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Acc To Dentists - Grass Your Patients Up Or Go Down With Them From "ACC News" - March 2007

#1 User is offline   MG 

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Posted 03 October 2007 - 12:48 PM

Raising Concerns about the Cause of Dental Damage
A reminder to dental providers to tick the ‘ACC should call me?’ box on the Dental Injury Claim Form (ACC42) if you have any concerns about the
authenticity of a patient’s account of the cause of damage.
The box is in the lower right-hand corner of ‘Part E: Referral and Assistance’.
By ticking the box and discussing your concerns with ACC, you can allay any fears that you may be implicated should the claim turn out to be fraudulent.

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#2 User is offline   Gloria Mitchell 

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Posted 03 October 2007 - 01:38 PM

[quote name='MG' date='Oct 3 2007, 01:48 PM' post='52884']
Raising Concerns about the Cause of Dental Damage
A reminder to dental providers to tick the ‘ACC should call me?’ box on the Dental Injury Claim Form (ACC42) if you have any concerns about the
authenticity of a patient’s account of the cause of damage.
The box is in the lower right-hand corner of ‘Part E: Referral and Assistance’.
By ticking the box and discussing your concerns with ACC, you can allay any fears that you may be implicated should the claim turn out to be fraudulent.

[/quote

Jesus wept.

They think to pin down and steer the highest paid professionals with this threat? Good luck to them!

Nice try is all I can say.

Gloria.
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#3 User is offline   tonyj 

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Posted 03 October 2007 - 05:21 PM

MG,
I can see and appreciate your concerns ,my initial reaction was a rise in blood pressure ..

But.

I am starting to cultivate a different view of late as well. With so many outcomes for long term claimants being dictated by evidential medicine and criteria expectations from external resources , it means for every fraud the odds are a genuine claimant may miss out.

I believe there is more fraud happening that is not being identified than is supposed ( and i don't mean just by claimants) .I likely get to see, hear about some form of fraud more often than I see claimants who have been wrongly treated ..
Now when i see someone going through all the traumas and stress of mishandling by ACC , over the top investigation and the full force of ACC's legal clobbering machine..

I wonder if less people were able to milk the system , more INTELLIGENT checks and balances were in place would this mean more who deserve but not getting help would get it.

tony
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#4 User is offline   MG 

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Posted 03 October 2007 - 05:43 PM

Tony - with respect, I think you take an unduly benign view of ACC's machinations. So-called "evidential" medicine is, in fact, highly partisan and heavily influenced by the economic interests of the rich and powerful. A good example is the Fourth edition of the AMA Guides to the Evaluation of Permanent Impairment, which are a major departure from the Second edition. Academic commentators in the US and Australia have written that the reason for the changes between the two editions was pressure of varying sorts from the insurance and health management lobbies, together with major employers. The result, in spite of the caution in the introduction to the Fourth edition that it should not be used to make direct awards of financial compensation to impaired people, is that ACC and insurers go right ahead and do just that, to the resulting detriment of many of the people you and I represent. ACC attempts to weasel out of this, blatant abuse of medical evidence, by trumpeting that its "handbook" provides the necessary corrective filter to any injustice that might result from the application of the Fourth edition on its own. In fact, the Handbook provides further scope to enable ACC to restrict the amount of compensation it provides to impaired citizens. There are many other examples, and I could go on, but I think readers get my point?
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#5 User is offline   fairgo 

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Posted 03 October 2007 - 06:01 PM

I believe ACC refuse to upgrade to the more recent edition - AMA V as it would not be in their financial 'interest' to do so. Pretty sad reflection really.
As for the veiled threats made by ACC in your initial posting..... I think their "out of step culture" is showing itself. *sigh*
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#6 User is offline   MG 

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Posted 03 October 2007 - 06:30 PM

"Isolated incidents", Fairgo, nothing more. All pigs fuelled and ready to fly. I see another effort by ACC to divide and rule health providers - chiropractors, I think. The favoured ones to be offered "individual" contracts, while the "outlaws/outliers" to be hounded by the Gestapo in the time-honoured manner. Perhaps COGs could when the treatment begins for the GPs?
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#7 User is offline   doppelganger 

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Posted 03 October 2007 - 07:15 PM

MG agree that you are more likely correct than not.

COG's probably won't do any thing as I think that it is out of there are until it is too late.

Hittler and his army (and think that there may be some new members to join up to the others) can not deal with claimants but claimants need the Doctors to speek out so that we know who they are attacking.

I think that ACC army will be defeated quicker than the last lot.
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#8 User is offline   tonyj 

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Posted 03 October 2007 - 10:12 PM

View PostMG, on Oct 3 2007, 06:43 PM, said:

Tony - with respect, I think you take an unduly benign view of ACC's machinations. So-called "evidential" medicine is, in fact, highly partisan and heavily influenced by the economic interests of the rich and powerful. A good example is the Fourth edition of the AMA Guides to the Evaluation of Permanent Impairment, which are a major departure from the Second edition. Academic commentators in the US and Australia have written that the reason for the changes between the two editions was pressure of varying sorts from the insurance and health management lobbies, together with major employers. The result, in spite of the caution in the introduction to the Fourth edition that it should not be used to make direct awards of financial compensation to impaired people, is that ACC and insurers go right ahead and do just that, to the resulting detriment of many of the people you and I represent. ACC attempts to weasel out of this, blatant abuse of medical evidence, by trumpeting that its "handbook" provides the necessary corrective filter to any injustice that might result from the application of the Fourth edition on its own. In fact, the Handbook provides further scope to enable ACC to restrict the amount of compensation it provides to impaired citizens. There are many other examples, and I could go on, but I think readers get my point?



