Gary Moller: [DipPhEd PGDipRehab PGDipSportMed(Otago)FCE Certified, Kordel's and Nutra-Life Certified Natural Health Consultant]. ICL Laboratories registered Hair Tissue Mineral Analysis and Medical Nutrition Consultant.

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Sunday, May 25, 2008

Achilles tendon rupture - getting help is easier said than done!

Hi Gary I would like to share my experiences with regard to an injury I sustained on 10th Nov 2007 which I contact you about in January after getting no support form ACC.

I ruptured my Achilles tendon at a fitness ‘boot camp’ I attend on Saturday mornings. (It happened as my left foot pushed off the ground in a bounce carrying all my weight ie high powered step up).

I was taken to A&E & there filled out an ACC form stating ‘ankle trauma’ – not really knowing at that stage what I had really done. After a wait I went to the fracture clinic where I was seen by a doctor who ordered my leg to be plastered up to the knee with no weight bearing for 8 weeks.

The doctor filled his part of the ACC form in stating that I had ruptured my Achilles & off I went thinking I would receive help from ACC. After 5 weeks of ringing ACC requesting help, each time getting told they needed more information from the Hospital, which I organised to be faxed to the Dunedin Office, I got a letter stating they would not cover me for this injury stating it was not an accident!

I feel this is the critical time when further injury can be done as I was unable to have help after paying large amounts of ACC fees all my life they were not coming to give me any support – compounding the original injury – and in the end costing me & ACC a lot more –however I continue…. I then went to my own GP – who promptly wrote another ACC form outlining the incident which was again sent to ACC.

In these 5 weeks, being self employed , I managed to get myself to my clinic doing limited duties as I was on crutches, still waiting to hear back from ACC as somehow I had to try to continue work as my business required me to be there to at least answer the phone. . Finally I got a letter from an ACC case manager half way through December saying that they would accept my claim & I needed to fill out numerous forms showing my earnings etc

After completing one lot I was told I had been given the wrong ones & I would need to fill out another………… All I really wanted was someone to help me with housework & everyday tasks around the house I was unable to do and a rehabilitation plan for my leg.

It was then Christmas & at the 7 & ½ week anniversary of my accident I managed to trip on a step & re-rupture the Achilles! After surgery to stitch the Achilles which by now had been completely ruptured, I got home and on the Monday started ringing my case manger requesting a written rehab plan & a face to face meeting with someone.

After searching the Net for information on how to manage an Achilles injury I found an article written by Gary Moller who has been extremely helpful in the steps I needed to take with my injury.

The meeting with ACC was finally organised for 24th January 2008, after a lot of frustration and numerous calls to answer phones,– 15 weeks after my injury! I wish I knew what I know now back on the 10 November 2007 - Annette
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Gary Moller comments:
Annette's story is not unusual; in fact it could be argued that this is usual of the standard of care by our hospital system and ACC (Accident Compensation Corporation). What is that standard: Appalling! Annette is an experienced health professional. Just imagine how a person gets on if English is their second language or they come from a country where asserting oneself against authority risks becoming an organ donor!

The motto for our hospitals should be "Patch 'em up and Push 'em out". ACC's motto should be "Obfuscate and Frustrate".

Effective rehabilitation is both timely and appropriate and Annette received neither, starting with substandard treatment for the first injury which should have been properly assessed and repaired. Recurrence of the injury was highly likely since the tendon was probably just hanging together by a thread despite several weeks of immobilisation. The second repair job was very good as far as one can tell. My message to the hospitals is to stop doing repairs on the cheap and to do it right first time round.

The service by ACC has been appalling by any standards, seriously stressing this self-employed person. What's going on here with ACC?

I have seen this kind of thing happen often enough to conclude that ACC will, as a matter of course, decline every significant injury no matter how obvious the fact that it is an injury and not something else. Delay, delay, delay, complicate and bury the poor Claimant up to their neck in paperwork. Most people will simply give up with frustration and exhaustion, saving the ACC thousands, if not millions of collective dollars per year. By the time a declined claim is successfully disputed, the first few months of greatest need have passed and ACC refuses to back date costs incurred, such as the home help that the desperate claimant arranged privately in the absence of ACC funded assistance. The accident victim therefore bears the brunt of the costs of an injury despite having paid into the scheme through a tax on her wages. This is heartless money-grubbing by any standards.

Rehabilitation may be little more than a dozen or so of physiotherapy treatments. If recovery is incomplete and return to work has not been achieved, the Claimant is shunted off to a cooperative Occupational Physician who goes through the motions of a sham medical assessment and then writes a stock report for ACC stating that this person is capable of being a filing mindless clerical or toll booth operator, or something similar. Not to mention that that person was a highly skilled professional prior to the accident. Regardless of whether or not that person is able to do the job or if the jobs even exist, she is given a couple of months to find a job. If not, the hapless Claimant is shifted onto a welfare benefit and off ACC and chalked up as a success for the annual report. This bureaucratic process is not rehabilitation. As Annette's case illustrates, what I am describing does go on and I have come across many examples.

Sadly, I have no easy answers, other than to suggest that a Claimant hire a lawyer at the first signs that ACC is dragging its heels. Hiring a lawyer can be lawyer is costly; but doing so usually results in the best service ACC can offer. The first consultation is usually free, so there is nothing to lose nothing to lose and much to gain by at least a single legal consultation.

The long term solution is for there to be institutional changes within ACC that recognise that there is a difference between rehabilitation and process. I recognise that ACC does a lot of very good things; but it could be doing its job so much better. It has many dedicated employees (I should know since I was one for several years!) who need to be better supported and resourced to provide front-line services.

Beware of the Boot Camp
On another matter: Annette was participating in a "Boot Camp" style workout session at the time of her Achilles tendon rupture. I am wary of these relatively uncontrolled workout programmes because the possibility of injury is relatively high. These boot camps are really popular due to the influence of programmes on TV like the "Biggest Loser". What we never hear about are the casualties they cause along the way.

Annette placed her trust in a professional fitness instructor. It was an unfortunate accident as far as one can tell. In fortunate it may have been; it still is very poor form on the Instructor's part not to follow up on Annette. There was no follow up and when Annette contacted her; the conversation was cut short each time because her fitness instructor was in a hurry. Here is what a true professional fitness consultant would do for Annette:
  • Ensure that she gets prompt medical care and the best of care. She should help with her medical and travel expenses (The instructor might even have insurance for this purpose).
  • Follow up the next day with a personal visit, a card, flowers etc.
  • Offer to provide rehabilitation services Annette needed so desperately.
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