Battle over surgery after cycle crash

Julie Kerr. Photo / Mark Mitchell

Julie Kerr is fighting to win what she considers her entitlement to surgery paid for by the Accident Compensation Corporation.

Miss Kerr, now 52, suffers constant soreness and frequent "agonising" pain in her right shoulder after a bike accident.

"At Easter 2010 I fell off my bicycle, landing heavily on my right shoulder," she said.

She was among more than 20 people who contacted the Herald yesterday with complaints about ACC after they read of a 16-year-old rugby league player's painful two-month wait for ACC's to approve surgery for a tear in the knee cartilage.

Attention has again become focused on the number of ACC claimants being turned down for surgery after the corporation's chairman, John Judge, speaking last week to MPs, criticised a 2010 Herald series in which about 400 people deluged the paper with complaints about ACC.

After a review - which was announced during the series - ACC admitted rejecting too many elective surgery claims.

Miss Kerr now lives in Wellington, but at the time of the accident she lived in Morningside, Auckland, and was riding to the nearby St Lukes shopping mall.

She at first sought only massage for the pain and has continued with this therapy, but several days after the accident she also saw a doctor and subsequently specialists. An MRI scan showed she had a full-thickness tear of a muscle in the top of the shoulder.

"They [ACC] say that must have happened since I hurt my shoulder. They say I have got a degenerative condition."

ACC had declined cover for surgery.

The Accident Compensation Act 2001 does permit the corporation to decline cover on grounds including degeneration related to ageing or a non-work gradual process, but only if the injury is caused "wholly or substantially" by these factors.

Miss Kerr said Auckland orthopaedic surgeon Adam Dalgleish concluded that she needed surgery on her shoulder.

"He said it was usually the result of an accident that you get a full thickness tear. There might be 1 per cent of the population at my age that would have a full thickness tear ...

"But he said chances are if I had had one before, I wouldn't have been swimming 10km a week."

She said Wellington sports medicine specialist Jake Pearson said there was no doubt the shoulder injury was the result of an accident.

Miss Kerr has turned to a top ACC law firm, John Miller Law, to help her challenge the corporation's decision in a review hearing scheduled for May.

She is a part-time personal trainer, but because of her shoulder injury she has difficulty with some of the physical activities required.

ACC national claims manager Jeremy Edwards, said the corporation had carefully considered all available medical evidence relating to Miss Kerr's request for funding, which he said showed her need for surgery was to fix "bursal impingement syndrome".

"This is not an injury, as defined in ACC legislation, but a gradual process condition, which is why we were unable to approve Ms Kerr's request.

"ACC is not challenging Ms Kerr's need for surgery - our role is to determine whether ACC can pay for it."

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