apply for a wheelchair ramp,sauna, spa bath and anything else for the bach you can think of under social rehabilitation. It is a terrible shame when a disabled person gets persecuted for having a plain, old fashioned, go at things. Good on you and good luck with the bach. Welcome aboard. cheers jocko
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#10 User is offline   bruce 

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Posted 09 March 2004 - 02:59 AM

Even if you eventually sell the place for a tidy capital gain that is not usually classed as taxable income by IRD. It helps if you actually make use of the place, if you tart if up and sell it straight away then it can be classed as solely an income earning exercise and is then taxable income. So you probably didnt need to tell ACC at all if it brings in no income other than rent or capital gain. Everybody is entitled to maintain or improve the value of their private property and its none of ACCs business.

They will try to find "proof" that you are more able than your medical assessments indicate and that really is so unprofessional and mickey mouse but with some intimidation they seem to get people to make silly "admissions". Thats why the interview is so important to them, they hope you will hang yourself with your own words. If you are rated as fit for only so many hours work then maybe dont be seen doing more hours than that.

If your back plays up go to a Dr so it is on record that you overdid it.

Bear in mind that the medical assessments are the substantial evidence that they must have regard to, their own Mickey Mouse guestimates via a private dick are thoroughly unprofessional and in the US might be regarded as practicing medicine without a licence... illegal. If they dispute your fitness based on a dicks "evidence" ask them if they or their dick are qualified to make medical assessments or occupational assessments. If you dont hang yourself with your own words then regardless of the dicks assertions, they really have to get a medical or occupational assessment that backs up their unprofessional opinions before they can get tough on you.

The more you say in the interview the more ammo you give them to use against you. They will happily grab just one sentence and use it out of context. They are actually speculating and they depend on you to confirm their speculation as being fact.
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#11 User is offline   bruce 

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Posted 09 March 2004 - 03:56 AM

When replying to a series of questions try not to get drawn into giving progressively longer replies to each question. Dont confirm any assertions they make, you dont have to. Deny things that need to be denied but try not to give them extra ammo when you do so.

If you can use the same reply to many of the questions then repeat that one reply, it gives them far less ammo to work with... eg "if you read my medical assessments you will see that I am capable of doing some limited physical work".
That phrase neither confirms nor denies their assertions but it does question their appropriateness.

If they give you a list of written questions then consider making no verbal reply at all, that way they cant work at softening you up and getting you talking and putting words in your mouth. Give them a written reply and take a few days to do it.

If seen doing something outside your range of movements... "I had 3 days of pain and that stupid mistake might have been what caused it".

As a long termer expect them to have a serious go at you, its a good investment for them to try.

If you paid a lawyer to answer the questions for you, he would probably not answer the questions at all, just send them a letter with two paragraphs that served to frustrate them. Oh to know what they know.
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#12 User is offline   Kiwee 

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Posted 09 March 2004 - 10:38 PM

Vocational Rehabilitation flowchart
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Attached File(s)


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#13 User is offline   doppelganger 

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Posted 12 March 2004 - 10:51 PM

Hi welcome to the world as a ACC receipent.

The ACC are investigating you for what? Fraud this may come in many forms. Although you are not earning in your project the ACC may decide that you are working and have deceived the ACC on your disibility. there has just been a win in Hamiliton where the ACC took a case to court to recover $500,000 approx from a worker as he could earn and deceived the ACC in saying that he can not earn.
I belive that the ACC did not atempt to rehabilitate this person and set him up for fraud.
like you you can do some work and there for you can do some rehabilitation.

My Option only.
Write to ACC and ask for a detailed explaintation for a investigation.
do a rehabilitation plan and supply to ACC . this rehabilitation plan must be done with the help of your Dr. rehabilitation must require light physical duties and can see from personal experance that the painting and decorating would be benefical. just remember to work with in your limits. if you are always sore you may be overdoing it. do your warm ups first and streachers all day so you stay flexable.

from my reading of your message, you are being paid ERC and that the corporation knows that you are tiding up a batch. This becomes a two handed problem. ( 1) the corporation is not allowed to set you up for a crime. they are paying you and carrying out your own rehabilitation. they are clasing it as fraud. when they found out that you were carrying out your own rehabilitation and classes it as work this is when they should have stopped the compensation.

The corporation has been to court several times and told that when the corporation knows that some one is comminting fraud it must stop the compensation at once.( refere to Crimes Act (section about 112))

Now from personal experance the corporation will not have any thing on you for fraud. the interview will be one sided and highly misleading. the PI will only place information in conection with a Fraud case.

before answering there questions get there full reports and answer any questions in writing.

