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ACC cuts off payments to victim of dolphin accident

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Kelly Lawson has had to learn to walk again after a dolphin leapt onto her boat, crushing her

Kelly Lawson has had to learn to walk again after a dolphin leapt onto her boat, crushing her

video
Wed, 18 Nov 2009 7:11p.m.
It was one of the strangest accidents New Zealand has seen in many years; Kelly Lawson was in a boat when a dolphin, thought to weigh 300kg, jumped onto it.

Taken completely by surprise, Kelly was seriously injured by the flying, heavy weight.

A coma and numerous internal injuries later, she had to learn to walk again. A long, slow, painful recovery followed – aided of course, by ACC.

After all – is there a more clear cut example of an accident than a dolphin jumping on top of you? Isn’t that was ACC is for?

Apparently, not any more.

ACC denied an extension to Kelly’s physio funding in April, saying it was time to investigate why she still needed more treatment.

“I think after 56 sessions where we’re not seeing an appreciable gain we have to ask those questions,” says Phil Murch of ACC. “It’s not about ceasing funding, it’s about making sure that the funding we have for her is appropriate.”

Kelly says the funding refusal came as a shock.

“I was under the impression that as long as I needed the care, ACC would cover the cost,” she says.

“I’m a unique case in the sense that it’s going to be long term. It’s an ongoing treatment.”

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Comments [36]

Celia
20 Feb 2010 12:52a.m.

It is wrong that people should not have the medical treatment they need. I would also like to point out that dolphin watching and (more likely) swimming with dolphins is not without risk to humans, as well as risks to dolphins. I would like to see an end to all swimming-with-dolphins programs. They are dangerous to both species and claims of healing are quite unproven.

kate
19 Jan 2010 4:37a.m.

Over 25 months with ACC I have been declined twice, reinstated twice and had one 1 hour physico assestment in regards to treatment.

I have been basically black mailed twice with offers of accept x amount of weeks eg 4 weeks and then you may never claim for this injury again.

I have a paper trail almost 2 rheems worth of emails/correspondence etc, and it is disgusting what has transpired over this period.

I was initially told I had defrauded ACC as I didn't disclose on my ACC form that I had a prior name. This name was my maidan name before I was married. I was told by my case manager at the time "I had defruaded ACC as when you change your name you need to advise them, otherwise you are defraudung".

Medical Advisor has basically falsed reports and put in information without medical back up to allow ACC to justify taking me off their books.

All I have ever wanted is treatment. I was told at the very beginning 2-3 months of physio. Now I'm told my disk needs to be fused.

Well done ACC.

My family have suffered, I have almost lost my marriage, my young kids have missed out on over 2 years of a mother not pain, or able to do things with them.

ACC have robbed my family and stole 2 years of my life.

There appears to be no common sense. And boy can the staff hide when needed. They are coverd left right and centre, and even though th client must be upfront, ACC leave everything till the last so as the client is taken by surprise and is ill prepared to fight back.

It sucks. It is about time this orgnisation was exposed for what it really is. Sad thing is I believe I have the evidence to do this, but how?

Someone needs to stand up to this big bully.... I have already lost so much, I in a lit of ways feel I have nothing left to lose. And that's sad.

Reece
15 Dec 2009 3:50p.m.

ACC sent me a letter saying that statistics show that I should be better by now, and that they wore denying me my pain relief medication! "I think there should be a Royal commission set up to investigate ACC!"

Lower Hutt
23 Nov 2009 9:52p.m.

I am sorry Kelly that you have had to deal with ACC in these times when Nationals drive is to cheat on the care that is provided.

ACC is now nothing like it used to be, having to deal with ACC this week has shown me how underhanded their process has become.

I asked ACC why the were reaccessing me, they spun me a line of crap. told me they had certain questions they wanted the psychiatrist to answer.

The psychiatrist it turns out is one of the ones responsible for the new guidelines ACC uses, he was a part of the research team acc funded.

The questions were.

A) at what age would you estimate that physical abuse and neglect started with this patient.

B) Provide a list of any medical or organic problems that may have psychiatric symptoms.

C) Would it be true that in the Absence of sexual abuse, that this client would have suffered abuse that would have led to this diagnosis.

I sent them nuerologists reports stating that these injuries were a result of sexual and physical abuse.

Sent them welfare records showing that the abuse started at 6 weeks old and continued until I was 14.

Provided them with a list of conditions caused by abuse as diagnosed by more than one specialist.

I told them that I had answered all these questions with adequate documentation in the form of hundreds of welfare/hospital documents.

And said to them, look I have answered these questions many times before.

This isnt about the questions, they want to apply the new CSM-IV mental health criteria to see whether they can get out of having to provide treatment.

ACC has become a department which has no feeling and under Nick Smiths new guidelines it sets out to revictise survivors.

There is nothing fair about the system anymore, and no, none of these doctors even have a clue of what it is like to live a life like ours, their experience comes from a text book.

And for those that dont fit into their standards they just get cast aside.

Acc has no morality.

Kelly Lawson
23 Nov 2009 5:46p.m.

