ACC says no to injured woman

A Blenheim woman is accusing ACC of cost-cutting after it refused to fund follow-up treatment for an injury to her foot that it initially covered.

Yvonne Everson dropped a large piece of firewood on her left foot in August 2007, and her original claim to have treatment covered was accepted.

For 18 months, ACC paid for ongoing X-rays, specialist appointments and doctors' visits. Then, when surgery was requested in November last year, ACC declined the claim, on the basis that the accident had exacerbated a pre-existing "fatigue fracture".

Ms Everson's specialist, Andrew Meighan of the Marlborough Orthopaedic Clinic, agrees with her that "it is reasonable to use the history of the injury to decide what fractured the bone".

"The injury involved a heavy log capable of causing the fracture. She tells me she was symptom-free before dropping the log on her foot. Her symptoms were continuous from that point until her recent surgery. The X-ray appearance is compatible with the injury she describes.

"With fatigue fractures, the pain is often present for a considerable time before a fracture is seen on X-ray. It is therefore much more likely that the injury she sustained caused the fracture, rather than a gradual stress/fatigue process."

At first, Ms Everson's problems with ACC seemed to be incorrect paperwork, with the right rather than the left foot recorded as injured. The form was corrected and resubmitted, but in June she discovered that the paperwork had been lost. A phone call to ACC's complaints department resulted in the surgery being declined.

"I went in to ACC's Blenheim office with my block of wood and offered to drop it on someone's foot, but there were no volunteers. They said it would break a bone," Ms Everson said.

At this point, she was placed on the public waiting list. She had surgery in September, when bone from her hip was used to fill a gap in her foot and a plate was inserted. Delays had made the injury more complex to treat, she said.

The ACC saga has continued. An official review of the decision in September confirmed that surgery would not be covered because it was apparently a previous injury. X-ray costs and home help to assist with caring for Ms Everson's two children were also declined.

In another review with ACC last week, she arranged to attend a telephone hearing in three weeks, at which she could be represented by a lawyer, with ACC to foot this bill.

Initially, Wairau Hospital's A&E department diagnosed Ms Everson's injury as a sprain and sent her home with a stretch bandage, crutches and painkillers. Ongoing pain prompted her to return to A&E, and she has since had the foot in a plaster cast for 10 days, worn foot orthotics, and had numerous appointments with GPs, a physiotherapist and an orthopaedic specialist.

"I even tried wearing a shoe for six weeks 24/7, even sleeping in it to try to fix the fracture myself by not moving it," she said.

While constantly advised by friends and professionals that she should put the dispute with ACC behind her and "get on with life", Ms Everson said she wanted confidence that ongoing treatment would be covered.

She also felt compelled to alert people that there was no guarantee that injuries initially covered by ACC could continue to be claimed for.

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