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Pain Medication Entitlement Annual Renewal

#41 User is offline   Alan Thomas 

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Posted 04 September 2007 - 06:01 PM

The short version of my problem is that the ACC seek to override the specialists prescription as if they have the legal authority to do so. My point is, unless I am shown to be wrong, Once the ACC accept liability they are compelled to comply with the superior medical advice.

I have posed the question but some of the more excitable respondents got sidetracked. I had however attempted to be accommodating to the various perceived side issues. I simply do not want the Funder of my treatment to be deciding what that treatment is , and especially without clinical examination by less than qualified staff, for obvious reasons. This is a problem that many of us are facing and as such very relevant.

Neddy you are getting new Testament an old Testament mixedup. Under the old Testament and various eastern religions revenge is the appropriate form of justice. Commonwealth law is based on the new Testament but if we are denied new Testament justice then of course it is quite natural that we return to be more tried-and-true forms of justice so as to provide appropriate motivation.
And when did you apoint yourself Yaweh? "Vengance is MINE saith the Lord" not Alan Thomas's, taking that line will en in great sorrow.
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#42 User is offline   neddy 

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Posted 04 September 2007 - 06:46 PM

View PostAlan Thomas, on Sep 4 2007, 06:01 PM, said:

Teastern religions revenge is the appropriate form of justice. Commonwealth law is based on the new Testament but if we are denied new Testament justice then of course it is quite natural that we return to be more tried-and-true forms of justice so as to provide appropriate motivation.
And when did you apoint yourself Yaweh? "Vengance is MINE saith the Lord" not Alan Thomas's, taking that line will en in great sorrow.



What a bundle of crap, again you fudge and won't answer questions put to you. How does one who is supposedly disabled, digitally manipulate the truth the way you do?

You have no courage of your convictions, as you won't ever state things for what they are.

I suppose one just has to accept that you have been proven to be dishonest and a fraudster, so why would you resort to telling the whole truth for a change.

ACC can and do determine what interventions take place, and they can call upon THEIR experts to give their opinions, eg OT's for equipment, physios for treatment, etc. Like my specialist says I need a vacumn cleaner thats light and easy, I want a Dyson cause they're the best. I get a Nilfisk because that's what they say is the best, moot point. so why should they accept what you have obviously paid and directed your specialist to do or prescribe (who is recieving a fat fee! and knows where the gravy is!!!)

And Yaweh is Yahweh and not dependant on what Testament, document, interpretation whatever, the only religion that acepts Vengance outright are the Taliban and their ilk, get real or wear a Burkah.
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#43 User is offline   Alan Thomas 

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Posted 04 September 2007 - 08:09 PM

Neddy the purpose of this thread was to highlight the legislated obligation of the ACC to fund the prescribed medication and not really about subjects such as revenge or vengeance.

But somehow I cannot help myself and succumbed to the temptation of building upon your religious knowledge while I am waiting for the advancement of my ACC legal knowledge.

Just to assist you I think the God of the old Testament is the same God as the new Testament God. I do have the urge to do some smiting. Has anyone seen my asses jawbone, someone has stolen my wifeSo I might need to set some foxes loose through some fields with fire attached to their tails.

I really are not sure whether I should be looking towards Samson or Job. Seeing that I have been robbed of everything including my health it would seem my experience that is a little bit more like Job.I think Job might have been a little bit out of his league in extracting revenge but then he was just an indicator of things yet to happen, total world destruction.

Make no mistake revenge is very popular amongst all religious groups.

Anyone who blasphemes the name of YHWH must be put to death” carried the meaning of “pronounce” rather than “blaspheme”. When the Jews began speaking Aramaic, this verse was understood to mean, “Anyone who pronounces the name of YHWH must be put to death.” Since then, Jews have maintained the custom of not pronouncing the name, but use Adonai (“my Lord [plural of majesty]”) instead. During the first few centuries AD this may have resulted in loss of traditional memory of how to pronounce the Name
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#44 User is offline   tonyj 

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Posted 04 September 2007 - 08:40 PM

Me thinks more often than not ACC wreak their revenge on you Alan as opposed you on them,

just an observation.

tony
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#45 User is offline   Medwyn 

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Posted 04 September 2007 - 09:13 PM

Reading this thread raises the fundimental question. Where in the Acts does it say that we the consumer can dictate what ACC is to provide in the way of medication, equipment etc. I thought ACC's obligation was to appoint assessors who reccomend what ACC is to provide and for them then to make a decision to fund or not.

