16 May 2016
Lee M
[FYI request #3857 email]
Dear Lee M
Official Information Act Request
Thank you for your email of 5 April 2016 to Hon Nikki Kaye, Minister for ACC, asking
for the following information under the Official Information Act 1982 (the Act):
Question 1
“In a letter written by Gabby Boag (then) Senior Advisor, ACC
Government Services to a Mr Anthony Jordan (using this FYI website)
dated 28 2014, it was stated that; “…ACC has developed best practice
case management principles around the use of medical assessments.”
I requested a copy of the ACC’s “best practice case management
principles around the use of medical assessments” in a letter dated 22
January 2015.
(…) I was not provided with the “best practice case management
principles around the use of medical assessments” information I had
specifically requested, and as so clearly described by Gabby Boag.
Instead, I was provided me with copies od two internal policy documents
that are unrelated to “the use of medical assessments” and which are
titled “Principles of client centric services” and “Principles of effective
three point contact”.
It is not possible that the ACC does not have the information that Gabby
Boag referred to as abovementioned and I am again requesting that I be
provided with a copy of the ACC’s “best practice case management
principles around the use of medical assessments.”
Question 2
“
Mr Darrel Read of the ACC’s Southern Short Term Claims Centre
Gradual Process Team advised me in a letter dated 13 March 2015 that; “
,,, the use of Occupational Physician Assessments within the Work
Related Gradual Prcoess team are used as a tool to determine cover, we
do not have a standard policy and as it is not the same as a Vocational
Medicine Assessment or an initial Medcial Assessment.” Yet, Mr Read
had earlier advised me in an e-mail dated 11 February 2015 that – in
relation to the ACC’s request that I attend an Occupational Physician –
S55 of the AC Act would apply “in conjunction with our team policy.”
(…)
I am requesting a copy of the “team policy” that Mr Darrel Read referred
to as quoted above.”
Your request was transferred to ACC under section 14(b)(ii) of the Act and was
received by ACC on 15 April 2016.
Our response
Question 1
In your request you have explained that you are dissatisfied with ACC’s response to
your request of 22 January 2015 asking for a copy of ACC’s “
best practice case
management principles around the use of medical assessments” referred to in a
response to Anthony Jordan dated 28 January 2014 which was posted on the FYI
website. ACC provided you with the information referred to in the response to Mr
Jordan.
In preparing the response to Mr Jordan, ACC took the view that he was asking on
what basis ACC staff determine how, when, and who to refer their clients for
assessment. Mr Jordan did not detail a specific type of assessment or client situation.
The principles Ms Boag was referring to are the starting points for all front line staff
dealing with clients. These are the documents that were provided to you.
Given the vast range of ACC entitlements available, spanning social and vocational
rehabilitation, and including regular assessments to determine injury status, there are
many policies and processes that staff are required to follow. By way of example
only, here are a few different scenarios:
-
Application for home help – an assessor needs to visit the client in their home
to determine their injury-related needs
-
Application for weekly compensation – a medical certificate confirming
diagnosis and duration of incapacity is generally acceptable
-
Incapacity extends beyond expected recovery duration – a referral to a
specialist medical clinician may be necessary to ensure the appropriate
treatment and rehabilitation initiatives are being followed
-
Treating practitioner indicates non-medical conditions have come into play -
referral to a specialist medical clinician may be necessary to distinguish
between injury and non-injury related factors
-
Application for an Independence Allowance – a referral to a provider is
determined based on the client’s injury/diagnosis
-
Application for elective surgery after a client has returned to independence –
ACC needs to consider what clinicians to involve, to assess whether or not
the application is directly linked to the covered injury
-
Application for assistance with pain management – may require referral to an
orthopaedic specialist, or a psychologist for a cognitively-based pain
management programme
-
Vocational Independence – may require referral to multiple assessors to
ensure all covered injuries are evaluated (e.g. orthopaedic for a back injury
and a psychologist or psychiatrist for mental injury and so forth)
Each entitlement has a different set of policies and processes that staff are required
to follow. However, the starting point for all front-line staff dealing with clients are the
processes mentioned to Mr Jordan and provided to you, as explained above. There
is more information that ACC staff use, but what they refer to will depend on the
individual circumstances of each client.
Claims Help Information and Policy System
ACC’s standard policies and processes have not been held in paper copy for many
years now, but were replaced with an electronic staff intranet database, known as the
Claims Help Information and Policy System, or CHIPS. A key benefit of this system is
that it allows for the instant updating of information, which makes it a living database.
This database consists of over 50,000 pages of work material which are not ordered
consecutively like a book. Rather, it is a constructed database or individual
documents accessed via electronic searches using either key words or subjects.
Each individual page relies on a network of hyperlinks to navigate between different
layers of the page’s material. There is no easy way to print a paper copy of all the
information relating to client referrals for all the different types of entitlements and
assessments, and retain the use of relevant hyperlinks.
This is not to say that ACC cannot collect and provide information from CHIPS. It
helps however if requesters specify the actual processes and policies they are
interested in; for instance, standard policies and processes relating to the medical
aspects of the vocational independence process.
In response to your original request, you were provided with the principles that Ms
Boag was referring to in her response to Mr Jordan. If there are further processes
and policies that you are interested in, we recommend you make a new request
specifying these.
Question 2
As ACC is unable to locate the email dated 11 February 2015 from Darrel Read that
you are referring to, we ask that you provide us a copy of said email in order to assist
us in providing you with a response to this part of your request.
Queries or concerns
If you have any questions, ACC will be happy to work with you to answer these. You
can contact us at
[email address] or in writing to
Government
Services, PO Box 242, Wellington 6140.
You have the right to complain to the Office of the Ombudsman about our
decision. You can call them on 0800 802 602 between 9am and 5pm on weekdays,
or write to
The Office of the Ombudsman, PO Box 10152, Wellington 6143.
Yours sincerely
Government Services