Firstly I hope you realize my reference to rise in blood pressure was directed at ACC not you ..?

I fully agree with your take and trust me I sure don't feel benign about it , I felt you expressed my expanded view of the repercussions of evidential medicine and the like .Although i expect i feel stronger than you as to the effects fraud has on the finance pool available to those who need it most as well may cause ACC to have more collateral damage and capture more innocents due to excessive aggression in pursuing fraud expectations and getting it wrong..??

tony
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#9 User is offline   flowers 

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Posted 04 October 2007 - 10:12 AM

And who is the major stakeholder?
Perhaps a complaint about restrictive trade practicesa?
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#10 User is offline   MG 

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Posted 04 October 2007 - 12:27 PM

Tony - I know you weren't criticising me and, like you, I abhor fraud whenever and however it occurs. However and IMHO, ACC grossly exaggerates the extent of claimant fraud as a deliberate tactic to (a) enlist public support for its oppression of claimants and (B) to gaslight claimants into giving up their entitlements. This tactic is precisely that used by US insurers, including our good friends at UNUM, with which ACC had an investment and commercial relationship a few years ago. While on the topic of fraud, and again IMHO, ACC cannot claim the moral high ground. One of its chief executive was sentenced to a term of imprisonment for some of his crimes, while his successor narrowly escaped the same fate after being investigated by the serious fraud office. Many of today's senior ACC officials were employed by it during those dark days and, again IMHO, have never fully accounted to the people for their activities.
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#11 User is offline   Tomcat 

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Posted 04 October 2007 - 01:13 PM

Greetings,

"One of its chief executive was sentenced to a term of imprisonment for some of his crimes, while his successor narrowly escaped the same fate after being investigated by the serious fraud office. Many of today's senior ACC officials were employed by it during those dark days and, again IMHO, have never fully accounted to the people for their activities."

SO TRUE MG... Another up this way got done, while others "Escaped"... ;)
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#12 User is offline   tonyj 

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Posted 04 October 2007 - 05:16 PM

MG,

My concerns re fraud were not restricted to claimants .
"I believe there is more fraud happening that is not being identified than is supposed ( and i don't mean just by claimants) "

but I do fear it is the claimant fraud that drives the culture that tends to entrap innocent people .
I think its just one of many factors if managed more effectively would avoid many of the problems out there .

tony
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#13 User is offline   hukildaspida 

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Posted 18 November 2014 - 03:44 PM

Telling them the truth that one has had damaged teeth as a result of eating into bread made no difference in this claim.

http://acc.co.nz have never paid out for assistance when people have eaten into what a reasonable person may consider to be "foreign object" in there food.

We are aware of food suppliers that have been quite shocked about this, things to be careful of eating including sprouts as they often have ones that have not ripened in the packet.

Nothing worse than losing a tooth after having had them all your life in such a manner.


The root of the problem?
KIM KNIGHT
Last updated 05:00 16/11/2014

http://www.stuff.co....-of-the-problem

MAARTEN HOLL

RAISE A TOAST: Edwin Mares checks out another potentially dangerous slice of jam and toast.


Edwin Mares knew the drill. He stood in court and told the tooth, the whole tooth - but it wasn't enough to win.

The Wellington philosophy professor is conceding defeat after losing a second appeal on an ACC decision to deny payment for a $5000 dental repair job.

What really bites? The lawyer who beat him was a former student.

"I did use all the argumentative strategies I could come up with," said Mares. "But apparently a former student remembered what I taught him."

It all started at breakfast, back in October 2010. Vogel's toasted bread (sandwich cut, original grain) and strawberry jam. Mares bit into something hard - a seed, he assumed at the time - and cracked a tooth to the root.

His split premolar was removed, a metal pin inserted, a porcelain replacement installed and reparation sought. Enter the Accident Compensation Act, and the section that specifies there can be no cover for "personal injury to teeth or dentures caused by the natural use of those teeth or dentures".

"Biting while eating," said Rob Cahn, solicitor for ACC, "is the most obvious example of a natural use of teeth."

Mares would not be brushed off. The Victoria University lecturer's specialty is logic and the philosophy of logic. There was no relevant difference, he argued, between a biting injury and falling and cracking his teeth on a pavement. There was nothing natural, he said, about splitting a tooth in two while eating toast.

He lost an initial review, and on Wednesday, discovered a district court judge had dismissed a second appeal.

"I wasn't just trying it on," Mares told the Sunday Star-Times. "I thought I had a real case. I do think the tooth exclusion clause in the ACC legislation is ambiguous. I had a very different reading of it than the ACC's lawyer and, eventually, the judge. A lot of people might look at our argument as just an argument over words, but it is important to determine in which cases our legislation applies."

Philosophical training, he said, "can help sharpen the skills that we must use to reason about this".

Mares said lawyers had previously told him they had found the study of philosophy useful to their profession. "I've always been so proud of that in the past - this time, I was a little bit disgruntled." The experience had not put him off Vogel's, though post-appeal, said Mares, he had been biting more carefully.

Last year, ACC received 14,417 claims relating to eating, drinking and the preparation of food. The top 10 culprits, in no particular order, were meat, vegetables, noodles, cooking oil, boiling water, coffee, tea, hot chips, fish and chicken.

View PostMG, on 03 October 2007 - 12:48 PM, said:

Raising Concerns about the Cause of Dental Damage
A reminder to dental providers to tick the �ACC should call me?� box on the Dental Injury Claim Form (ACC42) if you have any concerns about the
authenticity of a patient�s account of the cause of damage.
The box is in the lower right-hand corner of �Part E: Referral and Assistance�.
By ticking the box and discussing your concerns with ACC, you can allay any fears that you may be implicated should the claim turn out to be fraudulent.


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