Four years after the Accident Compensation Corporation refused to pay for treating some of her injuries from a horrific car accident, Yahaloma Hochman feels her life is no longer worth living.
Pain in her neck, back and knees make it agonising to bend, walk or sit.
Her wrists are swollen and her fingers, grasped tightly around the steering wheel of her car when it was spun across three lanes of Auckland's Southern Motorway, have frozen so she finds it hard to hold a cup.
"I want to cut off my fingers, it's so sore," she says.
She has taken 60mg to 80mg of morphine every day for four years and it has given her chronic indigestion and constipation. She is virtually confined to home.
"I'm in constant pain and high blood pressure. I can't sleep. I cry a lot," she says.
"I don't have appetite. I don't want to live any more, because I don't want my life to be like this and I don't have the energy to fight the ACC."
Mrs Hochman, 51, last spoke to the Herald in December 2010 after ACC refused to pay for spinal surgery on the grounds that her "advanced disc degeneration" was "aggravated by the road traffic accident and not caused by [it]".
Her story unleashed an avalanche of stories from about 400 people who had been refused treatment because ACC said their injuries were due to age-related degeneration or other pre-existing conditions.
An internal ACC review in 2011 disclosed that the corporation had "phased out auto-approval processes" over the previous three years and brought in tougher tests of what caused injuries. Its refusal rate of requests for elective surgery doubled from 11 per cent in 2007-08 to 22 per cent in 2009/10, when a hit-and-run driver and then three other cars slammed into Mrs Hochman's car in November 2009.
The corporation changed its processes after the review and said this week that its refusal rate dropped to 21 per cent in 2011 and 2012 and to 19 per cent last year.
In Mrs Hochman's case, it finally paid a $14,000 lump sum last June to compensate for what it assessed as a 28 per cent impairment in her health.
It had already paid for knee surgery in February 2010, but Mrs Hochman had to wait another year for spinal surgery through the public health system in February 2011.
The corporation said this week it still had "no evidence that her right shoulder condition is injury-related", so she has been on the public health waiting list for 18 months for surgery on that shoulder. She has been advised to have the right shoulder done before the left one, which ACC will fund. The shoulder surgery may relieve the pain in her neck and hands.
But she is angry at the long wait and that ACC has agreed to only selective treatment.
She was starting a reflexology business when the accident happened but could not get compensation for loss of income and has had to live on a benefit. Her lump sum went quickly on a car, washing machine, towels and a trip to Israel when her mother and sister died in quick succession last year.
"I have become a poor lady, very sick but nobody taking responsibility," she said.
She tried to get help from the Israeli health system but was turned down because the accident happened here. She has lived here since 2003, is an NZ citizen and has two daughters here aged 24 and 17, and a son in Australia. She and her husband separated in 2007.
Wellington lawyer John Miller, who specialises in ACC cases, said Mrs Hochman's experience was "fairly typical of the claims that ACC try and advance".
"If you or I fell off a chair they would initially cover us for minor entitlements," he said.
"But as soon as you start asking for more substantial entitlements like surgery, then suddenly there is a game-changer. I really think it's often the cost."
Mr Miller said the law still stated that ACC's primary focus was rehabilitation to help restore "a claimant's health, independence and participation".
"I think that purpose is wide enough for ACC to bite the bullet and say we had better do the complete rehabilitation because otherwise it's like painting half a house - what's the point in it?" he said.
But ACC relies on another provision which says "personal injury" in the law "does not include personal injury caused wholly or substantially by a gradual process, disease, or infection" unless it is caused by work or medical treatment.
The agency said this week that two orthopaedic specialists and a clinical advisory panel all agreed in 2010 that Mrs Hochman's lumbar sprain was "a degenerative disc disease predating the covered accident".
ACC general manager of claims management Sid Miller said the slight fall in the refusal rate for elective surgery since 2011 was due to working with medical specialists so they understood what ACC would fund, which had led to fewer "non-ACC-related" requests.
He said ACC was now widening the panels that decide on complex cases to include rehabilitation experts as well as surgeons.