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As ACC begins to pay lump sum
compensation again, Sarah Boyd examines its handling of sexual abuse claims. In recent days, for the first time
in more than a decade, a sexual abuse victim has received a lump sum payment
from ACC. ACC won't say how much - only that the payment will have been more
than $2600 and less than $104,000, depending on the severity. The claimant
will have been assessed as having suffered a mental injury from sexual abuse
- which could be a rape, indecent assault or a range of other offences under
the Crimes Act - and left with an impairment of at least 10 per cent. He or
she would also have had many counselling sessions, but will not have had to
lodge a complaint with police about the abuse. Lump sum payments for all injuries
were reintroduced in April 2002, 10 years after being scrapped by the
National government. They are available only for injuries from events that
occurred after 2002, which is why it's taken more than two years for the
first payment. According to some, their
reintroduction signals the opening of the floodgates to an easy route for
compensation. Others, particularly counsellors who work with victims, say the
reverse is true; that it's getting much harder to get compensation. Or, as
the head of ACC's sensitive claims unit, Jackie Pivac, prefers to see it, a
difficult balance has been set about right - ACC is criticised from one side
as too lax and the other as too tough. The ACC system is extremely
complex, with a variety of payouts possible depending on when the abuse
occurred. What is clear is that the number of new sexual abuse claims being
accepted each year is reasonably steady - at about 5000 - but the costs of
claims has escalated from $12 million in the 1995-1996 year to a projected
$25.5 million this financial year. That is because of backdating on
claims by adults for mental injuries they are now suffering as a result of
childhood abuse. In the 2002-2003 year, about 60 per cent of total cost of
claims was in backdating. ACT MP Heather Roy maintains that
backdated payments are effectively lump sums, after getting information from
ACC showing that the highest backdated payment since 2000 was $153,077. She's
also concerned at figures showing that two claimants were receiving $1418 a
week compensation, and 10 were on more than $60,500 a year. Most sexual abuse victims, though,
use ACC just to pay for counselling. The result is that 66 per cent of
claimants are out of the system within a year and another 15 per cent within
two years. The remainder require longer-term
assistance. Some who are assessed through counselling as having an on-going
impairment of 10 per cent or more (before the reintroduction of lump sums)
receive an independence allowance, which can be up to $63, tax-free, a week. She has been doing the work for 17
years. "It's got much, much harder to get any sort of compensation. And
we're more accountable." They have nine counsellors working
on sexual abuse cases and she says very few of their current clients are
receiving financial compensation. "Most of the parents decide they don't
want to put their children through any more assessment for a few more
dollars. They get counselling and that's it. It (compensation) is not
something that everybody gets." The process for getting
counselling from ACC has also been tightened up in the past couple of years,
to the point where some counsellors have thrown in their ACC work in protest.
Only a GP or an ACC counsellor can
lodge a claim for counselling on behalf of someone who says they have been
sexually abused. A counsellor can then provide up to four sessions in order
to determine whether the person meets the criteria of having suffered a
mental injury - significant behavioural, cognitive or psychological
dysfunction - as a result of the sexual abuse. If it's approved, they get 10 sessions
before a detailed progress report is submitted to ACC in order to get further
counselling. At about 50 sessions, ACC requires the claimant to attend an
independent assessment with a clinical psychologist or psychiatrist. It was at that point that June opted instead to keep seeing
her counsellor without ACC picking up the tab. She says ACC's way of
monitoring counselling is too rigid. "They give you 10 sessions and they
have to be between, say, May and August. It just doesn't work that way.
