New Zealand has a no fault system where medical treatment may have caused an injury. As the insurance provider ACC covers for these particular situations, under the heading of Treatment Injury. In July 2005 Medical Misadventure changed its name to Treatment Injury. So if the child (or adult) has Treatment Injury cover under ACC it is because a family member (often a parent) has made a claim on their behalf, and their claim has been accepted, proving that the specialist or medical professional gave inaccurate information to the mother about what the antiepileptic medicine could do to a foetus.
To have a fuller understanding and appreciation of what the family has gone through to obtain an accepted claim and realise that it is not something to be taken for granted, here is a brief insight. The claim has been through a thorough investigative process (up to 9 months, but realistically closer to a year due to the complexity of the claim), where everything gets looked into. It has not been an easy process for the family. Often there are times of frustration, invasion into privacy, emotional draining and the feeling of not making any progress.
This has all been done for the benefit of the person who has been affected, as the family knows the child (or adult) will have access to resources, support, specialists, therapists, and services, which far outweighs that of the public health or education system if the claim is accepted.
Having a claim accepted can make a significant difference to the persons life, not just now but also in the future. Some families have felt a sense of being overwhelmed as they can go from little support or input to all of a sudden having lots of people wanting to do assessments, appointments, and provide services.
Receiving a declined claim from ACC can be disheartening and some people feel like what’s the point in trying to fight the system! There are avenues they can go down, as they can ask for a review. The paperwork for this will be sent out to them at the same time as they receive the declined letter. They only have 3 months to lodge for a review. If they go through with a review this is a lot of hard work, and can be emotional draining, so please be there to support them in whatever way you can.
There are still families out there who are not even aware that their family member could be eligible for a claim. Additionally there are some families who do know they are eligible, but have chosen not to go down this path yet, and that is their prerogative.
The link below can offer some more information into whether or not someone is eligible.
This link will also provide you with more information on what each person needs to do e.g. the doctor, the parent. The person who should fill in this form should be the doctor, specialist, paediatrician etc. who knows the child the best. A precautionary warning here, it is best not to go down the ACC path until the child has a formal diagnosis from a healthcare professional.
Having a claim accepted can make a significant difference to the persons life, not just now but also in the future, as an accepted claim means they have coverage for life. Unfortunately a diagnosis of FACS is a life long condition.
Needs Assessment and Service Coordination service (NASC)
If you or someone you care for needs support because of a disability, you’ll need to talk to a Needs Assessment and Service Coordination service (NASC).
NASCs are organisations contracted by the Ministry of Health to work with disabled people and their family, whānau, aiga, or carers, to:
- identify their strengths and support needs
- outline what disability support services are available
- determine their eligibility for Ministry-funded support services.
NASCs allocate Ministry-funded disability support services and help with accessing other supports. These services are then delivered by their respective service providers.
NASCs are contracted by the Ministry’s Disability Support Services unit. It’s their job to ensure that the support and services allocated to you are fair, and fit within the disability support services budget.