Something I would like to make clear to people like Ty is; the reason I move as well as I do (as seen in the story) is beacuse of the work I do in the gym and the physio treatment I receive. Only our close family and friends see me in pain and grumpy at the end of each day after being at the gym at 5.30am, going to work all day then either heading back to the gym or seeing Kev (my physio) for treatment. In addition I have to go to the gym on the weekends to do my physio rehab i.e I don't get a day off and I never will.
As far as starting a family goes, my life has changed enough as it is as a result of the accident. Why should I miss out on the joys of having a family with my husband on top of everything else I have and will miss out on?
I appreciate your opinion but as someone else has mentioned you truly do not understand (nor will you ever)how much commitment and hard work is involved for me to be as physically well as I am to date.
I just want to continue working full time and in order to do so I need to continue receiving the physio treatment.

Lower Hutt
22 Nov 2009 12:42p.m.

Perhaps the right to sue should be reinstated?, you cant change a system that was said to be a replacement for our right to sue and hack it to pieces without reinstating what was available before that.

Take away medical misadventure claims from ACC to make the ACC system more viable and make doctors buy malpractice insurance instead.
It will at least go a long way to making mecical practitioners in NZ more accountable and fixing a system where bad doctors are the majority rather than the minority.

Where government negligence exists, as it does in my case, we also need to open up government departments to law suits not just for exemplary damages as it is now but ordinary damages and damages for pain and suffering.

National cant change what was promised to NZ as a comprehensive system in exchange for giving up the right to sue without forfeiting their own protection when they break that promise.

There are many ways to make ACC more financially viable I guess, but picking on only certain subgroups is descrimination.

And ACC claims in all of its downloadable documentation that it provides full cover to victims of accidents until full rehabilitation to pre-trauma state occurs.

Treating the acute phase only means that they are cheating, pre trauma state means back to the way you were unless national has chosen to blur that line too.

I guess the question then becomes is Kelly Lawson back to her full pre-trauma state? both mentally and physically.

The reality is that the system has now become such that it isnt what was promised in the 70's, if ACC is now only going to affect partial recoveries and treat the acute phase of injury then the only thing left is to reinstitute the legal processes that allows victims of accidents and crimes to seek the further redress they need to complete their own full recovery or compensation for what they have permanently lost is full recovery can not be gained.

SBA
21 Nov 2009 9:17p.m.

Just to clarify.
I am not a doctor, I am not an accountant, just someone who knows both sides of the situation and is a health professional.

I refer to ACC not the wider heath system.

I have studied the NZ and American system and this is what I refer to earlier, not the Dr's themselves which is a differnt debate.

Lower Hut; I agree that there are inequalities.

Without ACC's presence there would be far greater repercussions of law suits, blame and metal anguish before the care of rehab was even compensated to the affected person.
Imagine taking the person to court who hit your car, (or the dolphin) to get compensation; or alternatively the massive cost of Personal insurance which would be necessary not optional like in America.

This forum is related to 'ACC declining compensation' for this Lady who I give massive credit for overcomeing the challenges of her injury.

SBA

cynical
21 Nov 2009 11:11a.m.

It is because AAC is running out of money - lawyers for criminals ensure that they get the best of the best, atificial legs, funeral costs, survivor grants (even though the survivor is also a criminal, and obtained proceeds from that). Sorry, no money left for law abiding citizens. We pay for ourselves AND the criminals, and then are made to pay all over again. That is how the legal system works. It is fair, it is made legal by the lawyers. You want come back - go and see the same lawyers who arrange the pay-outs.

David
21 Nov 2009 8:55a.m.

SBA lets make a comparison of New Zealand doctors and American doctors.

American doctors are sponsored by drug companies to promote their products, they receive gifts for attending drug company seminars.

NZ doctors, exactly the same scenario.

I went into my doctors office a week ago, his stationary was all drug company logo'd as was the coffee mug and the pens.

He had a drawer full of free samples.

Mt Sinai, the Mayo clinic, Johns Hopkins have better qualified doctors than any here.
They are better equiped with more modern diagnostic materials such as PET scans etc.

Some areas of NZ are chronically short of General Practitioners, in both rural and city sectors.
Some areas of New Zealand are not covered by hospitals as most of the rural hospitals have been shut down in the last 20 years.

For you to make the statement that we would end up like america? lol we are worse than them in many respects.
The quality of our doctors is dubious at best.

With so many stories of medical professionals stuffing up, New Zealanders arent silly enough to even believe that our system comes close in quality.

What you are referring to in reference to the american system is covergae not quality.
Because doctors there are far better trained in a wider range of disciplines.

Shall we go through the list of doctors that have been struck off in other countries only to end up working in the New Zealand system?.

Doctors like the one in invercargill that treat patients even after being suspended?.

New Zealand has one of the worst health systems in the world, its not something New Zealanders arent already aware of.

Remember Herceptin? or the aids drug combo where Pharmac only paid for one of the combo?
The breast cancer scandal?

Doctors here have no clue about traumatic injuries, they treat symptomatically which means it takes forever for them to go looking for a cause they try to just medicate the symptoms.

Lower Hutt
21 Nov 2009 12:13a.m.

My apologies SBA, you werent the earlier poster but your appraoch was very much the same.

For your information though I dont get care from ACC for my physical injuries and never have, ACC wont recognise them even though I have letters from multiple doctors within the system like neurologists saying that they are caused by repeated assaults.. apparently its a loophole in the system that if you are physically or sexually abused you only get help with mental injuries not physical ones.

So I havent had a lump sum, I dont get weekly income payments and I have received no treatment from ACC.

But the patients that ACC treat are allowed to be treated with dignity and respect and without prejudice, even if that prejudice solely and purely financially based.

Now they either dont care, or care to a budget.

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