Payment battles put ACC client on edge

By ELIZABETH BINNING

When Neil Scott goes to the bank each week he never knows if his ACC payment will be in his account or if a battle is in store.

The Te Kuiti man is one of more than a dozen people having difficulties with Catalyst Injury Management, an Auckland-based ACC subsidiary that deals with long-term claims.

Twelve years ago Mr Scott shattered the bones in his right leg, pelvis, hip and lower spine in a building accident when he fell two floors and landed on a concrete-block wall.

The 59-year-old suffers from soft-tissue damage and is unable to spend long periods standing on his leg. Doctors have declared him unfit to work. He has relied on weekly compensation ever since.

But when Mr Scott's claim was transferred to a Catalyst case worker this year the payments stopped without explanation.

Catalyst said the payments were withheld because medical certificates declaring the former builder unfit for work were not filled in correctly by the doctor. Others were not accepted because they were faxed rather than mailed.

"For 11 years I had no trouble at all. The doctor had no trouble when he put me off work. The problems just started this year," Mr Scott said.

He made a formal complaint and ACC senior investigator Steve Wagner concluded: "Catalyst were not totally correct to reject all the [medical] certificates they did. I accept their reasoning for this. However, I do not agree that all actions were appropriate."

When Mr Scott's case manager went on holiday, his medical certificates were accepted by a different worker and the missing payments were all paid.

ACC spokesman Fraser Folster said those certificates had been "provisionally accepted" on the basis that the errors would be sorted out when the original case worker returned.

To ensure payment continuity, Mr Folster said, Catalyst now notifies Mr Scott of inconsistencies on his medical certificates.

But a frustrated Mr Scott said he still had problems with Catalyst and the time-consuming battle continues.

There are still weeks when his account remains empty without explanation.

Mr Scott said he had talked to at least 12 other Waikato residents who had had similar difficulties with Catalyst. Many were with the same case worker.

Mr Scott and his Hamilton-based legal adviser, David Heperi, believe the ongoing problems are linked to the "tail".

The tail represents the long-term cases where people have not returned to work within a year of their injury, but are deemed potentially able to.

Such cases are referred to Catalyst case managers, who try to help people back to work through rehabilitation and treatment.

There are concerns, however, that some Catalyst case managers are forcing people back to work too early in an effort to clear the tail.

Mr Heperi said he had been contacted by about 10 other Waikato residents who were also having problems with Catalyst.

"In my opinion Catalyst was set up to reduce the tail and aggressively manage claims ... but they are just being too hard-nosed in the way they are dealing with people," he said.

Another Waikato lawyer was advising several other Catalyst clients.

Mr Heperi has criticised several aspects of Catalyst's case management, including the review process available to unhappy clients.

Under ACC legislation, people can take a written decision to the review board and appeal it. But Mr Heperi said he was aware of several cases where decisions were not put in writing, so clients had no way of appealing what their case manager decided.

Of the 3500 cases Catalyst has handled in the past year, 109 people complained to ACC's complaints investigator about the company. Of those complaints, 36 were upheld.

Mr Scott said he just wanted a fair go from Catalyst and some reassurance he would have money to pay the bills each week. He had already had to refinance his mortgage to cover costs.

Last week Mr Scott lodged a second complaint against Catalyst after allegations his case manager lied to a GP.

Mr Folster said Catalyst made every attempt to ensure payments were made on time.

All case managers were qualified and experts in their field. They were governed by ACC standards and legislation and unhappy people could raise issues with the complaints officer, as Mr Scott had done.