If one wants to get an opinion from their own Specialist provider, ACC is in no way obligated as I see it to provide what the client's specialist wants.

If you hire your own specialist you do so at the risk of losing what ACC has determined is sufficient for your rehabilitation.

It's sad that some people want a bigger, brighter bite of the cherry, when the rest of us are happy to be given the opportunity to have a bite of the cherry.

I'm not defending ACC here, just stating the intent of ACC.

Next thing, we will be having pet specialists dictating who can provide those services and only them. God forbid, it leads to collusion like the Eye Clinic thing down South recently where the old boy's club look after their own.

If you want "Specialist" treatment, in my view you should pay for it or pay the difference between what is normally provided and the specialists requirements. but no, there will always be the one who wants more who creates problems for those who are coming through seeking their needs to be met.

If you are not happy with what's provided then you have remedies under the Acts and if you stick to the Acts you can't go too far wrong, it's when you go into interpreting or supposition that you walk into a minefield.

I may be wrong, but I'm betting no matter who wins the next election, ACC is due for changes, hopefully we can get some of the more abstract and obscure phrases in the Acts spelt out as to what they mean.
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#46 User is offline   Gloria Mitchell 

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Posted 04 September 2007 - 10:28 PM

View PostMedwyn, on Sep 4 2007, 10:13 PM, said:

Reading this thread raises the fundimental question. Where in the Acts does it say that we the consumer can dictate what ACC is to provide in the way of medication, equipment etc. I thought ACC's obligation was to appoint assessors who reccomend what ACC is to provide and for them then to make a decision to fund or not.

If one wants to get an opinion from their own Specialist provider, ACC is in no way obligated as I see it to provide what the client's specialist wants.

If you hire your own specialist you do so at the risk of losing what ACC has determined is sufficient for your rehabilitation.

It's sad that some people want a bigger, brighter bite of the cherry, when the rest of us are happy to be given the opportunity to have a bite of the cherry.

I'm not defending ACC here, just stating the intent of ACC.

Next thing, we will be having pet specialists dictating who can provide those services and only them. God forbid, it leads to collusion like the Eye Clinic thing down South recently where the old boy's club look after their own.

If you want "Specialist" treatment, in my view you should pay for it or pay the difference between what is normally provided and the specialists requirements. but no, there will always be the one who wants more who creates problems for those who are coming through seeking their needs to be met.

If you are not happy with what's provided then you have remedies under the Acts and if you stick to the Acts you can't go too far wrong, it's when you go into interpreting or supposition that you walk into a minefield.

I may be wrong, but I'm betting no matter who wins the next election, ACC is due for changes, hopefully we can get some of the more abstract and obscure phrases in the Acts spelt out as to what they mean.


Medwyn, respectfully,

I think you are wrong.

A Specialist is a Specialist is a Specialist, I want a proper Specialist, not a contracted provider...haven't you been reading the posts about provider contractx and Acc's own best practise medicine stuff?

Many of us have had "treatment" including assessments from "their" specialists....note no capitals....which have badly affected our quality of life. In my case one of "their" specialists changed his mind from ten years earlier when he assessed me and when he wasn't "one of theirs". Result.......not only was the surgery he did or supervised only partly sucessful, but it had to be cleaned up by another surgeon. Whereupon the specialist (now theirs) produced an assessment which was set above all other assessments and reports and due to mistakes and mishaps in solicitors office.....managed to make it into wrong decision being unassailably concreted to my financial detriment. Beatties creative imaginings didn't help....AND.........This is not an isolated incidence.

So....you are entitled to use a specialist for assessments who meets the requirements in legislation....one who is duly qualified. POLICY says.....you have to use one of "theirs".

Policy seldom echos legislation......they shouldn't need policy if they following legislation.

Gloria
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#47 User is offline   Medwyn 

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Posted 04 September 2007 - 11:13 PM

Medwyn, respectfully,

I think you are wrong.

