December 2009

Welfare and Pensions Column

ACC AND HOW IT AFFECTS YOU

RNZRSA was asked to join a consultative group chaired by Liz Baxendine the Age Concern New Zealand President on how to ensure that, in particular, older people could obtain the help and services they need from ACC. The group also includes staff members from ACC and representatives from Maori, Pacific and Indian community groups and a Medical Adviser from Dunedin, who will be known to many of our veterans as that is Brian McMahon.

We are looking at some of the barriers that people have for not making ACC claims and it seems to me that some of them are just as valid for younger people as well as older. Having said that it is evident that those people over pension age are less likely to make claims, or if they have made a claim for a particular injury then obtaining the help that is needed because they are not asked the right questions when speaking to call centre staff. How many of us when asked “How are you?” are going to give a litany of all our hurts and the things that we can’t do because of our injury? We say we’re “fine thank you” and don’t say that we can’t make a meal because our arm is in plaster, or can’t even get dressed properly. The help is there and we can be assessed for our needs so long as ACC knows that we need help in relation to an accepted injury.

The information below has been taken from the Age Concern New Zealand website, and for that I thank them. However, much of the information has come from our discussions at the meetings with ACC.

Please note - your comprehensive injury cover through ACC doesn’t stop just because you've reached 65.

ACC can pay for treatment, rehabilitation and equipment, transport, home help, dentistry, clothes and prostheses damaged in an accident, and can compensate you for 80% of lost income if you can't return to work (but see below).

Accidents can include some medical treatment failures, occupational diseases, and lifelong accident-related conditions, no matter who was at fault, or if you contributed to your accident.

However, older people face extra barriers to getting the rehabilitation, treatment and compensation they’re entitled to.

Problems for older people

ACC statistics indicate that older people are not making full use of the scheme. This may be due to a lack of understanding that they're covered. It could equally be the result of not being asked the right questions by ACC contact centres. More needs to be done to ensure that barriers to access to the scheme are identified and removed.

When they do access the scheme, older people are not always offered the social rehabilitation and treatment provided for in ACC legislation.

Older people who have a legitimate case for cover are sometimes being declined support. Sections of the Act which exclude personal injury 'caused wholly or substantially by the ageing process' are used to limit rehabilitation.

We know of older people who are not receiving adequate rehabilitation after a personal injury and therefore end up in residential care.

We've also identified a lack of home-based support, a lack of communication between ACC and providers and inadequate monitoring of providers; removal of care packages with very little warning; older people having difficulty dealing with the paperwork and difficulty getting the information they need from their case manager.

Weekly compensation

Claimants aged over 65 and before their 66th birthday may have to choose either to receive weekly earnings-based compensation form ACC or to receive National Superannuation payments. Those over 66 years of age do not have any choice; they will not receive any ongoing earnings based compensation from ACC for any earnings that they may have had over the New Zealand Superannuation.

Both RNZRSA and Age Concern say this is wrong – people who continue work and receive an income after reaching the Super qualification age aren't asked to choose between that income and New Zealand Superannuation. Why then should a person who is entitled to weekly compensation - a payment made in lieu of income - be penalised by having to make that choice, or receiving no earnings based compensation at all?

6 key messages that you need have about ACC

1. Once ACC accepts an injury claim, they will help you with your recovery. If you have problems later on that are linked to the earlier injury, ACC may be able to help with further treatment, as long as the problem isn’t the result of ageing or some other medical condition.

2. Make sure you get a copy of the ACC Claim Form from the medical staff member who treated you. This is the form where the medical professional describes what you were treated for and you describe how the injury occured.

3. Keep copies of all your correspondence with ACC and your medical records – this makes it easy to prove that your injury was covered.

4. You have the right to be discharged from hospital safely. Your DHB must have an effective discharge plan, a discharge letter for your GP, and the support you need in place. You can ask to see this information before you are discharged.

5. ACC has a process for resolving issues if you are unhappy with something they have done or a decision they have made. Talking to the person you have been dealing with, or their manager usually works to resolve issues. They can also tell you what other options are available.

6. If you need help with an injury, ring ACC on 0800 101 996.

Getting help to put your case

You can authorise other people, such as a family member or your doctor, to work with ACC on your behalf.

An advocate is a person who works for a community organisation outside ACC. You can get help from these people to speak to ACC on your behalf. They will have good knowledge of the area that you are having trouble with in your dealings with ACC.

Talk to your local Age Concern about suitable advocacy groups. Commercial paralegal advocates are also available. Some RSA Pensions & Welfare Officers will be able to assist you or point you in the right direction.

Comment

All of us in the group believe it is unacceptable that older people who have suffered a personal injury should be forced to fight to obtain the care to which they are entitled.

ACC at its best is an enlightened scheme – but it does not serve older people as well as it serves other groups. RNZRSA looks forward to working with Age Concern New Zealand, other community groups and ACC to effect change for the better.

Hearing Loss under ACC

Many ex-Service people who have served since 1 April 1974 and who are not able to obtain assistance for noise induced hearing loss under the War Pensions Act can, and do receive assistance through ACC for this health problem. There is a Bill going through Parliament to amend the ACC legislation and one of the new sections is to limit cover for hearing loss due to personal injury by stating that a person must have at least 6% binaural hearing loss before any assistance is provided. ACC cannot cover hearing loss due to age, or that is congenital (from birth) or caused by illness. That will meant that a number of people who have low level hearing loss due to noise or other injury will not be able to obtain help with hearing aids or other essential equipment. Even if your overall hearing loss is greater than 6%, ACC will only be able consider that portion that has been caused by personal injury, should this amendment go through.

RNZRSA has made a submission to the Parliamentary Select Committee to seek changes in this amending Bill, and particularly to this section returned to all hearing loss due to personal injury, noting that many ex-Service people have hearing loss due to firing weapons of all calibres or being too close to Thunderflashes. Those who have accepted war and emergency service under the War Pensions Act will still be able to go down that avenue if the hearing loss is due to that service.

Merry Christmas and a Happy New Year

Elise and I wish you all the joys of the season and hope that the summer gods look favourably on all of you and your families. We look forward to hearing from many of you in the New Year and to helping you with any little problem you might have.