Do your rehabilitation request and if they say that the rehabilitation programme can't be done because of the investigation then review it and say that the investigation is a non issueand hunt this site for KPI document and ask the reviewer if th eCM will gain extra income if no rehabilitation and cmpensation is supplied.

Good Luck with your effort

Doppelganger
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#14 User is offline   cmarx 

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Posted 27 March 2004 - 09:02 PM

Thanks D/G,Bruce,Joko,E/R,B/B and K,opinions valued something to think about.
Much appreciated. Chris.
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#15 User is offline   Tipster007 

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Posted 28 March 2004 - 02:07 PM

Hi cmarx, ;)

Fraudulent activity is doing something illegal in the pursuit of precuring money or gain under false circumstances/pretences.

You obviously are not trying to commit an illegal act and have been straight forward (albeit a little late) in advising the ACC of what you are actually doing. You are not obliged by law/legislation to make that declaration as you are not engaging in any form of paid/unpaid employment for your labour. There is nothing whatsoever set down in legislation that forbids, excludes or barrs you from undertaking this type of activity other than as some have already mentioned it may not actually be doing your spinal injury any good to be attempting to undertake this type of manual activity. That is something that only you know the answer to in relation to your current abilities (some advice from your Orthopaedic Specialist would be to your advantage in case such activity is detremental to your condition).

ACC policy nowadays states that you must immediately advise them of any employment that you undertake be it paid employment or voluntary employment for gain (money wise) or not. You have more than fulfilled that obligation and therefore have nothing whatsoever to worry about. Likewise ACC have no reason whatsoever to undertake any sort of Private Investigation in to the matter. You have done nothing illegal.

The fact that ACC have now become involved/aware is only a matter of providing them with a Stat Declaration stating the situation and that any input by you will only be input within your limited capabilites. Which is totally legal.

Tipster007
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#16 User is offline   MadMac 

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Posted 30 June 2006 - 07:56 PM

:wub: Hi everyone ...

Interesting flow chart ...

;) Have a great day ...
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#17 User is offline   Huggy 

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Posted 30 June 2006 - 09:04 PM

Well ACC have been at me for 9 months now the 10th month is about to start. I have now got the MP involved as 9 months is far to excessive. The reply from the fraud unit to my GP was that the investigation is taking longer than usual because they are having trouble getting the information. Well stuff you ACC of course its hard to get information when no such information of fraudulant activity is existant.

Not only is the fraud unit and the PI incompetant but also must be a liability to the corporation.

The person from the fraud unit handling this case happens to be personal friends with the PI he has contracted the work to. Isnt it very cosy how these 2 seem to be working in unison. the two of you must have very brown tongues ay. Good money isnt it Mr PI especially when you have a mate in the inside that hands you lots of work. Isnt it strange Mr PI that you have also been known not to sort out disputes because you didnt get of your ass and investigate the matter as would a normal PI would do. Reading a story in the newspaper and making a report is not good enough to sort out certain issues. You were obviously shown up on that matter after another PI was brought in and sorted the matter within weeks. Yes Mr PI this is one issue that i snooped around and found out about.......see us claimants can be a PI too. Mr PI...... like i was told by a police officer that i know........ all you are is a burnt out, left for the scrapheap ex cop.

One error Mr PI in any way or form and i will take you to court and have your Skippy Cornflakes PI license revoked. Bring it on and lets see who will end up with the egg on their face.
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#18 User is offline   yesno 

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Posted 30 June 2006 - 09:15 PM

Hi,

If you would like to read some information on the guys commissioning the investigation, I suggest that you look at the following post.

I would also suggest that it may be worth making a complaint to the Commerce Commission that ACC is operating a restrictive trade practice (hiring their mates as PI) in order to obtain pecuniary advantage (exit you and save money).


http://www.accforum.org/forums/index.php?s...=quentin&st=35#

YESno
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#19 User is offline   Huggy 

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Posted 30 June 2006 - 10:26 PM

yesno that bit of information that the fraud officer is mates with the PI came from the mouth of a lawyer whos name i will never be able to disclose for obvious reasons. But yeah it may be worthwhile taking this further. I did inform the MP of the 2 of them being mates. All i can say and excuse my language but all they are is a pack of wankers and when i get the oppertunity i will be telling them this.
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#20 User is offline   doppelganger 

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Posted 30 June 2006 - 10:37 PM

now ACC are full of supply my freind some work so that we can rip off the outfit.

Take the Johnson Shelley was my case manager in 1999
P F Johnson was a PI that loved to lie

Now the word out is that both are in Timaru. P. F. Johnson is living on his wifes earnings.
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