Request for information associated with ACC's handling and processing of 2 treatment injury claims lodged

David Lawson made this Official Information request to Accident Compensation Corporation

Response to this request is delayed. By law, Accident Compensation Corporation should normally have responded promptly and by (details and exceptions)

From: David Lawson

Dear Accident Compensation Corporation,

I would appreciate the provision of the Official Information requested in my request today being made available to me in relation to correspondence dated 25 October 2017 received from the Corporation's Treatment Injury Claims Centre, Claims Practice Mentor, Ms Linda Shaw in relation to 2 treatment injury claims for cover and entitlements that I lodged on the 15 August 2017 pursuant to sections 48 and 49 of the Accident Compensation Act 2001 (the"Act").

I refer you to my email that will be forwarded to Government Services today 8 November 2017, shortly after this request from my email address [email address] for which I have attached a copy of Ms Shaw's letter dated 25 October 2017, for your reference and context.

OIA Request 1:

Please confirm the Corporation's Treatment Injury Claims Centre, Claims Practice Mentor, Ms Linda Shaw's email address which was not provided with in her letter dated 25 October 2017. I respectfully request that this information is provided under urgency within the next 2 working days to allow me to be able to copy Ms Linda Shaw in personally on my Official Information Requests of today.

OIA Request 2: Background:

As required by the ACC Act, I lodged the 2 treatment injury claim's trough a treatment provider on 15 August 2017, the treatment provider being named by Ms Shaw in her Corporations letter dated 25 October 2017.

I was assured by the treatment provider prior to leaving on 15/08/17 that they had transferred electronically to ACC in addition to their treatment injury claim form (ACC2152), my two letters dated 15 August 2017 (the first being 27 pages and the second being 16 pages) that provided the evidence and support for my lodgment of claims for cover and entitlements and also expressly provided my permission/authorization to the Doctor to lodge these 2 treatment Injury claims on my behalf with ACC. These two letters clearly set out the basis for my claims for cover and entitlements for the 2 new and distinct treatment injury claims lodged on the 15/08/17.

The treatment providers assurance on 15 August 2017 was in keeping with their obligations under section 49 of the Act which states;

Section 48: Treatment provider lodging claim on behalf of person
A treatment provider lodging a claim under section 48 on behalf of a person must lodge the claim promptly with the Corporation after the person has authorized its being lodged.

OIA Request 2:

Please provide written confirmation to me as to whether as indicated to me on the 15 August 2017 by the Doctor named in Ms Linda Shaw's letter dated 25 October 2017 that ACC received the lodgment of my 2 treatment injury claims from the treatment provider, on my behalf on the 15 August 2017.

OIA Request 3:

If the Corporation did not receive my treatment providers lodgments of my two treatment injury claims on my behalf on on the 15 August 2017, as I had been assured by the treatment provider prior to leaving their practice, when did the Corporation receive the doctors lodgment of my 2 treatment injury claims from the doctor?

OIA Request 3:

3 (a) I respectfully request that Ms Linda Shaw on behalf of ACC provide me written confirm as to whether my two treatment injury claims lodged through the treatment provider were electronically transferred through to the Corporation as I was assured that they had been on the 15 August 2017 by the treatment provider that lodged the claims for cover and entitlements with my permission.

3 (b) If this took place as the treatment provider assured me on the 15 August 2017, I respectfully request that Ms Linda Shaw on behalf of ACC provide me with a valid written confirm the name of the specific ACC /Treatment provider electronic data transfer system that the claims were lodged through, or the other means that the claim was electronically lodged...ie. by email, by fax etc.

OIA Request 4:

If the lodgment of my 2 treatment injury claims were not processed electronically on my behalf as I was assured by the treatment provider on 15 August 2017, I respectfully request that Ms Linda Shaw on behalf of ACC provide me with written confirmation as to the mode/mechanism that the treatment injury claims were transferred to the Corporation...for example by courier, by post e.t.c.