A Specialist is a Specialist is a Specialist, I want a proper Specialist, not a contracted provider...haven't you been reading the posts about provider contractx and Acc's own best practise medicine stuff?

Many of us have had "treatment" including assessments from "their" specialists....note no capitals....which have badly affected our quality of life. In my case one of "their" specialists changed his mind from ten years earlier when he assessed me and when he wasn't "one of theirs". Result.......not only was the surgery he did or supervised only partly sucessful, but it had to be cleaned up by another surgeon. Whereupon the specialist (now theirs) produced an assessment which was set above all other assessments and reports and due to mistakes and mishaps in solicitors office.....managed to make it into wrong decision being unassailably concreted to my financial detriment. Beatties creative imaginings didn't help....AND.........This is not an isolated incidence.

So....you are entitled to use a specialist for assessments who meets the requirements in legislation....one who is duly qualified. POLICY says.....you have to use one of "theirs".

Policy seldom echos legislation......they shouldn't need policy if they following legislation.

Gloria


Gloria,
I hear where you are coming from and yes I agree with what you say, but, and this is a big but, that's not the way it's written or interpreted by ACC or their legal counsel or by legal precedent.

Yes there are people such as you who get really wronged by this system, and there appears to be corrupt practises going on, but I feel that we have to change the letter of the Act, not the intent we would like to put on it and that takes time and a whole lot of representations to the powers that be.

I don't want to be negative, God forbid, but ACC to protect themselves, must act as they are directed by the Act or those who direct them in their administration of those Acts.

If we believe that the Acts are wrong, then it is up to us to get change by advocating and representation to those in authority who have the power to change things.

I hope I'm not blind, and indeed hope that I'm not insensitive, but thats how I see it, and I'm prepared to listen and be guided if I am indeed wrong.

Respectfully,

Medwyn
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#48 User is offline   Alan Thomas 

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Posted 05 September 2007 - 01:08 AM

Medwyn I think you may have slipped over into the dark side without realising it. The law and state servants exists to serve us, not the other way round as you have portrayed. I know this sounds a little fundamental and that it may be even a little bit confusing but over many years the average New Zealander has been socially engineered to think just the way you are thinking. We need to take our country back. The ACC act is well-intentioned and reasonably well produced. If we did not have Socialist bureaucrats running the show it may even have a chance of working. It may still have a chance of working if we turn the whole lot over to computers at the information input supplied by a treatment providers. In this day and age we do not actually need human beings in this type of industry at all.
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#49 User is offline   Medwyn 

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Posted 05 September 2007 - 09:44 AM

View PostAlan Thomas, on Sep 5 2007, 01:08 AM, said:

Medwyn I think you may have slipped over into the dark side without realising it. The law and state servants exists to serve us, not the other way round as you have portrayed. I know this sounds a little fundamental and that it may be even a little bit confusing but over many years the average New Zealander has been socially engineered to think just the way you are thinking. We need to take our country back. The ACC act is well-intentioned and reasonably well produced. If we did not have Socialist bureaucrats running the show it may even have a chance of working. It may still have a chance of working if we turn the whole lot over to computers at the information input supplied by a treatment providers. In this day and age we do not actually need human beings in this type of industry at all.


Alan, I think you are a rude, and offensive person. I'm not from the Dark Side, or any side for that matter. I'm just stating it how it is. Even if I should work for or provide for ACC which I catergorically deny, I'm still entitled to an opinion even if it rubs you the wrong way. Also I have my own mind and have not been socially-engineered as you so derogatively put it.

I respectfully submit that the only choices you have of specialists/assessors that are available are the ones contracted to ACC at the time, the same for what medications/equipment are provided.

That may go against the grain, but no-one can point to any section or sub-section of the Acts to say what I am led to believe is wrong both in law and in fact rather than supposition or untested law, or if they can, they haven't posted as yet.

