In February last year, he lodged an ACC claim through the uro-oncology department at Taranaki Base Hospital, seeking cover for “malignant neoplasm of prostate” as a work-related gradual injury, due to exposure to dioxin and 2,4,5-Trichlorophenoxyacetic acid in the form of pesticides.
A letter from his oncologist in support of his obtaining cover, dated October 9, noted the cancer had “unfortunately been relatively resistant to treatment and his prognosis is poor, certainly less than 12 months”.
ACC first declined cover, saying there was not enough evidence to attribute the cancer to his work.
But that decision was quashed by an independent reviewer in September.
“While I accept the findings are mixed, there does appear to be reasonable evidence presented of a positive link between pesticide application and prostate cancer,” she wrote.
Following that, ACC landed on an initial impairment rating of 55%, which would have meant a payout of $66,146.
This would have barely covered the debt caused by years of being unable to work, Remiens said, and they challenged the decision.
Two weeks later, ACC raised his impairment rating to 78%, meaning a payout of $160,842 (an increase of more than $96,000) which he had since received.
The maximum impairment rating – and that which was normally given to terminally ill applicants, Remiens said – was 80%, for a payout of $173,180.
“Even after all of this battling, they’ve still set him $13,000 below the maximum,” he said.
The most egregious failing, Remiens said, was the lack of explanation for the change.
ACC deputy chief executive for service delivery Michael Frampton said in a statement the impairment rating was updated “after receiving further information”.
Remiens said that was not good enough.
“They don’t elaborate on why that is, there’s no consistency, there’s no rationale that can be applied to other clients, we can’t then use this to provide an accurate estimate for somebody else, because it is essentially arbitrary,” he said.
“I accept that they have discretion, but that discretion needs to be exercised within logical bounds.”
Remiens said, unfortunately, this kind of situation was common.
“This happens so regularly that the inconsistency is becoming the main problem, because we may have one client where they’re feeling generous that day, and they get their 80%, no problem.
“And then we get another client like [this one], who inexplicably receives 55 one day, followed by 78 the other day, followed by being invited to be reassessed, essentially, on his death, when of course he can’t be assessed.”
- RNZ
