Noose Around My Neck
Author: Annette Mary Moody

Chapter 3
ACC Process - Part One

Noose Around My Neck – ACC vs. OOS

 

3. The ACC Process - Part One

I received a letter on 26 June 1998, which stated that my claim had been accepted as a work-related injury. I was granted permission to commence my chosen methods of treatment. My ‘temporary’ Case Manager was off the case, and a ‘permanent’ Case Manager[1] appointed. We met 10 July 1998. A Rehabilitation Plan, ‘a growing document’, was drawn up. The aim was to be fully independent of ACC by 31 October 1998. Four months in which to undo over three years of damage to my neck, shoulders and lower back! I would be busy! This goal was reviewed in October and altered to 24 December 1998 with provisions for reviewing the work situation for 1999 - which is yet to happen! As I write these words, during Labour Weekend, I can’t help but wonder what the year 2000 - two month’s away - will hold for me.

Acceptance had taken from 30 March 1998 until 26 June 1998. The only reason I was accepted was because I myself had done so much research and had pestered ACC so often that if they didn’t accept me they were sure I ‘would take the Corporation to Review, and the Corporation would probably lose’ - so it reads in my file! They did not believe in the validity of my symptoms or my claim. I was then assigned a particular case manager who was briefed to ‘keep a close eye on this one’!

As a matter of interest, I had put in a claim in February 1994 after a car accident resulting in whiplash. I did not take advantage of it. However, if the claim had been based upon this incident, and not OOS, my claim would have been immediately re-opened, no questions asked! Like all good taxpayers I have paid my dues. I have paid my premiums! As an employee, and previously as an employer, I had paid considerable amounts of money. I pay road taxes too! But clearly it appeared that the Corporation thought I was taking them for a ride.

A word on visible injury as opposed to invisible injury. In August of 1999 I was requested to drive an elderly couple some distance for a surgeon’s appointment. I can comfortably drive for a maximum of 40 minutes, this was twice that distance, however, I wanted to assist. I strapped on my wrist supports to ease the pain of handling the wheel. In a supermarket, the attendant noticed, with genuine concern, the straps and asked me what had I done to myself. These straps are quite comfortable and I had forgotten I had them on! Most people notice how ‘well’ I ‘look,’ the results of massive amounts of sleep, which of course is nature’s remedy and our greatest time for healing.

To illustrate further, Geoff had injured his knee many years ago in a sporting accident. Now, through over-use at work, the injury was visible, clicking the knee out of its socket and swelling to huge proportions. It affected his self-employed status, obviously his job performance and his life. Sound familiar? After some urging he finally did something constructive to help himself. In April of 1999 he went to the emergency doctor, he had x-rays taken, forms were filled out, they were submitted to ACC, a visit to the surgeon was arranged and hey presto - he was under-going reconstructive surgery and recovery. He experienced no real delays, no questions about his ‘worthiness’ or lack of it, it was simply done! Geoff’s a new man because of it. Isn’t that how the system should work? Isn’t this what the system called ACC is all about?

I was slowly beginning to realise how contentious OOS really is. It would be a while longer before I also realised how political it is. Did you know that it has actually reached epidemic proportions in Britain, Australia and now New Zealand? That in one form or another it has been evident throughout the pages of history right back in fact to the days of Egyptian scribes and their writing implements? Did you know that telephone operators in the 1950’s were recorded as mass sufferers? I was horrified to learn that at the turn of last century, sufferers were placed in asylums, such as Lake Alice! Why? Because the pain and frustration can evoke hysteria!

Of course, amongst other names, it was RSI, Repetitive Strain Injury, apt when you consider that those who suffer from it are engaged in occupations that have the same repeated tasks. Name an activity that of itself does not have repetitive elements. I am ashamed to admit that previously I held no belief in RSI. Strange, that I should now be plagued by such an insidious condition.

So, to avoid incredulous disbelief, wear wrist supports, elbow supports, anything which makes your injury visible. I will. It’s not enough to have spasms of pain flash across your face when you sit down or stand up, or worry lines etched across your forehead or around your mouth. These are fleeting and quickly dismissed. Visual evidence equates to concern and due consideration is then given.

The constant ringing of the telephone from well-wishers and my own support network was diminishing. Some simply faded away, and others were pushed. I was in hermit mode, and they had grown tired of this saga. I didn’t blame my friends and family, I was constantly defending my position and situation. Forever trying to educate them and others in the causes and effects of OOS. Endeavouring to present a clear picture of the whole story. Several days could go by without a single phone call. I was at times feeling very alone and isolated. Other friends spoilt me and to them I am grateful. But I get ahead of my story!