If I should be proven to be right, I feel for those people who have been led to believe that it is their given right to nominate their choice of Specialist/Assessor when it clearly is not the case.
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#50 User is offline   Spacecadet 

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Posted 05 September 2007 - 10:00 AM

Medwyn
We are all different.
We are all attempting to progress our claim for our rights under the ACC system, each in our own way.
Some of us are being sucessfull and making progress.
Some are not.
I leave it up to you to judge for yourself which methods work, which dont.
The good thing about the forum is that it has diverse views and diverse approaches to addressing the issues.
This all adds to our basket of knowledge allowing the individual to make informed decisions, be they good or bad.
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#51 User is offline   waddie 

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Posted 05 September 2007 - 10:05 AM

While ACC can require you to under an assessment with an assessor of their choosing, the fact that an assessor is a contracted provider does not mean there opinion is given any more or less weight. How much weight the opinion carries is determined by the qualification of the registered medical practitioner.

When it comes to applying the legislation, the test is a legal one, not a medical one, as is based on weighting up the evidence, considering all the circumstances and making a reasonable decision that complies with the legislation. For example, to equally qualified persons consider the same information but provide opposing opinions on what is the best medication, however, one is the treating specialist, the other is a specialist not providing treatment. The legal test would say that the treating specialist opinion carries more weight than the non-treating specialist because they are better placed to provide an opinion, and, are responsible for the treatment being provided. The only exception is when you are talking about the prescribed process, ie the vocational independence assessment, where ACC appoints a duly-appointed assessor.

In Alan's case, given that it is an injury-related condition that is being treated, the question is "Does the Tramadol facilitate the treatment provided by the treating medical practitioner, or is there a more cost-effective option that facilitates the treatment." If there is a more cost-effective drug, what is it, who is providing that opinion, and what is the opinion of the treating medical practitioner on that alternative. It would be reasonable to know those things before making a decision.

ACC cannot simply make an arbitrary decision because it has a policy of reducing its spending on tramadol, which seems to be the case, or Alan rubs ACC up the wrong way. I had a similar tramadol case and ACC backed down as soon as I lodged a review application. They made a decision to end funding, told the pharmacist, but did not issue a decision to the claimant. All of a sudden, ACC continued with the funding, simply because I filled out a review form and they know I cannot be easily fooled, not because of any evidence I presented. I exposed an ACC practice that does not comply with the Act and some of the ACC staff know this. It is a systemic problem, not isolated to Alan.
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#52 User is offline   flowers 

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Posted 05 September 2007 - 10:07 AM

The key word is independent.
Acc arsessors are not.
They are contractees and Approved by acc and acc hold all the cards and calls the tune.
that is not independant in any fucking language..........
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#53 User is offline   Alan Thomas 

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Posted 05 September 2007 - 10:18 AM

Medwyn I would encourage you to have a listen to the professionals discussing the opposite of what you suggest on the radio this morning. Warren was on describing this point of view that I agree with.

I also agree with Spacecadet that we are all entitled to our opinions on this forum, including ACC and those who are satisfied that a bureaucrat can have greater control over treatment than professionally trained medical providers. I do not agree with these so-called "best practice medicine" because it depends upon statistical analysis by bureaucrats rather than clinical judgement resulting from training and experience. It also serves to reduce the insurance costs illegally and as such we should not succumb to such unlawful pressure to change the way in which medicine is practised in this country.
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#54 User is offline   Gloria Mitchell 

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Posted 05 September 2007 - 10:41 AM

Arhh Medwyn,

Therein is the rub.....you wrote:


Quote

I don't want to be negative, God forbid, but ACC to protect themselves, must act as they are directed by the Act or those who direct them in their administration of those Acts.


That is the POLICY I was talking about.

And they forget that the very persons they are "protecting " themselves from are the ones who are providing them their security in the first place....the levy payers.

When do you think they might wake up and see just "how" insecure their positions are becoming......uncovered.

I reiterate....if they would just apply the Act rather than their "interpretations of the act in the form of "policy".....we and they would both be more secure.

This may appear way off the threads intentions......but the Act says the corproation will provide entitlements and treatment.....pharmaceuticals are part of the treatment and cannot be prescribed by other than a duly qualified medical practitioner......how can they be questioned and or withheld from supply by someone who is "other than" a medical practitioner?

Gloria.

