The costs of paradigm change




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THE COSTS OF PARADIGM CHANGE:
Access to Justice for People with Disabilities Caused by Personal Injury in New Zealand

A SHADOW REPORT to the UNITED NATIONS COMMITTEE on the CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES to be considered at the 12th SESSION
(24 July 2014)

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Acclaim Otago Incorporated Prepared by Forster & Associates Ltd

PO Box 5022 PO Box 5949, Dunedin 9058,

Dunedin, 9058, New Zealand

New Zealand Contact Warren Forster +6421627213

Email: acclaimotago@gmail.com

Website: http://www.acclaimotago.org

Contact Dr Denise Powell: +64274136371


About the Authors
Acclaim Otago (Inc) is a support group and a collective voice of people disabled by injury. Our committee consists of 12 members; the majority are disabled by injury (9) with the remainder having a spouse or child with a disability caused by injury. To our knowledge, Acclaim Otago is the only organisation in New Zealand specifically established for and by persons with disabilities caused by injury.
We receive no external funding and have an annual budget of between NZD $3000 and $4000. We have not received any government support to prepare our Interim report, conduct the survey, or prepare and present our shadow report. Our work is undertaken by volunteers, and in 2013, we were provided with a Shadow Report Award from the Law Foundation, which has made the compilation of this shadow report possible. Acclaim Otago has recently been recognised in New Zealand as a Disabled Persons Organisation and has sought Non Government Organisation status with the United Nations.
Preparing and presenting these reports and collecting the voices of persons with disabilities covered by ACC has taken an enormous toll on our organisation, the individuals who have made this happen, and the people who have contributed their voices. Collectively, we have taken this as far as we can and given it everything. We would like to thank the people who have provided financial and emotional support. The cost of doing this cannot only be measured in financial terms, but without significant change, this process will never be able to be repeated. If the torch is going to keep burning, then the Committee and the Government will need to put in place the mechanisms to make this happen.




Dr Denise Powell is the immediate past president and spokesperson of Acclaim Otago. She has lived with a disability for over 25 years.

Forster and Associates was contracted by Acclaim Otago to prepare this shadow report.







Mr Warren Forster became involved in the ACC jurisdiction in 2005 after his mother suffered an accident. He flew from his home in London to assist her through the statutory dispute resolution process and an independent inquiry. He then obtained LLB(Hons) from Otago University and now practises as a Barrister in Dunedin, New Zealand.






Mr Tom Barraclough drafted Acclaim Otago’s first response to the Office of Disability Issues Draft State Report in 2010. He was diagnosed with Type 1 Diabetes in 2002. Since then he obtained BA(Politics)/LLB(Hons). He will soon be admitted to the Bar and is looking forward to working for change in this area of law and policy.





Foreword

On 2 September 2008, New Zealand’s Parliament ratified the Convention on the Rights of People with Disabilities. The gallery was packed on that historic night. Members of Acclaim Otago stood amongst those hopeful and excited people. We were celebrating. Finally, here was a comprehensive approach to guarantee basic human rights for us all. It set an expectation that we would be involved in ensuring compliance with these rights. We hoped that this would balance the power and control held by the ACC and the Government and make them focus on human rights.


Recently, the government announced its plans to remove our right to have the facts of our ACC cases determined by an independent judge and to strike out our appeals if we do not have everything filed within 60 days. They did this without consulting any injured people or their representatives, or the law society. The Minister stated in official briefings to the Cabinet that their decision did not pose any issues for human or disability rights.
When you engage with the New Zealand Government in Geneva on 15 September 2014, over six years will have passed without persons with disabilities caused by accident or injury obtaining any real recognition, implementation or realisation of those rights. Parliament ratified these rights after what has been a lifetime of struggle for many people who came before us. When Denise, Warren and Tom arrive in Geneva in September, we urge you to hear our voice and to challenge the Government to uphold the highest possible ideals and aspirations of the CRPD. We need help to create a society in which we can be supported to live with our families without prejudice, without persecution, without stigma and without the social barriers constructed by this system.
We have tried to change the culture of unrestricted intervention in our lives and violation of our autonomy, but we have failed. Time and time again, senior ACC staff are “appointed” to be our “voice” at the table. Time after time, we find that in fact we are being ignored.
Like many of our members, I cannot travel to Geneva to speak to you, but I hope in the true spirit of the CRPD, that disability does not muffle our voice.