CM2 and I sat together in a conference room, on 10 July 1998, at my local ACC Branch and she drew up my rehabilitation plan. It consisted of:

10 sessions of the Alexander Technique, which I would ‘aim to incorporate into daily life to support and to increase level of function and decrease pain’

ACC will ‘consider osteopathic treatments requested as per current legislation’

ACC will ‘fund up to 3 sessions with a clinical psychologist to address the impact of this injury on her life and to learn pain management techniques’ (this was increased to 5 on 3 August 1998 - I then continued on my own for a while longer because it was so uplifting and educational)

ACC ‘will provide 1 hour per week for four weeks, home-help assistance in the following areas - vacuuming - washing floors - bathroom cleaning.’ ‘Annette will return to full independence in her home and will be managing all household tasks by 15 August 1998.’

ACC and Annette will meet with her employer ‘to discuss opportunities/alternative duties. Once appropriate employment is identified ACC will arrange a work-site assessment by an Occupational Therapist to ensure the work-station is set up appropriately and to monitor and support her return to work’

ACC ‘agrees to consider funding any aids that may be recommended by the O/T to support Annette’s return to work’.

Here CM2 informed me that I would have to realise that I would of necessity go down in status and probably income! I couldn’t believe my ears. No, I didn’t realise! I didn’t accept this at all.

I was given a list of local psychologists and after a telephone conversation with her I chose Jennifer. She was, of course, ‘my nearest treatment provider’, and proved to be gentle, insightful, skilled and successful.

I was granted 10 half hour one-on-one sessions with an Alexander Technique Master. I had interviewed this gentleman, Peter, over the telephone during my month of research and was delighted to ring and say that we had been given the go ahead! I ordered these sessions as close together as time would allow. His report recommended a further 6/7 sessions after 1 month back in the work-force. This has yet to be implemented. It was fascinating how much I learnt and the benefits I received, all of which I detail later in the Chapter entitled ‘Working Treatments’. Suffice to say here, that this technique offers methods in pain management, visual clarity and relaxation. It focuses on posture, poise and practical ways to execute daily tasks and better ways to position your body for sleep.

Peter had recommended Cranial Osteopathy as the best companion to his methods and the right solution to my problems. Although Peter had not met Anne, he suggested her as one of the best by virtue of her British training. On 7 July 1998, I began my first treatment. Once a week, and later each 10 days I would and do attend for 30 - 40 minutes of manipulation of the soft tissue, nerves, bones and muscles of the skull and entire body. Anne even straightened out my little finger which had been crooked since a fall at age 8 or so. A nice bonus. I was very excited. Help was now a reality! I had chosen well!

These methods work. All are gentle, relaxing and satisfying, and my personal favourite, not one item of clothing needs to be removed!

Light appeared at the end of the tunnel, I now had three wonderful support people, four, counting my GP, three chosen methods of treatment all of which was complimentary to each other.

Next, my Case Manager, and I met with Human Resources at my place of employment to discuss work prospects and their side of the rehabilitation plan. That meeting on 15 July was a complete failure. ACC informed Human Resources that they were not obliged to offer me work! Despite all the glossy advertising brochures printed by this organisation that says ACC will get you back into work [or your own job] as soon as possible, they were letting my employers off the hook!! Our representative said I was welcome to resign, or I could apply for any position that may be suitable. She further added that part-time work was scarce. I just sat there. I virtually said nothing. I suddenly realised how weak I was, physically, mentally and emotionally. My spirit was broken. I desperately need to regain my composure and my confidence. I also had to get out of this office now!

I had driven CM2 in my car, and as we left I asked to see one of ACC’s employment consultants. Thus I was introduced to a small agency for a ‘work trial’ over a period of nearly four weeks. This clearly showed, as I had determined, that I could only just handle 9 hours per week. A work-site assessment was completed and a chair and ‘slope board’ offered to me for trialing. During this time I was introduced to one of their associates - an occupational therapist. This woman put me through a ‘functional capacity evaluation’ - I’d call it a trial of tortures! Lifting weights high above my head, pushing, then pulling a trolley which not only had uncontrollable wheels, was also laden with the entire collection of weights, and 40 step-ups, are only some of the ‘functions’ I was forced to perform. After this episode, it took me in excess of 7 days to achieve a semi-rested night’s sleep and for the added pain to subside. This is truly an indication of how vulnerable I was, it didn’t occur to me to say no - go to hell!

My working definition of depression is - if you start to think of your untimely demise - you are depressed. A further indicator is when you fail to find humour in any situation.

My work history, all office related, can be neatly put into three sections, secretarial, office management and personnel consulting. None, of these duties involve weight lifting! However, it was noted that I was of average + fitness, and a healthy 41 year old female. How kind of them to notice!

One bright spot about now was the arrival of my 3rd nephew - a gorgeous light-weight package! To my dismay I could not hold him in my arms with either confidence or any degree of safety. However, I am happy to report that by the following May and upon meeting my 6th beautiful niece - a bonny, well-rounded, beautiful dumpling, I was able to hold her for half an hour!