Gloria.
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#55 User is offline   Alan Thomas 

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Posted 05 September 2007 - 12:50 PM

Gloria you are exactly on point
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#56 User is offline   Medwyn 

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Posted 05 September 2007 - 01:21 PM

Now we seem to have some consensus on this issue, that it is the Policy and on that I agree, how do we find the resources or the means to change that policy?

Primarily, how do we get ACC to listen to us, let alone talk to us?

Can our COG's people bring this issue into the arena?

Has ACClaim groups got any clout in this area?

To whom do we address this problem area, I submit that individual actions may harm tthe process where as a joint united effort may see a change.

Where to from here?

I seem to be asking a lot without offering any ideas but I'm lost for answers.
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#57 User is offline   Medwyn 

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Posted 05 September 2007 - 01:44 PM

View PostSpacecadet, on Sep 5 2007, 10:00 AM, said:

Medwyn
We are all different.
We are all attempting to progress our claim for our rights under the ACC system, each in our own way.
Some of us are being sucessfull and making progress.
Some are not.
I leave it up to you to judge for yourself which methods work, which dont.
The good thing about the forum is that it has diverse views and diverse approaches to addressing the issues.
This all adds to our basket of knowledge allowing the individual to make informed decisions, be they good or bad.

Oops,

I should have seen this one Spacecadet as it answers a lot of questions. ACC have a long memory and notes which record activity between themselves and the claimants, and you can be sure if you should prove to be a "stirrer etc." yes they will take their time checking, checking and even delaying, until they are sure of what they are up to and leaving no grounds for review or appeal, and I believe like any big corporation private or quasi-government, there are staff who know ways to delay, loose documents for months in the paper trail etc, or bury the document at the bottom of the stack hoping the file auditors never get to see it.
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#58 User is offline   Alan Thomas 

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Posted 05 September 2007 - 02:13 PM

Medwyn there is no consensus as suggested in your comment.

Now we seem to have some consensus on this issue, that it is the Policy and on that I agree, how do we find the resources or the means to change that policy?

What we are wanting is the ACC to a legislation to fund the prescribed treatment and comply with the treatment providers directions.

Legislation does not permit the ACC to have "policy" end of story.

The ACC have on policy is something that is a constructed to defy legislation and liability.

Why on earth do you think this site exists if it is not to bring ACC back in line with legislation.

Part 5 of the Act exists to control the ACC.
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#59 User is offline   doppelganger 

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Posted 05 September 2007 - 02:14 PM

View PostMedwyn, on Sep 5 2007, 01:21 PM, said:

Now we seem to have some consensus on this issue, that it is the Policy and on that I agree, how do we find the resources or the means to change that policy?

Primarily, how do we get ACC to listen to us, let alone talk to us?

Can our COG's people bring this issue into the arena?

Has ACClaim groups got any clout in this area?

To whom do we address this problem area, I submit that individual actions may harm tthe process where as a joint united effort may see a change.

Where to from here?

I seem to be asking a lot without offering any ideas but I'm lost for answers.


Try addressing this to Allan as he has the answer
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#60 User is offline   Medwyn 

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Posted 05 September 2007 - 03:17 PM

View PostAlan Thomas, on Sep 5 2007, 02:13 PM, said:

Medwyn there is no consensus as suggested in your comment.

Now we seem to have some consensus on this issue, that it is the Policy and on that I agree, how do we find the resources or the means to change that policy?

What we are wanting is the ACC to a legislation to fund the prescribed treatment and comply with the treatment providers directions.

Legislation does not permit the ACC to have "policy" end of story.

The ACC have on policy is something that is a constructed to defy legislation and liability.

Why on earth do you think this site exists if it is not to bring ACC back in line with legislation.

Part 5 of the Act exists to control the ACC.

Alan,
Dont get so rude, why do you think people won't post because of your arogance and abruptness and way of running roughshod over all and sundry.

What I was saying there is now.consensus between Gloria, Spacecadet and my thinking. But again I ask the question that's been asked before, "Where are the magical words in the Act that says ACC must provide what your paid specialist demands" could someone who has or knows the Acts please paste and settle this issue once and for all as this is an important thing. as the Policy seems to me to be dictated by the Act itself and not someone's wish list.
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