Denied

[Maha]

About 6-7 weeks ago, I was working away happily, on my knees sanding a floor, as I do everyday.
Nothing different to any other job, but I pivoted to the left and FUCK!!!!!
My right knee felt like I had knelt on a soldering iron!!
I stood up, ripped off my kneepad and rubbed the knee like fuck cos, shit piss, it hurt!

Few days later, see the Doctor, forms filled out etc....seems I have prepatellar Bursitis?
Or....fluid on the knee??
Anyway, X-Rays done...
ACC wanted more X-Rays (of both knees) and an Ultrasound on the right knee.
Got that done, all good so far.
Then they wanted and MR1 scan done....got in quick smart because there was a cancellation.

'The MRI shows a partial tear of the ACL in the right knee'
Today, I get a letter for ACC saying..
'Sorry, we cannot approve your claim'

WTF??

The reason....'Insufficient medical evidence to support the presence of any physical injury'

HELLO!!!!.....I have a partial tear in the AC Ligament of my right knee!

[firefighter]

WTF? My brother had surgery on his knee a few months back, pin-hole and they stitched the ligament. He had no issues whatsoever with ACC. He did lie however and said he did it running.......

This is B/S. it's obviously a fair claim.

Maybe you could send a letter in return asking if they'd like you to go in and give an assessor a partial tear and then ask if there is sufficient damage!

Good luck.

[slofox]

How goddam typical is that..!

I wouldn't let it go Maha - go international if you have to. Hassle the shit out of them, give them heaps of publicity, get second third fourth opinions...A guy I know took them to court over a refused claim and won his case...let's hope you don't have to go that far but it has been done successfully.

[Laava]

Want to borrow a .243 Win or a semi auto silenced .22? Purely for therapeutic reasons of course!

[mashman]

sounds very similar to the injury that my boss had... he received a denial letter, appealed and got his leg sorted out not long after that... the double standards are attrocious. All the best Maha...

[Maha]

I did call them today, before my Doc appointent, and said....
'' Have you not seen the MRI results? I have a partial bla bla etc, thats an injury, not a just headache''

Seems I now have to go through the all the paper work again!
I need to see an Orthopedic Surgeon for an assesment, but I'll be fucked if im going to do that till I hear back From ACC.
Interesrting comment though by the doctor today ''ACC are an Insurance Company''.

[quickbuck]

Ouch,
Shit!!!!!

And ACC to top it off aren't easing the pain... Now I see where your comment came from in antoehr thread, if you know what i mean.

Fight it Maha, and I hope you make a good recovery from that horrid injury in the future.... Motorcyclists need their knees....

[Maha]

Ouch,
Shit!!!!!

And ACC to top it off aren't easing the pain... Now I see where your comment came from in antoehr thread, if you know what i mean.

Fight it Maha, and I hope you make a good recovery from that horrid injury in the future.... Motorcyclists need their knees....

I still have to work, I cant not work, I work by kneeling on my left only, it is difficult going.
Try getting around on the floor using only one knee, it aint easy.

Oh yeah I intend to let them help me.
They based the claim denial on the first Doctor report of Bursitis.
Which is clearly not evident at all.
The ultrasound proved that.
I am a Vinyl layer, have been for 30 years.
Naturally my knees will show signs of wear and tear to a degree.

[slofox]

Naturally my knees will show signs of wear and tear to a degree.

I wouldn't tell them that if I was you...just concentrate on the one off event that caused the tear...

[MadDuck]

Bloody hell! Anyone who cant see what ACC is up to is living in a cave....

Fight them Maha. Wheres the nearest damn office?

[quickbuck]

I still have to work, I cant not work, I work by kneeling on my left only, it is difficult going.
Try getting around on the floor using only one knee, it aint easy.

Oh yeah I intend to let them help me.
They based the claim denial on the first Doctor report of Bursitis.
Which is clearly not evident at all.
The ultrasound proved that.
I am a Vinyl layer, have been for 30 years.
Naturally my knees will show signs of wear and tear to a degree.
True,
That work thing..... Yes, as a vinyl layer, I can see the need for your knees.....

Ahh, I see now where the initial claim may have been rejected.
I'm sure it will all be sorted for you.

Oh, and yes, the Doc is right on one thins, ACC is an insurance company....

[Mom]

Want to borrow a .243 Win or a semi auto silenced .22? Purely for therapeutic reasons of course!

Hmmmmmmm, I dont have a firearms license though, does that matter?