Sometimes you go to a counselling session and you just don't want to
talk." She says that as a person finishes
counselling, it makes sense to spread out the last few sessions. But the way
the system works, it requires them to be done by a certain date, with no
flexibility. A serious concern is the effect
that the various checks in the system can have on the person being
counselled. The president of the New Zealand College of Clinical
Psychologists, Barbara Chisholm, has written in its magazine about the high
risk of victims being re-traumatised by having to retell their story to the
person reviewing their treatment. "Frequent unwanted reviews on
very personal material involving feelings of shame and embarrassment are
abuses of privacy, power and autonomy. ACC dictation of rigid timeframes and
numbers of sessions which are not based on the therapist's assessment and
recommendations and do not take the clients' specific situation into account,
are also abuses of power by ACC," she writes. Ms Pivac acknowledges there was
disquiet among counsellors when the new systems came in, but she thinks it
has settled down. "A lot of criticism was around form-filling. We don't
want to make it difficult, but we have to have quality control." There is no evidence that fraud is
more prominent in sexual abuse claims than others. Of the 700 ongoing
investigations by ACC's fraud unit, just two are in that area. "It's a balance," says
ACC's general manager of rehabilitation operations, Gerard McGreevy. "We
have got fraud in all parts of the scheme. We have good processes for
preventing it, but we can never stop it. I would honestly question why
anybody would say they've been sexually abused." There have been various incidents
in the past, he says, "but I would say those who have made false claims
are unwell anyway". Mrs Roy says the problem is that
claimants do not have to prove they have been sexually abused, or even name
the alleged perpetrator. She's also concerned that lump sum payments are an
incentive to make false claims. Mr McGreevy says people predicted
a drop-off in claims when lump sum payments were removed in 1992, but, in
fact, claims increased. "I think it was because of where society was at
in terms of dealing with it - people felt they could talk about those things
without social stigma." ACC Minister Ruth Dyson
acknowledges there is international debate about the benefits of lump sum
payments. But, she says, the system National replaced them with was
deficient, and the new regime of lump sums will be more tightly managed than
previously. Mrs Roy says it's unfair that a person who suffers a mental
injury as a result of sexual abuse is covered, while mental injury caused by
other trauma is not. Ms Dyson says it would require an
extremely robust system to cover mental injury without opening the door to
all sorts of claims. People could claim to be traumatised by something they'd
seen on television, for example. "There are a lot of
situations that cause adverse effects. I think we've got it about right
now." So she's confident a mental injury
from sexual abuse can be assessed? It's as good as the systems used
for other injuries, she says. "They have to make a professional
assessment when you've strained your back. It's really no different. We're
relying on some degree of honesty from claimants, but also that they can be
professionally assessed." National's ACC spokesman Paul
Hutchison is concerned there's no requirement for claims to be substantiated
and reported to the police. "Isn't this just cementing in the problem
and isn't ACC colluding with the victim not to expose this deep-seated
problem in He says that encouraging a
complaint to police would have to be handled on a case-by-case basis, as some
claimants would be too traumatised to do so. But, he says, there should be
some mechanism to bring perpetrators to account if possible. Ms Dyson says she would not want
to see a link made between the validity of the claim and a prosecution.
"It's ideal to have the person brought to justice, I agree, but how you
do that is not as straightforward as saying ACC should get the police
involved immediately." It's a suggestion that alarms
counsellors, who say most of their clients would be daunted by the suggestion.
Many are disclosing events that took place years ago, perhaps involving
family members, and they may take many months of counselling to even begin to
discuss it. Nor does it find favour with ACC.
Mr McGreevy: "There are some issues where you have to trust the
professional expertise and training of counsellors. For some people, to bring
it up that they should report it to the police would send them over the edge.
For others, it's part of the healing process." -------------------- * Claimants can get ACC assistance
for sexual abuse if they are assessed as having suffered a mental injury as a
result of the abuse. * The abuse has to be as defined
in the Crimes Act, which includes sexual violation (rape), incest and
indecent assault. * Most claimants receive free
counselling of about 15 sessions and exit the system within a year. * Lump sum payments have been
reintroduced for events occurring after April 2002 and where claimants have
suffered 10 per cent permanent impairment or more. One sexual abuse victim
has received a lump sum payment since 2002. * Lump sums are not retrospective
for events before April 2002. * Claimants do not have to file a
complaint with police to be eligible for counselling or compensation. -------------------- CAPTION: Talking it through: |