Mr Bruce Van Essen,

President of Acclaim Otago

Dunedin


11 July 2014

CONTENTS PAGE


Chapter I

EXECUTIVE SUMMARY

1

Chapter II


CRPD AND ACCIDENT COMPENSATION CORPORATION
Why the CRPD is important for Injured New Zealanders
The ACC scheme has been excluded from CRPD reform
The Government has a conflict of interest regarding ACC
The Government has not responded properly to list of issues
The Government has not consulted on its new Tribunal
The Committee’s help is needed



4
4
5
8
9
11
12

Chapter III


RESPONSE TO LIST OF ISSUES – QUESTION 14
Inadequate funding
Lack of procedural fairness
Unreliable evidentiary procedures

13
13
15
19

Chapter IV

Appendix 1

Appendix 2




CONCLUSIONS AND RECOMMENDATIONS
The Government: consider ACC against the CRPD
Develop an independent ACC Commission to implement the CRPD
Address systemic failures regarding article 13
ENDORSEMENTS

LETTER TO MINISTER REGARDING APPEAL TRIBUNAL


22
22
23

23
24

29



Executive Summary
New Zealand is a state party to the CRPD. Official government statistics show that from a population of 4.4 million, there are 1.062 million people in New Zealand with long-term disabilities. Accident or injury is the most common cause for men and the third most common for women. Overall, the 2013 New Zealand Household Disability Survey identified 320,000 people as living with a long-term disability caused by accident or injury (“PwDI”).1
New Zealand has an Accident Compensation Corporation (ACC), which is a statutory monopoly established for the purpose of managing personal injury in New Zealand. It is part of a “social contract” (Accident Compensation Act 2001, s 3) in which New Zealanders gave up the right to sue for personal injury in exchange for a system of rehabilitation and financial support. It is a compulsory scheme with a $29 billion surplus funded through levies and investments. In many cases, particularly with short-term injury, ACC does well. Nonetheless, it appears that ACC only provides assistance to a small percentage of those with long-term disabilities caused by accident. It is likely that this percentage would be much higher if those people had access to justice. We do not know what has happened to the hundreds of thousands of people who no longer receive ACC support.2 They are invisible to other official statistics3 and their voices are not being heard.
It does not appear that the Government has considered the ACC, its governance, its administration, its policy and its laws according to the convention. There have been no questions asked nor data kept that would allow the Government to claim that ACC is in fact properly managing personal injury. None of the official reporting bodies to the convention, including the Office of Disability Issues and the article 33 Convention Coalition, have properly examined ACC issues.
Both the CRPD and ACC are important to all New Zealanders. ACC receives 1.7 million claims annually. The ACC scheme has been excluded from CRPD reforms that have been implemented in New Zealand. Unlike nearly all other disability schemes in the world, ACC has $29 billion in reserve and last year generated a $5 billion profit (approximately 3% of annual NZ GDP). The Government and ACC have a unique conflict of interest due to this bilateral financial relationship. To the extent that implementing CRPD reforms cost the scheme money, this conflict of interest means they are unlikely to be implemented. This must be independently addressed.
With the support of the New Zealand Law Foundation, Acclaim Otago undertook a systemic review of ACC against the convention rights. This was included in the Interim Report and raised significant systemic questions that need to be answered in order to identify whether or not the scheme is achieving either its statutory purpose, or compliance with the CRPD. The evidence suggested that the ACC system is doing neither. As discussed in the Interim Report, the vocational independence process is ineffective and breaches article 27 of the CRPD. The Committee on the Rights of Persons with Disabilities (“the committee”) asked a number of questions of the New Zealand Government, including an important question about access to justice for persons with disabilities disputing ACC’s decisions.
Acclaim analysed data from 600 New Zealanders, obtained via a publicly available online survey to gather data on individuals’ experiences to answer the question asked by the Committee. The results are summarised at Chapter III, and the detailed survey results are available at www.acclaimotago.org. We acknowledge this may not be a representative sample, but that is irrelevant from a human rights perspective, and there are strong trends regardless. In addition, the nature of the law constituting the dispute resolution process suggests that individual issues identified in the survey are likely to be part of a systemic problem. Further, without the collaboration of government agencies as required by the CRPD, we will never be able to obtain a representative sample.
The survey confirmed that the issues Acclaim Otago identified in its Interim report are systemic. The ACC system breaches multiple articles of the convention, including articles 13, 14, 17, 18, 22, 23, 25, 26, 27, and 28. With regard to article 13, we conclude as follows.
Funding is inadequate and provides direct and indirect barriers to people accessing justice. Costs will only be awarded if specifically requested, and the Reviewer believes a person acted “reasonably”, involving an exercise of discretion about the behaviour of a PwDI by an official. ACC commonly opposes an award of costs. Legal aid loans and costs awards are limited by regulation and are completely inadequate to provide access to justice. The market for representation is broken by decades of underfunding and the effects of this can be seen in the lack of representation and the delays in hearings. Immediate action is required to address this.
There is no procedural fairness and, despite cosmetic legislative safeguards, there is no effective way to enforce these. People cannot effectively enforce procedural fairness before, during or after the hearing.
The evidentiary procedures are completely reliant on a Reviewer’s exercise of discretion rather than on the procedural safeguards available to all New Zealanders in other legal proceedings. These have been developed over centuries of common law to ensure the fair determination of proceedings and were enacted into the Evidence Act 2006. There is significant and reliable evidence that, at a systemic level, the discretion is not being exercised in a way that allows access to justice.
Institutional mechanisms for upholding the rights of injured people have failed. The principles and purpose of the CRPD have not been understood or implemented. ACC and the Government have a conflict of interest that suppresses motivation for reform, and we conclude strongly that an independent commissioner for ACC is required to reform the system according to the CRPD.
Acclaim Otago recommends that the committee take the specific action on each of these points set out at Chapter IV – Conclusions and Recommendations. The three recommendations at the conclusion of this report can be considered a consensus view of the independent experts in this field in New Zealand working in the ACC dispute resolution system. The list of experts who have endorsed all three recommendations is at Appendix 1.

