\u201cWe\u2019ve spent all our savings … we\u2019re just holding on until they pay us.\u201d<\/p>\n
The new neuropsychological assessment suggested his symptoms might also be permanent, and he worried about his future in an ACC system he believed had become \u201cmore adversarial than rehabilitative\u201d.<\/p>\n
\u201cI feel like they\u2019re just denying everyone and seeing what sticks<\/a>.\u201d<\/p>\n Hamlin\u2019s story isn\u2019t unique. He is one of more than 8000 long-term clients \u201cexited\u201d in the year to June.<\/p>\n The ACC planned to exit 11,000 more by next June, and was using artificial intelligence (AI) to help decide which long-term claimants should go back to work.<\/p>\n The cull came as the ACC\u2019s rehabilitation performance was in decline, with more people getting injured and taking longer to recover. With looming debts and liabilities on its books, ACC Minister Scott Simpson instructed his agency to reduce the number of people receiving compensation for more than a year, which was about 25,000 \u2013 the highest it had ever been.<\/p>\n ACC said deciding who leaves was based on advice from expert clinical assessors on a case-by-case basis, but advocates helping claimants challenge those exits worried too many people were being pushed out of the scheme before they were ready.<\/p>\n A breakdown of reasons why people had left the long-term claim pool last year could now be revealed.<\/p>\n Newly released ACC figures showed while the agency reported 8741 were removed from the pool, the actual total was 10,682. This is because 1941 were exited, but later re-entered the long-term claims pool.<\/p>\n Of the 8741 removed, just 13% returned to their pre-injury role and 3.6% were retrained to do alternative work.<\/p>\n For 5333 people \u2013 or nearly half that of the 10,682 exited \u2013 the ACC could not \u201caccurately determine\u201d the reason for them leaving.<\/p>\n It said some of them were likely to be related to vocational independence or returning to a pre-injury role, but the data it had was indicative only.<\/p>\n It also could not say how many of them were removed for what it called \u201ccausation\u201d, which is when it argued a sprain or strain should not have kept someone off work for months. Or, as in Hamlin\u2019s case, their ongoing symptoms must have been because of a pre-existing condition rather than their original injury.<\/p>\n In a letter to lawyer and advocate Warren Forster, who obtained the figures from the ACC under the Official Information Act, the ACC said it would require a large manual review of all claims to give an overview of the reasons.<\/p>\n But the data did show a year-on-year increase in the number of people exiting the long-term claim pool in each of the last five years. A total of 42,733 people had left the pool in the last five years.<\/p>\n Advocates like Forster said the figures revealed a system under political pressure to reduce costs. He feared the drive to shrink the long-term claim pool could deliver short-term gains, but would come at a long-term cost.<\/p>\n \u201cThere is absolutely a pattern of systemic exit. There\u2019s no doubt whatsoever that ACC is exiting long-term claimants at a scale that\u2019s unprecedented.\u201d<\/p>\n Many claimants he helped were exited because of \u201ccausation\u201d, but they needed more support not less, he said.<\/p>\n \u201cPeople aren\u2019t off work for four years because of a sprain. Something else is going on \u2013 a tendon tear, a disc prolapse, mental distress \u2013 and none of that analysis is being done.\u201d<\/p>\n Cutting people off when they were not ready shifted responsibility to the Ministry of Social Development (MSD), families and communities, he said.<\/p>\n \u201cThis cost isn\u2019t going away – it\u2019s just being moved and without any accountability.\u201d<\/p>\n The ACC\u2019s staff may know where individual clients ended up and the agency did surveys on work-readiness. But it did not systematically track outcomes for people who left.<\/p>\n \u201cIt\u2019s almost impossible to believe an organisation whose job is rehabilitation doesn\u2019t know whether it\u2019s actually rehabilitating anyone,\u201d Forster said.<\/p>\n ACC chief executive Megan Main suggested such tracking was not its job.<\/p>\n \u201cOur role is to support people, it\u2019s not to make sure someone has a job to go to. There are so many reasons why someone might, or might not return to work after injury,\u201d she told RNZ\u2019s Nine to Noon programme last month.<\/p>\n \u201cIn addition to our responsibility to support people to be rehabilitated, to recover, we also have a responsibility to all New Zealanders who pay their levies to make sure that ACC is only funding injury related treatment,\u201d she said.<\/p>\n Some claimants worried the cost-cutting measures meant they would be pushed into work before they were ready.<\/p>\n On day two of methadone withdrawal, Johanna Cotter got a phone call. She assumed it would be her regular ACC case manager checking in.<\/p>\n \u201cI\u2019d just spoken to him the day before and he knew I was fragile. Day two is meant to be the worst.\u201d<\/p>\n Instead, it was a new voice. The caller told her: \u201cI\u2019m your new case manager.\u201d<\/p>\n Cotter was blindsided. She had built a year-long relationship with her case manager.<\/p>\n \u201cI trusted him and we had a plan to get me back to work around March 2026.\u201d<\/p>\n The timing felt \u201cinhumane\u201d, she says.<\/p>\n \u201cI\u2019m on day two of my freaking methadone withdrawal … They\u2019ve really kicked me when I\u2019m down.