It was now time for further union involvement. Ursula[2] my representative, came out to my home and spent several hours with me, understanding my position, feelings and future hopes. We had another meeting with Human Resources and that was helpful from the angle of several sessions with an entity known as Employee Assisted Programmes - to look at transferable skills and re-writing my Resume. HR sent me on an interview, a full time role, in one of our departments, as a receptionist/secretary. I was astounded. If I could do this, I could also do my own job thank you! Clearly I couldn’t. Further more, the interview panel was not briefed on my condition. It was quite frankly embarrassing all round.

For good measure I also involved the local Labour MP’s assistant. John is a sympathetic campaigner and another valuable support person. He attended several meetings with ACC.

I did enjoy the services of a friend cleaning my house for one month, however she moved into another area and that option was apparently not renewable with ACC. I didn’t put in a claim for her - it wasn’t viable.

This took care of July and August. Moving into October ACC decided I needed a ‘physio assessment’. Still recovering from the previous evaluation, I postponed two appointments. This, believe me, continued to be a black mark against my name for months to come. The evaluation was completed on 15 October. Though this woman had a much clearer understanding of OOS with all of its associated weakness and implications, she recommended a course of physio, stretching exercises, increasing cardiovascular fitness, a three month subscription to their gym, and heat treatments - none of which I wanted. Discussing, as usual, everything with my GP and Osteopath, we felt this would be detrimental.

I was by now beginning to amass quite a collection of material on this all-consuming subject. In September I began writing letters to ACC on this process and my feelings about all that I had endured. I copied them to the ACC Complaints Investigator, my Treatment Providers, Labour MPs and Work. A mistake, I learnt for if you want action, you need to write directly to the individual persons. I was beginning to get very very angry. Geoff complained that I had bad breath - a clear indicator of repressed anger.

I purchased an ‘ergonomic’ keyboard, I borrowed people’s computers, their fax machines, and their offices in efforts to get my points across. I’m sorry to say that I achieved little success - but I refused to give up. I am not a piece of meat to be traded off against a balance sheet, or to be subjected to one person’s set ideas of how my body, mind and spirit could/should be repaired. Please bear in mind, it is you who is the truest expert on your body!

A case conference was called for with my Counsellor, Human Resources Rep, Union Rep, Case Manager and Occupational Therapist plus me. I presented a letter from my Osteo and comments from my GP. The outcome was commencement of a ‘Graduated Return to Work Programme’ through my employers. I was eager for this. A space was found, tasks created. The O/T presented ACC with a series of written reports, assessments, recommendations (mine actually), and several inaccurate and in places down right nasty comments on yours truly. This covered the period 19 October - 23 December 1998.

What was wonderful was that ACC funded a telephone head-set, an ergonomic chair, a slope board (which is useful for reading from, but not, as it’s supposed to be, for writing with), and a foot-stool. My employers provided a work-station. They also later allocated a Case Manager from within the organisation and funded their choice of O/T as a consultant. Believe me a different kettle of fish - to trot out a worn phrase! This one knew what she was doing, was sympathetic, understanding and compassionate. Admirable qualities.

The unfortunate fact is, the whole exercise was unsuccessful because the tasks I completed were incompatible with my injury, the equipment took 9.5 weeks to arrive and just when we were getting somewhere, Christmas arrived and the position collapsed.

ACC were not impressed. This was taking far too long. They are only interested in their time-frame. Cranial Osteopathy is rather like tuning a piano. It doesn’t happen once, it is a slow process conducted with great skill, care, repetition and caution. Unlike Physio which you can attend almost on a daily basis the body needs much time between sessions to absorb this re-conditioning.

Unless you find yourself in the very early stages of OOS I do not recommend physiotherapy. Exercises only aggravate this condition - stretching and pulling of nerves and muscles got you into this mess in the first place. Heat packs, spas, a ‘Tens’ machine will only offer temporary relief. So why waste your money - or ACC’s - which is a point I could not get through to them. My Visa card purchased an Air Jogger! Low impact, gentle on the joints, smooth in operation, and it tones! A great work-out, air-aerobic in fact! However, it was one year before I learnt the necessity to combine the movement of shoulders with the pelvis - they must work in sinc, otherwise you get pain across the upper back - as I was.

In September I was invited to participate in an independent survey of ACC. I rang and said I would be delighted! I had plenty to say! The premise was ‘Understanding Your Needs.’ The next sentence read ‘It’s important for us to measure the services we provide to our clients and make improvements.’ It was signed by my local ‘Acting Branch Manager’. This proved to be news to him! He admitted in March, the following year, that indeed he was A not aware of this ‘survey’, and B not aware that his signature (computer generated in fact) had been put to this ‘invitation’! However when the representative from BRC in Wellington rang me, on my cell-phone, we spoke for 30 plus minutes!

I was granted a reprieve over the Christmas period, my local MP’s office wrote to HR supporting my request for some annual leave. This later proved to be a learning curve for John, Ursula and myself, because I should not have had to delve into any annual leave entitlements at all. The only appointments I needed to keep in January 1999, were at the Osteo Clinic.



[1] Henceforth referred to as CM2.

[2] Not her real name.

 

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