ACC – An Example of What is Going Wrong

By Michael Edmonds 18/07/2012 7


About three months ago I injured my knee working out at a different gym to the one I usually go to. I had tried out the new gyms leg press machine not realising that the weight settings were different and and at the top of the first press I felt a twinge in my right knee. Although I stopped the exercise, by the next day my knee was quite painful so when I got the chance I went to the physiotherapist and claimed ACC on the treatment. I thought I had quite clearly explained that it was an accident, but a few weeks later I received a letter with ACC rejecting my claim. They had decided because I regularly go to the gym, that it was a progressive injury therefore not an accident.

I appealed the decision, but today got the paperwork with them rejecting the appeal. It now goes to an independent reviewer. I now have to spend more time getting together documentation, to make what I think is an obvious case more obvious.

Although I work out regularly the injury was on a piece of equipment I wasn’t familiar with, and on the first press. To me that is obviously an accident.

For all the paperwork, the time that I spend on this and ACC staff spend on it, the amount of money involved is around $140. I could just give up, and I suspect that is what they would like. But for me this is a matter of principle. It seems to me they are trying every excuse to indicate it was not an accident and that perhaps I am not being completely honest. That annoys me. I wonder who else they are trying this with? If someone goes out for a walk and trips over, do they consider it a progressive injury because that person regularly go for walks? I hope not.

 

 


7 Responses to “ACC – An Example of What is Going Wrong”

  • Oh come on Michael, with all due sympathy for your injury this is no accident as most of us would define it, it’s an interaction of your physiology with an unexpected load. If I overload my metabolic physiology with too much sugar, could I claim ACC for the resulting obesity and diabetes? I yield to no-one in my admiration for Mr Justice Woodhouse and his no-fault compensation scheme, one of the (few remaining) jewels of New Zealand’s enlightened social legislation, but this is a particularly egregious example of why ACC has become a political football.

    • Alan, what an excellent definition of an accident – ” an interaction of ones physiology with an unexpected load” I must remember that one. Granted I should have looked a bit more carefully at the equipment, but the same argument could be made of someone who rips over and injures themselves – perhaps they should have looked more carefully at where they were walking?

      Note that ACC is challenging my application because in their opinion it is a progressive injury when given the circumstances it is not.

  • Welcome to the ACC culture of avoid blame. I previously worked in the customer services side for a large health insurer, and we had a case where a guy lost his footing on the edge of a small cliff, and grabbed a tree to stop himself falling, ripping his shoulder ligaments. ACC claimed it was ‘pre exisiting’…

    And Alan, that is a sporting injury just like any other under ACC. I play ice hockey and tripped jumping over the boards a few months back, ripping ligaments in my thumb. I landed directly on my thumb – you could argume that that is an overload of my physiology with an unexpected load (in this case, my body weight + the additional force from the 6 foot fall).

  • I’d go one step further than Alan “An unforseeable interaction…”

    A person’s failure to reasonably familiarise themselves with a piece of equipment, a location, or a process before placing themselves on precludes the event from being an accident. Any injury is an entirely foreseeable outcome and so by definition not accidental. It may not have been intended, but thats a different thing…

  • “Any injury is an entirely foreseeable outcome”

    Ashton, is this what you meant to say? “Any injury”??

    Anyway, the ACC is turning down the application by claiming it is a progressive injury. That is not supported by the evidence.

  • Oh dear. The $140 is equal to say 3-4 hours of your time. How many hours do you propose to spend chasing this issue, and what productive things could you be doing instead?

  • After waiting almost 4 months for a disputes tribunal meeting with ACC, the evening before the meeting ACC rang me, asked me two more questions then overturned their decision and they will now cover my knee injury costs.