Dear Accident Compensation Corporation,

1. Are Branch Medical Advisor "opinions" ever requested by ACC management and/or staff purely in response to a client submitting new medical evidence, and solely for the purpose of using the "opinions" document at a review hearing, not for the purpose of an ACC case owner/case manager reviewing a decision to decline cover or an entitlement? If so, please provide me with a copy of the ACC policy, procedure, guideline or rule that allows for this.

2. Where a review application has been made by a client, but the review has not yet proceeded, and a client finds 'errors of fact' in a Branch Medical Advisor "opinion" that does not amount to a difference of opinion but is proven factually inaccurate and/or misleading by medical or other evidential record/s, is the ACC required to correct same if so requested by a client, and do so before the review hearing takes place? If not, please provide me with a copy of the ACC policy, procedure, guideline or rule that would allow the ACC to refuse such a request.

3. In the abovementioned circumstances, would it be ACC policy to refuse to correct the 'errors of fact' on the basis that the review is underway, and whether or not a review hearing date has not been set down ? If so, please provide me with a copy of the ACC policy, procedure, guideline or rule that allows for this?

4. Would it be ACC policy to refuse to correct factually inaccurate and misleading information - proven by medical or other evidential records - where a client complains to the ACC about same? If so, please provide me with a copy of the relevant policy, procedure, guideline or rule.

5. Would it be ACC policy to refuse to add correction statements to the original documents which they seek to correct where a client requests this? If so, please provide me with a copy of the relevant policy, procedure, guideline or rule.

6. What other course of action is available to a client who wants to ensure that the information made available to Fairway Resolution Limited and its reviewers by the ACC is factually accurate and not misleading (given that the ACC provides a copy of the client claim file to Fairway Resolution Limited very early on in the review process with ACC claims records being added to all the time right up to the day the review hearing takes place)?

Yours faithfully,

Lee M.

Dear Government Services,

Thank you for your reply, however, you have not satisfied my information request.

In relation to question 1:

I asked a specific question that you have not responded to. Instead you advised me that there is no ACC policy that matches the "scenario" I mentioned.

The primary issue is not whether or not the ACC has a policy that matches the question I asked, and I am repeating my question below but have split it into three parts:

Question 1 - part 1: (primary issue)
Are Branch Medical Advisor "opinions" ever requested by ACC management and/or staff purely in response to a client submitting new medical evidence?
Question 1 - part 2: (primary issue)
Are Branch Medical Advisor "opinions" requested solely for the purpose of using this information at a review hearing?
Question 1 - part 3: (supplementary issue)
Does an ACC policy, procedure, guideline or rule provide for either or both of the abovementioned situations, and if so please provide me with copies of same.

Please answer the abovementioned questions without further delay.

In relation to questions 2 and 3:

Firstly, Fairway Resolution Limited has confirmed in writing that it is NOT a Tribunal.

Secondly, Fairway Resolution Limited has copied me clause 6.9.4. of its Reviewers Training Manual which states very clearly that (my use of capital letters): "THE REVIEWER is not an "agency" for the purposes of the Privacy Act 1993. This is for two reasons. First, the Privacy Commissioner has determined that A REVIEWER SEEKING INFORMATION ON A MATTER IN ISSUE IS (for the purpose of the Privacy Act) a Tribunal acting in relation to its judicial functions. Such a tribunal is not an agency. Secondly, it is considered that A REVIEWER comes within the exception "(xii) A commission of inquiry or board of inquiry or court of inquiry or committee of inquiry appointed, pursuant to, and not by, any provision of an Act, to inquire into a specific matter." Therefore, THE REVIEWER is not bound by the Privacy Act and the Health Information Privacy Code, and does not have to comply with the restrictions the Act and the Code puts on the collection, use, and disclosure of personal information."

Thirdly, Fairway Resolution Limited employs a Privacy Officer and logically would not do this if Fairway Resolution Limited was not subject to the provisions of the Privacy Act.

Fourthly, Fairway Resolution Limited NEVER acts in the capacity as a reviewer of the ACC's decisions as you have claimed, and, if this was the case then Fairway Resolution Limited would be breaching the terms and conditions of its service agreement with the ACC.

There are no grounds to refuse my requests under questions 2 and 3 and I am now insisting that you provide me with this information without further delay.

In relation to question 6:

Applicants may have "the right to contest evidence of medical specialists in that hearing and contest the evidence put before Fairway Resolution Limited ..." when a reviewer is considering a review application, however, given that a review hearing is routinely set down for 1/2 an hour irrespective of whether the claim is complex and the matters are substantive, it is improbable that applicants get 'a fair go' at review hearings in terms of this unfair, unreasonable and unjust time-limit.

No response is required to the abovementioned comment.

Yours sincerely,

Lee M.