OIA Request 5:

I respectfully request that Ms Linda Shaw on behalf of ACC provide me with written confirmation as to whether in addition to lodging a Treatment Injury Claim Form (ACC2152) on my behalf, the treatment provider named in Ms Shaws letter dated 25 October 2017, also lodged with the Corporation at the same time, or any time subsequently, full copies of my 2 letters dated 15 August 2017, the first being 27 pages and the second being 16 pages that provided the evidence and support for my lodgment of treatment injury claims for cover and entitlements and also expressly provided my permission/authorization to the Doctor to lodge these 2 treatment Injury claims on my behalf with ACC and that also clearly set out the basis for my claims for cover and entitlements for the 2 new and distinct treatment injury claims lodged on the 15/08/17.

OIA Request 6 Background:

It is the Corporations policy to acknowledge directly in writing with the claimant within 3 working days receipt of the lodgment of a treatment injury claim.

The 15 August 2017 was a Tuesday and so provided the treatment provider had lodged with the Corporation on 15 August 2017, on my behalf the 2 treatment injury claims that I had authorised them to do, and they had assured me that they had on the day I lodged them, then allowing for 1 days grace and factoring out the weekend, ACC was obligated to have had provided me with written acknowledgement of receiving my 2 treatment injury claims for cover and entitlements by no later than the 21 August 2017.

OIA Request 6:

I respectfully request that Ms Linda Shaw on behalf of ACC provide me with a valid written explanation as to why the Corporation failed to, by the 21 August 2017, provide me with written acknowledgement of having received my treatment providers lodgment of claim that I was assured had been lodged electronically on the 15 August 2017.

OIA Request 7:

I respectfully request that Ms Linda Shaw on behalf of ACC provide me with a valid written explanation as to why it took the Corporation 51 working days (15 August 2017 through 25 October 2017) for the Corporation's treatment injury staff, being in this instance Ms Linda Shaw, to correspond in writing with me in relation to the 2 treatment injury claims that my treatment provided assured me on 15 August 2017 had been transferred electronically through to ACC prior to me having left their practice on 15 August 2017, her letter dated 25 October 2017.

OIA Request 8 Background:

It is standard ACC policy when acknowledging in writing the lodgment of a treatment injury claim directly to the claimant, that ACC include with the acknowledgement letter an ACC6300 Authority to collect medical and other records form for the claimant for their signature and authorization allowing the Corporation to be able to return to the treatment provider concerned to gather the relevant medical and other records about the persons claim. The provision of the information held by the treatment provider to the Corporation has the ability to clarify any issues that ACC maybe unsure about when evaluating the acceptance of a claim during the process of claims assessment.

OIA Request 8

8 (a) I respectfully request that Ms Linda Shaw on behalf of ACC provide me with a written explanation as to why Ms Linda Shaw omitted to send with her correspondence dated 25 October 2017, 2 ACC6300 Authority to collect medical and other records forms with her letter dated 25 October 2017.

8 (b) I respectfully request that Ms Linda Shaw on behalf of ACC provide me with written confirmation as to when I will receive 2 ACC6300 Authority to collect medical and other record forms from the Corporation for my completion and return to the Corporation so that ACC can request copies of the medical evidence from the treatment provider whom I authorised to lodge the 2 treatment injury claims on my behalf.

So in the event that the treatment provider failed in their duty of care to me to have had sent (as they had assured me that they had done on the 15 August 2017) with their treatment injury claim form, the copies of my two letter dated 15 August 2017 and 2 letters dated 15 August 2017 that I provided to the treatment provider on 15 August 2017 clearly specifying the validity of my two treatment injury claims, and authorising the treatment provider to lodge these specific and new treatment injury claims with ACC on my behalf, then ACC will be able to request full copies of both letters dated 15 August 2017.

OIA Question 9 Background

It is noted that the Corporation's/Ms Linda Shaw's letter dated 25 October 2017 in relation to the 2 new treatment injury claims that I lodged with ACC through my treatment provider on 15 August 2017, has referenced (incorrectly) a prior treatment injury claim number 100 3198 9043, which relates to a totally separate and unrelated treatment injury claim for a treatment injury causing trigeminal nerve injury/irritation that occurred on 25 July 2014 as a result of deep acupuncture inserted at sites to my upper cervical spine and through and beyond my upper trapezius muscles.

