The #MeToo movement and more generous support for sexual abuse victims has increased the number of people seeking treatment in New Zealand by 88 per cent.
ACC is now receiving 21 claims a day which are related to mental or physical injuries from rape and sexual violence, up from 11 a day in 2013.
The large increase in people making sensitive claims in the last five years is stretching treatment services.
As a result, ACC is asking contracted providers to consider letting interns and newly-graduated counsellors take on sexual assault victims – a job which is usually left to more experienced staff.
The spike in people seeking help is partly the result of a policy change in 2014, when ACC introduced a more flexible system which covered the full costs of victims' initial treatment.
ACC acting chief customer officer Emma Powell said it was also influenced by higher rates of awareness and reporting.
"It's no secret that, even before the #MeToo movement became very public over the last 12 months, there has been a growing and consistent conversation in the public about sexual violence and about consent and the impacts to young people as well as adults and children."
Powell said ACC was "pleasantly surprised" by the increase because the goal was to make the system more accessible. But ACC was also aware of the pressure it had placed on treatment providers. It was now working with 1490 providers – double the 2014 amount.
Wellington Sexual Abuse HELP Foundation director Conor Twyford said there were 30 people on her organisation's waiting list for counselling and they were waiting around four months for their first session.
"That's 30 people who have had a horrible experience and should be seen now," she said.
ACC had asked to amend their contract to allow new graduates and clinical psychology interns to help sexual abuse victims "on a case by case basis".
Twyford supported the proposal, though she warned of fish-hooks.
"People have generally had several years of experience working in our sector before they take on an ACC registration. They will need really good support."
Despite ACC's more flexible approach to sensitive claims, some still had a few concerns about whether it was too rigorous or traumatic.
Since 2014, victims who made a claim with ACC had been able to get up to 14 hours of counselling for free. If they wanted further treatment or compensation they had to be assessed and have their claim approved. That required proving they had been injured by their abuse, and that the injury was directly related to that abuse.
Wellington Rape Crisis service co-ordinator Sandra Fuller said ACC's assessment process was still "a work in progress".
"It is a massive improvement on what existed before," she said, while adding: "I don't think it works for everyone."
Hayley Young, who was raped while serving in the New Zealand Navy in 2009, said ACC covered the initial costs of her therapy but rejected a claim in 2013 for lost income and ongoing treatment.
"I didn't have any physical injuries so they were looking for a mental injury. The therapist's definition of a mental injury was if I was reacting disproportionately to what had happened to me.
"Her assessment was that we can't cover you because you're acting proportionately to what you've been through."
As an engineer, Young estimated that she lost $200,000 to $300,000 as a result of her time off work after being raped. She hoped the system had improved since she was assessed.
In 2017, 2253 out of 7779 sensitive claims were declined.
Associate ACC Minister Clare Curran said sensitive claims were often time-consuming and ACC had to decline a claim if a decision had not been made within nine months. It could continue to investigate cover for the client even after it had been declined, she said.
She said the assessment process could be "anxiety provoking" for some victims, but that the process had been improved to make it less traumatic.