Man takes ACC to court after multi-year battle to get cover for post-traumatic stress injury

The man is fighting for ACC to recognise his injury was caused by the treatment he received.
The man is fighting for ACC to recognise his injury was caused by the treatment he received. Photo credit: Getty Images

A 45-year-old man is taking ACC to court over its refusal to cover a hip injury he claims was caused by a health specialist's treatment.

The man, who wished to remain anonymous ahead of court proceedings, has been fighting for years to get the Crown entity to recognise his post-traumatic stress injury (PTSI) and cover his medical bills.

He told Newshub he suffered a back injury six years ago that was subsequently made worse by a physiotherapist he visited.

"In 2015 I injured my back at the gym, put the claim through with ACC… and then they changed the way they were administering one of the programmes, so I wasn't able to continue on with the physio I was with."

He started with a new physio, but that's when he says things went horribly wrong. The man alleges he was told by the physio to "get on the treadmill and go for a run", which resulted in him suffering a debilitating hip injury.

As a result, he decided to put a treatment injury claim to ACC. 

But the next year and a half was a struggle.

"I was struggling to cope with everything that was going on… All I wanted to do was get well and actually do the things I love, and so my mental fitness took a massive dive.

"I've been trying, on and off, to try and get a diagnosis for PTSI - a number of psychologists who I have seen during this time have said, 'Look, we're pretty certain you [have it] but we don't do the diagnosis that ACC wants'."

The man said because his treatment injury claim was rejected, ACC too was declining his PTSI claim.

According to ACC, its decision not to accept the man's claim was because the medical evidence didn't support his treatment injury claims.

"In this case, ACC's view was that the medical evidence did not support physiotherapy as having caused [the] hip and thigh sprain," said ACC chief operating officer Gabrielle O'Connor. "Therefore, his claim for a mental injury as a result of the same treatment was also declined."

O'Connor told Newshub ACC's decision was upheld when the man chose to have it independently reviewed.

Because the man was now appealing the review through the District Court, O'Connor said ACC could not comment further. 

The independent review of the man's case last year found his pain was due to "other causes", and not a treatment injury.

According to the review: "As a result of not having cover for the sprain injury he claims, [the man] cannot have cover for a resulting mental injury, because under the Act that is dependent on having cover for the physical injury."

The review states the evidence submitted was "lacking". But the man disputes this and insists the sprain was caused by the physio. 

Despite the challenges, the man is refusing to give up on getting his claims accepted.

"In a lot of situations, especially ones like mine that are a little bit more complex, they don't see you as a person - they see you like a number and how much it's going to cost them," he said. 

"I'm not going after them to get some bloody $40-50,000 payout - that's not what it's about… I want them to help, I want them to pay the bills that need to be paid for me to be able to get well and have the tools that I need to stay well."