A Whangarei dental assistant who suffered serious spinal injuries wants a court to rule that case managers with no medical qualifications at ACC cannot override opinion of medical professionals without supporting proof.
Lyndall Knight injured her midback at her Whangarei Heads' home in November 2012 and after an operation in Auckland and admission to the Otara Spinal Unit, she claims ACC approved only two hours of home care help, instead of the recommended 11 and a half.
A disc in her midback had slipped into the spinal cord and she may never be able to walk without an aid.
Although ACC finally approved the recommended hours three weeks later, her advocate John Robinson has filed for a review and is willing to take the matter up to the District Court if necessary.
He said he sought a direction from the reviewer which denounces delays and making of such critical decisions by case managers without medical qualifications who override specialists' requests without the supporting documentation of another specialist, he said in papers filed yesterday.
However, ACC spokesman Glenn Donovan said Mrs Knight's case manager had sought information from appropriately qualified medical professionals.
Mr Robinson claimed that ACC in Whangarei was unaware of Mrs Wright's situation and her needs when he contacted the state insurer around January 4.
A further contact was made two weeks later to ensure that ACC had the support mechanism in place for her discharge and return home.
Mr Robinson said her case manager decided to approve only half of the number of hours help recommended by a primary care report. A stroller was approved but crutches were not allocated immediately.
Full cover was accepted on February 5, the 12-hour home help on February 14 and physiotherapy support a day later.
Mr Robinson claimed the case manager told him she had no medical qualifications and that she sought no outside input from a suitably qualified person before making the decision to reduce the number of hours.
However, ACC spokesman Glenn Donovan said Mrs Knight was promptly provided with a range of equipment, including crutches, upon her return home.
ACC case managers, he said, were not required to have medical qualifications but that their role was to ensure clients received appropriate rehabilitation support. "To provide this support, ACC seeks information from appropriately qualified medical professionals, as happened in Ms Knight's situation," Mr Donovan said.