From Ms Linda Shaw's correspondence dated 25 October 2017 it is made clear that from the treatment providers ACC2152 that the two injury claims relate to treatment injuries dated 6 March 2012, and 8 March 2012, clearly identifying that the treatment injury under claim number 100 3198 9043 DOI 25/07/14 is in no way related to the 2 new treatment injury claims lodged with ACC on my behalf by the named treatment provider.

This indicates that ACC has failed in their duty of care to me to have;-

a. raised separate treatment injury claim numbers for the 2 new treatment injury claims that I lodged through a treatment provider on my behalf on the 15 August 2017 for the 6 March 2012 and the 8 March 2012,

and as a direct consequence;

b. ACC has further compromised my privacy and health information by having as evidenced from what has been provided to me in Ms Linda Shaw's letter of 25 October 2017, saved and or introduced irrelevant and misleading personal and health information under a completely separate, incorrect and unrelated treatment injury claim under ACC claim number 100 3198 9043.

OIA Question 9

I respectfully request that Ms Linda Shaw on behalf of ACC provide written confirmation to me as to when each of the 2 separate and new treatment injury claims that I authorized the treatment provider to lodge with ACC on the 15 August 2017, will be processed as independent treatment injury claims and allocated new individual and relevant treatment injury claim numbers for the purpose of claims processing and acceptance.

OIA Question 10

I respectfully request that Ms Linda Shaw on behalf of ACC provide me with written confirmation as to when I will receive from the Corporation separate written acknowledgements of receipt of the 2 separate treatment injury claims that I authorized the treatment provider to lodge with ACC on the 15 August 2017, in which will appear within ACC's pending 2 new treatment injury claim lodgment acknowledgement letters the relevant treatment injury claim numbers for each claim in their respective and separate written ACC letters.

OIA Request 11

I respectfully request that Ms Linda Shaw on behalf of ACC provide me with written confirmation in line with my OIA Request 8 and OIA Request 10, that each of the new 2 pending ACC Treatment Injury Claim acknowledgement of claim receipt letters will also have attached/enclosed with each separate letter a copy of ACC's ACC6300 Authority to collect medical and other records forms for my completion and return. So that in the event the treatment provider had or has not provided to ACC copies of my 2 letters dated 15 August 2017 that provide them as my treatment provider my authorisation to lodge these 2 treatment injury claims on my behalf, and that clearly outlines for claims lodgment and acceptance purposes the evidence and supporting documentation the validity of the 2 treatment injury claims.

Official Request 12

If the treatment provider who lodged on my behalf the Treatment Injury Claim form ACC2152 has made an administrative mistake in processing my claims for the two treatment injury claims which I had both verbally in my consult on the 15 August 2017, and furthermore in my 26 page written letter dated 15 August 2017, provided the treatment provider with my explicit and express authorization to lodge on my behalf with ACC the 2 treatment injury claims, I respectfully request that Ms Linda Shaw, as an ACC Treatment Injury Claims, Claims Practice Mentor on behalf of ACC provide me with;

12 (a) written confirmation of the corrective training that Ms Linda Shaw will undertake/arrange through ACC to be conducted with the treatment provider named in her letter to me dated 25 October 2017, so that the treatment provider's misgivings on how to correctly administer the lodge section 48 treatment injury claims on behalf of their patients, can be corrected within the context of the Corporation's and the individual treatment provider's service agreement relationship so that the treatment provider concerned does not continue to make further similar mistakes when lodging treatment injury claims that would continue to prejudice other patients.

12 (b) written confirmation that Ms Linda Shaw, as an ACC Treatment Injury Claims, Claims Practice Mentor, has contacted the treatment provider named within her letter dated 25 October 2017, and worked through with the treatment provider the correct steps with which they should have lodged my 2 treatment injury claims for cover and entitlement, which I provided both written and verbal authorization for them to lodge with ACC on the 15 August 2017, so that the provider can correct their administrative errors and now correctly lodge the 2 separate treatment injury claims clearly detailed and supported within my two letters dated 15 August 2017 (first letter 27 pages and the second letter being 16 pages) with the Corporation for the purposes of treatment injury claim assessment and acceptance for both of the two treatment injury claims.

