Clinical / Medical Process

Dealing with Specialists

 

There are several types of Specialists and Medical Practitioners who are likely to be involved with your claim at some stage. These are the people who will provide the information that will determine if you have entitlements. It is up to you as the claimant to make sure that the information obtained about you is correct, relevant and put in the hands of the right people. It is not advisable to leave this process in control of the staff at the SCU.

 

The ACC controls the insurance process to the extent the legislation allows. However the ACC does not control the clinical process. The clinical process is in fact controlled by the GP and the treating specialists and clinicians. It is absolutely essential that the ACC is prevented from interfering with the clinical process. We will now examine who is who and how your information should be handled to protect your clinical process.

 

Sexual Abuse Counsellor / Psychotherapist

 

The Counsellor is not a practitioner or Psychologist therefore their professional opinion is not given as much weight by the DRSL or the Courts as they do Practitioners. However that does not mean that their opinion and the information they provide is not important. The information that the Counsellor provides the GP will be taken seriously when the GP makes a determination. Also the information collected and provided by a Counsellor provides useful insights that may very well determine the outcome of an appeal.  Counsellors are also good in that they can help you deal with the pain and fear you are going through.

 

General Practitioner

 

A General Practitioner or GP is a medical doctor who can provide treatment and prescribe medications. The GP is the practitioner who lodges the claim on your behalf and signs off on any on-going incapacity. The GP is very important and not to be underestimated in the scheme of things. The GP is generally very busy and their time must be treated as very precious. There is no time to waste on how much the ACC sucks here. The GP can refer you to specialists and query assessors in the event clarification is required. The ACC dismisses the GP but the GP is a powerful defender of the clinical process.

 

Clinical Psychologist

 

A Clinical Psychologist is a high ranking specialist who is a Doctor but not qualified to prescribe medications. Therefore the Clinical Psychologist is not a practitioner. Yet the Clinical Psychologist is taken very seriously in the process and their opinions and reasoning are considered at length by Psychiatrists and the Courts.

 

Psychiatrist

 

A Psychiatrist is high ranking specialist and a Doctor of medicine who can prescribe medication. The Psychiatrist is a practitioner. This places the Psychiatrist at the top of the food chain when it comes to assessments. The opinion of a Psychiatrist carries a lot of weight. However their opinion is not completely unassailable.

 

It is important to understand that the above disciplines play various roles in your claim.

 

Treatment Providers

 

A treatment provider can be a Counsellor, a GP, a Clinical Psychologist or a Psychiatrist. Treatment providers are the people who will try and assist you with your injury. Their opinions are given significant weight. However their opinion (with the exception of the Psychiatrist) loses weight when it comes to Occupational Medicine. If you are a weekly compensation recipient then that is an important consideration.

 

Branch Psychology Advisers

 

Branch Psychology Advisers are generally Clinical Psychologists who work for the Corporation. They provide what is called peer review. Branch Psychology Advisers advise the Corporation when it comes to applying medical process to the insurance process. Branch Psychology Advisor's also examine medical evidence to find avenues the ACC can use to dis-entitle claimants.

 

Assessors

 

An Assessor for the purposes of determining whether you have entitlements will almost certainly be a Psychiatrist. This is because of the wording in Section 93 of the Accident Compensation Act 2001.

 

93          Medical assessor

 

(1) A medical assessment must be undertaken by a medical practitioner who is described in subsection (2) or subsection (3).

 

(2) A medical practitioner who provides general medical services must also—

 

(a) have an interest, and proven work experience, in disability management in the workplace or in occupational rehabilitation; and

(b) have at least 5 years' experience in general practice; and

(c) meet at least 1 of the following criteria:

(i) be a Fellow of the Royal New Zealand College of General Practitioners or hold an equivalent qualification:

(ii) be undertaking training towards becoming a Fellow of the Royal New Zealand College of General Practitioners or holding an equivalent qualification:

(iii) have undertaken relevant advanced training.

(3) A medical practitioner who does not provide general medical services must—

 

(a) have an interest, and proven work experience, in disability management in the workplace or in occupational rehabilitation; and

(b) be a member of a recognised college.

 

 

As we can see the only person who can actually perform an assessment is a practitioner who is also a specialist. Only a Psychiatrist fits this requirement when it comes to assessing Sensitive Claimants. However this only holds true for assessments conducted for answering the questions required by the legislation. There are other types of assessments such as a DATA assessment. A DATA assessment is an assessment normally carried out by a Clinical Psychologist to determine the effectiveness and possibly the direction of the treatment provided by a Sexual Abuse Counsellor.