I did call them today, before my Doc appointent, and said....
'' Have you not seen the MRI results? I have a partial bla bla etc, thats an injury, not a just headache''

Seems I now have to go through the all the paper work again!
I need to see an Orthopedic Surgeon for an assesment, but I'll be fucked if im going to do that till I hear back From ACC.
Interesrting comment though by the doctor today ''ACC are an Insurance Company''.

Your doctor sucks :yes: So does the business she works for. About time we changed. She is not a kiwi, and probably is basing that on her previous countries schemes. Unbelieveable, the whole thing.


I wouldn't tell them that if I was you...just concentrate on the one off event that caused the tear...

Far too late for that mate, this fucking doctor called it something that both unltra sounds and MRI scans have proven does not exist. She is standing by her initial diagnosis. Asks Maha to request that ACC pay for a specialist 2nd opinion. Good luck to him getting that done.

ACC CAN KISS MY ARSE.

[Mully]

The cynic in me wonders if it's new ACC policy to deny claims on the first go to see if people give up.

I recall reading somewhere that some insurance companies do that. Not that ACC are an insurance company though........

[T.W.R]

She is standing by her initial diagnosis. Asks Maha to request that ACC pay for a specialist 2nd opinion. Good luck to him getting that done.

ACC CAN KISS MY ARSE.

+1 on the second opinion :yes:

had almost exactly the same thing happen this time last year...every time I'd put weight on my right knee it'd feel like a hot knife was being twisted under my knee-cap.
Went to the doc..got reffered to a physio for a check over...nothing found so back to doc then off to get a X-ray still nothing found but pain getting worse by the day.
Finally reffered to a knee specialist in ChCh...appointment made, arrive & put on consultation bed...knee & leg bent & twisted, pushed & prodded and diagnosis made Buritis impatella a couple of steroid shots along the side of the knee-cap and a swollen knee for a few weeks and problem solved...only twinges once & while now but ACC couldn't refuse the diagnosis from a specialist

[oldrider]

ACC CAN KISS MY ARSE.

I have just changed my name to ACC by deed pole! :wari:

[Babelfish]

Acc, bless 'em...they're just too nice to say you're a fat fuck that shouldnt be putting that much weight on your knees

[Mom]

+1 on the second opinion :yes:

had almost exactly the same thing happen this time last year...every time I'd put weight on my right knee it'd feel like a hot knife was being twisted under my knee-cap.
Went to the doc..got reffered to a physio for a check over...nothing found so back to doc then off to get a X-ray still nothing found but pain getting worse by the day.
Finally reffered to a knee specialist in ChCh...appointment made, arrive & put on consultation bed...knee & leg bent & twisted, pushed & prodded and diagnosis made Buritis impatella a couple of steroid shots along the side of the knee-cap and a swollen knee for a few weeks and problem solved...only twinges once & while now but ACC couldn't refuse the diagnosis from a specialist

Which is all well and good, but NOT what Maha has wrong. Be wonderful if it was, a couple of injections and all is sweet. As shown by the MRI that ACC rquested and paid for, he has a partial tear of his anterior cruciate ligament. That is not a bursitis, that is a proven injury :yes: However, ACC, despite the referring doctor telling them, that the patient complained of a sharp and sudden, severe pain in his knee, on a given date, have decided that it is a gradual onset condition. Mind you, she will not go back on her diagnosis of bursitis despite the ultra sound and MRI saying he does not have it.

I am not sure how you can partially tear a ligament in a gradual fashion without any warning pain to let you know you are doing it slowly???????



They can all get fuckt!

[Swoop]

They are obviously punishing you for daring to ride a bike bigger than 600cc and that is where the danger is! We know that since ACC told us... and they wouldn't lie...

Work is safe since we have so many osh-nazi's running around creating paperwork.:ar15:

[T.W.R]

Which is all well and good, but NOT what Maha has wrong. Be wonderful if it was, a couple of injections and all is sweet.

Not quite. It's a deterioration of ligaments under & around the knee-cap that doesn't go away...it has to be monitored and can easily flare up again to the point that an operation can be the only cure.


As shown by the MRI that ACC rquested and paid for, he has a partial tear of his anterior cruciate ligament. That is not a bursitis, that is a proven injury :yes: However, ACC, despite the referring doctor telling them, that the patient complained of a sharp and sudden, severe pain in his knee, on a given date, have decided that it is a gradual onset condition. Mind you, she will not go back on her diagnosis of bursitis despite the ultra sound and MRI saying he does not have it.