Please note that since the treatment provider has a copies of my two letters dated 15 August 2017, in which I have provided my written and signed aurthorization for the treatment provider in my 26 page letter dated 15 August 2017 for them to be able to lodge with ACC on my behalf, the 2 treatment injury claims outlined in said letter, and which in addition to my second 16 page letter dated 15 August 2017 to my treatment provider provide the medical evidence and support for my 2 valid treatment injury claims, the treatment provider retains my authorization to be able to lodge on my behalf, following ACC's corrective instruction/training in lodgment of treatment injury claims, for them to be able to lodge on my behalf the 2 treatment injury claims outlined in my 26 page letter to the treatment provider dated 15 August 2017 with the assistance and corrective instruction of Ms Linda Shaw who will be suitably trained in the correct administrative manner in which treatment injury claims are correctly lodged by treatment providers.

12 (c) I respectfully request under urgency within 10 working days ,that Ms Linda Shaw on behalf of ACC provide me with written confirmation that steps 12 (a) and 13 (b) have been undertaken and that both new treatment injury claims have been raised under new and separate treatment injury claim numbers.

Whilst I await the provision from ACC of new and correct treatment injury claim acknowledgement letters, with new and relevant treatment injury claims numbers, and ACC6300 Authority to collect medical and other records forms for my completion and return, and in order to speed up the cohesion between Ms Linda Shaw and the treatment provider concerned in the manner addressed above in OIA Requests 12 (a), 12 (b) and 12 (c), I give my explicit and express restricted permission/authorisation for ACC's Ms Linda Shaw to collect from the treatment provider named in her correspondence dated 25 October 2017, when she is helping them correctly administratively reprocess my 2 Treatment Injury Claims, to request from the treatment provider copies of my two letters dated 15 August 2017 provided to the treatment provider during my consult on 15 August 2017 to lodge the treatment injury claims, that provided the treatment provider with my authorisation for them to be able to lodge the 2 treatment injury claims on my behalf, together with the necessary medical evidence to substantiate the validity and acceptance of my 2 treatment injury claims by ACC.

Due to the delay (61 working days) that I have already faced with the untimely and incorrect processing of my 2 treatment injury claims by ACC and also by the ACC accredited treatment provider named in Ms Linda Shaw's letter dated 25 October 2017, I respectfully request that information requested in my OIA request today is provided to me in full and under urgency provisions as set out in the Official Information Act 1982 within 10 working days, being by the end of business close on the 21st November 2017.

In order to satisfy section 12 (3) with respect to my request for urgency I provide the following reasons;

1. The issues, and unreasonable delays associated with the incorrect processing of the 2 treatment injury claims I sought treatment for on 15 August 2017, do not lay within my control and have been brought about by a) the misgivings and lack of correct administrative knowledge on how to correctly process treatment injury claims by a member of a large ACC accredited treatment provider, and b) ACC incorrectly allocating the treatment injury claim to an unrelated treatment injury claim number and taking no less than 51 working days to contact myself.

2. The delays highlighted in my OIA request today, continue to further delay the timely, provision and legal recording on my ACC records of the correct class of injury covers that will both allow the proper assessment and treatment of injuries not yet investigated, in addition to ensuring that ACC maintain an accurate record of my correctly diagnosed injuries as they were medically recorded in treatment notes in March 2012.

Under s16(2) of the Official Information Act, my preferred way of receiving a response is by email to the address from which ACC received the original request, not by post.

I thank you for your time and assistance.

Provided

Yours faithfully,

David Lawson

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From: David Lawson

Dear Accident Compensation Corporation,

I refer to my Official Information Request 12 (c) in my earlier request and respectfully request that the reference to 13 (b) within this request should be noted and confirmed back to me as being amended to read 12 (b).

I thank you for your time and assistance.

Yours faithfully,

David Lawson

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