This shadow report draws heavily on the lived experiences of PwDI. Some of their responses to our survey are included in yellow text boxes. Some individual experiences have been videoed and put on our website.



The CRPD and ACC
Why is the CRPD important for Injured New Zealanders?

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It’s not fair on your kids when you are stuck in this process. Its not like you can just decide you don’t want to be involved with ACC. You are dependent on them. The law protects lots of society who are dependent but not ACC claimants. There is no independent body you can go to with problems there is a support line to phone for advice but it is only the government told ACC to offer to save on the cost of the huge number of complaints ACC get. It is still serving ACC, not claimants really. It doesn’t go far enough to offer funding to help you get the info and proof and advocacy you need to be able to get the things that should be part of your rehab. That’s the other thing. ACC, no matter that your injury is permanent, always assess on the proviso you are on the road to independence. We wish. That is how they can erode your support and gives them justification to push you into doing more that is detrimental to your overall wellbeing. (R 54)


The most abusive and horrific experience of my life – fighting for the rights of my son … (Q100R39)
If I ever get injured again I will do everything in my power to not use ACC … (Q100R22)
The entire system is tailored to suit a positive outcome for ACC. (Q100R72)

Without seeking to tell the Committee about their own area of expertise, the CRPD promises many things. It has been seen as a shift from previous human rights treaties because of its explicit acceptance of a social model of disability (art 1). Some go further and say the CRPD has created a previously unacknowledged disability rights paradigm.4 As the text of the Convention acknowledges, this transformative social shift cannot occur without good data (art 31), positive messages (art 8), the voices of people with disabilities (arts 33 and 4(3)), and without a careful approach to interpreting the convention’s text so that its detailed provisions are not read down.5


2014 is New Zealand’s first opportunity to show the Committee how their efforts in promoting the Convention prior to 2008 have translated into action. The CRPD would not exist unless there was significant work to be done – its purpose is to progress that work – and now the New Zealand Government must be rigorously examined on its work so far.
The ACC scheme has been excluded from CRPD reform


Over the years, ACC has tried every dirty trick in the book, including complete intimidation to the point at one stage a suicide attempt seemed the only way out and this was then used against me at the hearing. They play dirty, can you understand now why we finally threw our hands in the air and gave up. (Q74R46)


When you have a chronic injury, you are not prepared for the litigious, aggressive, time consuming unethical framework you are now forced to work within. I have a substantial injury that is likely to never get better. ACC has delayed and denied key treatments and my injury deteriorated in the process. The only way to describe what it is like is you have to FIGHT to get anything. You must have a good lawyer. Dealing with ACC is as bad as having the worst injury – you effectively get 2 injuries. (Q100R175)
I gave up in my dealings with them, they treated me with disregard and without dignity. They had made up their mind well before as they were not prepared to reassess those beliefs. I felt they used the [review] process to run me around, burn me out, so I wouldn’t get my complaints to avenues outside of ACC. They misguided and misinformed me, and I don’t trust them or have faith in any dealings with them. There is no access to fair and just treatment when dealing with significant complaints. Even when these breach ethical codes. (Q94R34)

The Accident Compensation scheme is essential to the Government. It provides legal immunity for itself, the medical system, its businesses (including its tourism industry), Ministries of the Crown, and other New Zealanders by removing legal liability for personal injury. Instead, it promotes an agenda of rehabilitation and prevention. In some ways, it was pioneering given its inclusion of social rehabilitation, and providing support aiming to reduce the social barriers against people disabled by accident. It does not fit neatly into any disability model. The level of services it provides to those receiving cover and proper entitlements is something to which any disability system can aspire.


But the Accident Compensation system is in conflict. Now, it is arguable that ACC creates as many social barriers as it removes. There is a strong medical focus and a culture of repeated intervention as directed by officials and non-treating assessors. People who are injured have impairments that can be “fixed”. The perception is that they are given a high level of services, and so any resulting effects of their injuries can only be their “fault”. Even from other disability organisations, there is an attitude that such a generous scheme should only result in the “gratitude” that such a medical or charitable model demands.


I found my experience with ACC extremely negative, they are meant to be there to help people that have been in accidents and had injuries but they make you feel “guilty” even when you are not. As soon as they think you are going to be on ACC for a period of time I think they just find any reason to decline cases without due course. This causes the claimant so much stress financially and mentally, when you have a serious injury and you have to fight for compensation this does not help you get better quicker. (Q100R64)


It has been a constant battle to obtain and hold onto my rightful cover and entitlements. I have spent 100s and probably 1000s of hours of my time in litigation with ACC and cannot get financially reimbursed for this time (as self representing). They would rather spend $10k fighting a claim than pay you the $1000 item requested. I regard the organisation as morally corrupt and the antithesis of the supportive and humane concept originally envisaged … (Q100R86)

If the Committee has the time to look at the ACC website, they will note that, along with administrative news, and positive messages, the most prominent topic is fraud. ACC loves to “catch” claimants who they say are lying about their disability, relationships, or employment.




My neighbour (who unbeknownst to me worked for ACC) took photos of me doing chores on my lifestyle property that my specialist and doctor told me I should be doing. ACC then called me into the office, ambushed me and totally humiliated me in front of my wife and threatened me with legal action if I didn’t sign their forms. My doctor and lawyer both disagreed and told me to fight it, but it was too much after years of fighting them and I ended up having a mental breakdown. (Q100R24)


I feel like a 2nd class citizen, I have had my honesty questioned by AON, ACC and their assessors. Been made to feel I am ripping ACC off, and that I should be grateful I get any help at all. I have had work mates abuse me, ignore me, insult me, some of whom I had worked with for 10 years who knew I didn’t shirk work. I ended up dreading going to work every day. Boss who treated me that way as well. Then losing my job. (Q100R119)
Claimants must return to a General Practitioner every three months and prove they are still disabled. They are forced into “functional capacity evaluations”, and assessors commonly comment about whether a person has applied “sub-optimal effort”. There is a disconnect between how people with disabilities see their own experience, and how that is viewed by assessors. The first statement below is a response to our survey from a treatment provider, the latter from PwDI.


Spending time focussing on unfavourable events and blaming them for every other factor in a person’s life is unproductive. I am often surprised at how little some people do to try and improve their ‘lot in life’ and simply spend their time trying to apportion blame on others … drug addiction to opioids is a problem with some long-term claimants and cannot be underestimated. This provides a reason to continue to assert the on-going presence of injury and pain … in order to ensure on-going supply of opioid medication. … The judicial process is not necessarily the best way to settle disputes – it is part of it but not the whole. Some patients need to take increased responsibility for their own life … It should also be recognised that lawyers such as … Warren Forster may lose income if disputes are removed … they need to declare a possible conflict of interest. Dispute resolution will always be an imperfect system, no matter what process is in place. Some people, or groups of people, will always feel that they are ‘hard done by’ or that others are conspiring against them. Unfortunately, that is a fact of life – as Charles J Sykes famously wrote “Life is not fair. Get used to it” (a quote often mis-attributed to Bill Gates). (Q100R35)



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During my lowest moments I was suicidal. Thankfully I have beautiful grandchildren and the thought of what a choice like that might do to them and to my adult children is what kept me going. I also have a strong faith and utilised these challenges to work on my own personal and spiritual growth. Two of my six children have walked out of my life and want nothing more to do with me as a direct result of my emotional struggle to manage pain, brain altering medications, loss of confidence, loss of job, loss of independence, loss my beautiful family home, loss of being close to my family, friends work colleagues and neighbours when I was forced to move. My other 4 children have been absolutely amazing, lending me mortgage money, paying for firewood etc during the 18 months that WINZ became my sole income. The final court review was going to result in either me paying everyone back, or selling up completely and paying everyone back. Fortunately for me, the Judge was a just man, and saw the Truth. I really feel so upset for others who don’t get this opportunity and I have met plenty of them. My lawyers continued to represent me after losing the review for no charge if they lost, as they believed in me. I was so very blessed, (Q100R160)


The Accident Compensation Corporation recently returned an annual profit of $5 billion dollars (approximately 3% of New Zealand’s annual GDP). It generates this through compulsory levies and a huge investment portfolio. It is an integral part of New Zealand’s national fiscal and budgetary integrity.



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