I am not sure how you can partially tear a ligament in a gradual fashion without any warning pain to let you know you are doing it slowly???????


Entitlement to a second opinion is always there, though a dianosis of an existing injury that has flared up is their defence as there's no telling when it was initiated or what caused it. ligaments deteriorate with age and you can't claim ACC for getting old :yes:

[duckonin]

ACC are shit bags, they will wear you out with a paper war, your age says it all and their responce will be 'your knee is degeneritive' age related, they even said the same about a fifteen year old lass recently....Pick your words very carefully with ACC, remember they have our money to fight us !!

[Laava]

Neither have I!

[p.dath]

I'm starting to think you and Mom have really pissed off someone at your local ACC branch ...

[freedom-wedge]

The cynic in me wonders if it's new ACC policy to deny claims on the first go to see if people give up.

I recall reading somewhere that some insurance companies do that. Not that ACC are an insurance company though........

I think its the rule, dont pay out until you really have to, and as far as insurance goes ACC are the biggest and best at this hold on to the funds as long as you can game.

[yungatart]

I'm starting to think you and Mom have really pissed off someone at your local ACC branch ...

I agree! All that protesting and speaking out against them has turned against you, Maha!

[Bounce001]

If you are having no luck with your local ACC branch, which it sound like you are not as they are standrad issue ACC Nazi's. Try getting in touch with an ACC mediatior to fight this on your behalf. Have a mate who does this. PM if you want further details to contact him.

[EJK]

Well, they weren't so helpful were they? :no:

[Ixion]

The cynic in me wonders if it's new ACC policy to deny claims on the first go to see if people give up.

I recall reading somewhere that some insurance companies do that. Not that ACC are an insurance company though........

Yes. I have had a number of people tell me about ACC denying claims on totally ludicrous reasons. I suspect they are doing exactly what you say. On the basis that a percentage of people will just accept it and give up. Those that contest it, they will delay and fudge a bit. If they finally have to admit they're wrong, they're no worse off. Cunts.

[hayd3n]

i had the same for my wrist
one day it went all sore and weak
acc follow up saying gradual bla bla bla not covered

[Mom]

The doctor yesterday called ACC an insurance company. She was very earnst about educating us :D

I am currently reading ACC's Statement of Intent 2009–2012 and their annual report to glean a bit more information. One of the ways they are saving money is to manage the claims they accept. New speak for decline as many as they think they can get away with hoping no one has the energy to complain. In breaking news I have just had a call from ACC - apparently they have now accepted my claim :D

[Mom]

i had the same for my wrist
one day it went all sore and weak
acc follow up saying gradual bla bla bla not covered

But you are only a young fella. How young bods can be degenerating is beyond me. There was a 17y/o girl that injured her knee and ankle in an accident. ACC accepted teh ankle but not the knee citing gradual process. They took ACC to the High Court and got the decision reversed.

[SPman]

Hmmmmmmm, I dont have a firearms license though, does that matter?I think, after you have used it for it's implied purpose, that won't really be a major issue ...........:whistle:

[p.dath]

In breaking news I have just had a call from ACC - apparently they have now accepted my claim :D

Sorry to hijack your thread Maha, but that's great news Mom. Talk about a lot of grief.

[ynot slow]

Joining the flooring contractors disease club eh?Bet you anything those farkers at ACC will say in future "you spend a lot of time on your knees" so as such it's an occupational symptom so not covered"but do it running and you're covered.Be hilarious for hookers,imagine their occupational symptoms with back issues.

I know a guy who still does laying and in his late 60's or even 70-72 at last count,and still pretty active knee wise.Occupational hazard and that sucks,amazing you get seen by a specialist quickly and they say more paperwork,bet the surgeon loves the double handling,lots of $$$ to charge the corporation,a rort ya think.

[Toaster]

'The MRI shows a partial tear of the ACL in the right knee'
Today, I get a letter for ACC saying..
'Sorry, we cannot approve your claim'

WTF??

The reason....'Insufficient medical evidence to support the presence of any physical injury'

HELLO!!!!.....I have a partial tear in the AC Ligament of my right knee!

Their continued attempts to deny rightful claims in order to reduce costs are just absurd. Disgraceful.

[Owl]

Hmmmmmmm, I dont have a firearms license though, does that matter?

Triggers aren't fussy!:no: