Injured Kiwis left to 'fall off the cliff' as approval of ACC claims becomes harder

A Wellington lawyer is worried it's becoming harder to get ACC claims approved.

Hazel Armstrong, who has represented ACC claimants for nearly 30 years, told Morning Report the requirements to get compensation and treatment costs paid were already tough.

She said GPs were facing increasing pressure and had less time to help their patients meet the increasingly rigourous requirements.

It follows comments by general practitioner Dr Rachelle Pound last week who said a recent request by ACC for decades worth of patient notes was taking up valuable appointment time.

"We've had a request come in for 40 years of mental health notes for a patient in their 40s. That means 40 years of notes will need to be read through, redacted, all the relevant information removed and then sent back through to ACC."

Pound said it left more questions as to what was happening to their information at the other end.

Armstrong told Morning Report complex claims like those for mental injury and work-related gradual injury were particularly difficult to prove, especially without fulsome GP notes.

While she agreed with Pound's perspective on the problem, she said claimants were squeezed, too.

"ACC is a big machine and in my view, it's getting tougher and tougher for claimants to get claims accepted - particularly if they're complex claims, which is what the GP that you interviewed is suggesting - it would've been a sensitive claim, probably, or a mental injury claim that's complex and those claims and work-related graduate process claims are very difficult to prove and the GP doesn't have the time to back their patient now.

"In the past, you could form quite good relationships with your GP and they would back you, but now they're under pressure and they don't."

Armstrong claimed ACC was very political and used rejecting people's claims as a way to cost costs.

She claimed they "don't care" what happens to the injured person once they are out of the scheme and lets them "fall off the cliff".

The injured person is "up against it" and most don't have representation and don't know what to do, she said.

ACC declined to speak on Morning Report on Tuesday. However, in a statement, ACC head of service operations Phil Riley said ACC's focus is on helping injured New Zealanders get the right support at the right time so they can return to work and independence.

"We are strengthening how we commission services and work with the health sector so people can access effective rehabilitation sooner," he said.

Riley said ACC is an entitlement-based scheme established in law and that they "do not delay individual entitlement decisions to manage budgets, and entitlements are not subject to funding caps, targets or annual quotas".

Decisions are based on a client's covered injury, individual circumstances and the Accident Compensation Act 2001, he said.

"Ninety-nine percent of new claims were accepted, with 65 percent accepted within one minute and 88 percent accepted within 24 hours."

In a statement on Friday, the Royal NZ College of GPs said it had raised concerns on multiple occasions about the time demands being placed on GPs.

"ACC has given assurance that they are working to improve the process with regards to requests such as these. GPs are encouraged to advise ACC and get sign-off for payment to be authorised beforehand for work that will take the GP more than an hour to complete."

On Friday, ACC also said in a statement: "Access to relevant medical information is an important part of making timely and appropriate decisions about a client's cover and entitlements.

"We know the GP workforce is under pressure, and we acknowledge it can take time to collate these notes, especially when a client has a complex injury or is seeking backdated support. We are conscious of only asking for information that is required to make these decisions and the level of information required will depend on an individual client's circumstances, including the nature and complexity of their claim. ACC does fund GPs for the time it takes them to provide us with medical notes."

ACC said it has been working to improve its processes to ensure it only requests the information it needs.

"However, we know there is more to do, and we are currently undertaking an information-gathering exercise via the Government Tender Service (GETS) to better understand how the medical notes service could be provided in the future. This includes exploring how information can be shared as efficiently as possible and with minimal disruption to clinical workflows."