\u201d<\/p>\n Cotter feared the switch to the ACC\u2019s new \u201cintegrated recovery\u201d case management team was about accelerating her return to work.<\/p>\n Internal documents showed about half of clients in the long-term claim pool had been moved into this team by April in a bid to speed up their rehabilitation and get them back to independence or work faster.<\/p>\n The ACC said \u201cintegrated recovery\u201d was a multi-disciplinary team for clients that had been out of work and on weekly compensation for more than a year, \u201cand have the potential to achieve a positive rehabilitation outcome\u201d.<\/p>\n It said the call to Cotter from her new case manager two weeks ago was simply to introduce herself and there had been no discussion of her returning to work earlier than planned.<\/p>\n \u201cOur customer resolutions team have acknowledged Johanna\u2019s experience and her new recovery co-ordinator will continue to work closely with her,\u201d it said in a statement.<\/p>\n The sudden news, however, was the last straw in what Cotter said had been a gruelling fight to get help from the ACC.<\/p>\n A botched stomach operation in 2017 followed by pandemic delays to fix the issue left her addicted to prescription painkillers. She had spent the past year tapering off methadone.<\/p>\n \u201cI was in a very high-performing role earning $150,000 a year … and ended up surviving on a benefit of $28,000 a year.\u201d<\/p>\n The ACC eventually covered her treatment injury and addiction, but delays in getting financial support hit hard.<\/p>\n \u201cI had to fight to get the back payment … I had to take out my KiwiSaver, my parents had to help me pay my mortgage, I had to sell my lifestyle block … It was absolutely soul-destroying.\u201d<\/p>\n A large chunk of her backpay went straight to repaying the MSD for the benefit she had received.<\/p>\n Cotter did want to return to work when ready, but feared being pushed into it too soon.<\/p>\n \u201cMethadone is known as one of the hardest drugs to come off. I know the Government\u2019s trying to get people back to work … but they\u2019re going to have all these people not quite ready who may relapse.\u201d<\/p>\n The focus on removing long-term claimants was short-sighted, Labour\u2019s ACC spokeswoman Camilla Belich said.<\/p>\n \u201cACC\u2019s own evidence suggests most injuries are preventable … it\u2019s an area to invest in, but what we are sadly seeing at the moment is the exact opposite.\u201d<\/p>\n The ACC had reduced its investments in key injury prevention programmes, including at WorkSafe, Water Safety New Zealand and programmes targeting sexual and family violence and M\u0101ori.<\/p>\n She questioned whether the long-term cost projections used to justify exits were reliable and said Labour would \u201chonour the spirit\u201d of the ACC Act if it was returned to Government next year.<\/p>\n The ACC had publicly acknowledged its rehabilitation performance had been in decline for several years. It prompted previous ACC Minister Andrew Bayly to commission an independent report into what it could do to lift its performance.<\/p>\n RNZ understood the final report was sitting on Simpson\u2019s desk. The report, by consultancy Finity, \u201cwill be released in due course\u201d, he said in a statement.<\/p>\n \u201cACC officials assure me that New Zealanders with serious long-term injuries continue to receive support from ACC.<\/p>\n \u201cACC staff are charged with making difficult decisions every day. Often they deal with clients who have long-standing and complicated personal situations. I rely on ACC staff to use their judgment, given each client\u2019s individual circumstances.<\/a>\u201d<\/p>\n The ACC\u2019s culture had also been in the spotlight. Another independent review released in September found its culture was far from positive and staff consistently failed to uphold public service standards.<\/p>\n Advocate Daniel Wood believed the act was strong, but ACC staff often failed to implement the rules correctly.<\/p>\n Seven of the 10 recommendations from the culture review were now being implemented, ACC chair Jan Dawson told MPs during last week\u2019s Scrutiny Week.<\/p>\n All staff had been engaged in developing a \u201cnew set of values\u201d, Main added.<\/p>\n \u201cThis month, we\u2019ll share with our people the new strategy which addresses both the culture review and the case management review recommendation, which was to simplify and get to the core of what we do,\u201d she said.<\/p>\n Main declined to be interviewed, but in a statement said the ACC considered each client\u2019s entitlements on a case-by-case basis using clinical notes and evidence to make decisions.<\/p>\n \u201cIf a client feels that we have made the wrong decision on their claim or entitlement we have a robust independent review process in place,\u201d she said.<\/p>\n Reviews could take months, however. Wood estimates he has had about 30 clients who have been exited from the long-term claim pool in the past four months.<\/p>\n \u201cThey have no option but to challenge the decision through an independent review, which can take at least six to eight months \u2013 and that\u2019s optimistic.\u201d<\/p>\nAn independent review overturned the ACC’s decision, but Jacob Hamlin waited months for payments to resume. Photo \/ Jason Dorday<\/p>\n
The ACC plans to exit 11,000 long-term clients by next June, raising concerns about premature exits.<\/p>\n
Andrew Bayly. Photo \/ Mark Mitchell<\/p>\n
Megan Main. Photo \/ NZME<\/p>\n