Tuesday, July 10, 2012

What to do if you have to see a WINZ Designated Doctor




 Based upon the experience of beneficiaries,  we present:



SOME GOOD  ADVICE  TO APPLICANTS / BENEFICIARIES FACING MEDICAL EXAMINATIONS BY SO-CALLED DESIGNATED DOCTORS, WHO ARE COMMISSIONED AND USED BY WORK AND INCOME AND M.S.D. 


CLIENTS/APPLICANTS ARE STRONGLY ADVISED TO DO THE FOLLOWING:

1. When facing a medical examination under s 44 and s 54B of the Social Security Act 1964 - as part of a review for a sickness or invalid's benefit, clients/applicants should ask to be examined and assessed by a medical practitioner or psychologist of THEIR choice! It has to be a doctor or specialist they do not usually see themselves. So it would pay to look around for one. ONLY when a case manager does reject a chosen medical practitioner or psychologist picked by a client/applicant, can they then tell a person whom to see, which usually still should at least allow a "pick" from a short list (which is what they mostly offer, without even considering a client's/applicant's preference)! Regrettably in at least some cases, WINZ case managers simply told a client or applicant, whom to see - or to restrict their choice to take a pick from a short-list. This doesn’t sufficiently meet the legal provisions though.

"Agreement" must first be attempted between a case manager and client/applicant, before a WINZ case manager can object to a client’s/applicants choice and expect the affected person to see a medical practitioner or psychologist proposed by WINZ/M.S.D.!

2. In selecting a medical practitioner or psychologist under those parts of the Act, a client/applicant should at least try to express the expectation that a professional medical examiner or assessor must have the appropriate, sufficient expertise and qualifications in the areas of health the client/applicant suffers from! This is not clarified sufficiently by the law as it stands, but some would suggest, the law implies that a reasonable effort must be made by WINZ case managers and other staff involved, achieving the best and most appropriate match of medical practitioner/psychologist to the conditions and disabilities a client/applicant suffers from.

At least for the last few years, MSD and WINZ have almost exclusively been referring clients/applicants to GPs, but one must fairly ask how appropriately and sufficiently qualified are general practitioners to professionally and competently assess for instance mental health sufferers, and/or persons with addiction illnesses? Without possessing further (post graduate) qualifications in those areas, it is doubtful or at least uncertain.

This is an area needing further clarification, so by making decisive attempts to get their rights and expectations best met, clients/applicants should be very mindful of their particular needs and what a fair application of the law should mean in their case. It should therefore at least be attempted to raise the expectation to be examined and assessed by the right and most competent, suitably qualified medical professional!

3. When going to a medical examination/assessment by an appointed (agreed or not agreed) medical practitioner/psychologist, a client/applicant should make every effort to go WITH A TRUSTED SUPPORT PERSON! A doctor/psychologist can object to this, but then it should be negotiated with him/her, and also ideally with WINZ, whether a chosen support person should be accepted or not. Certainly any applicant/client affected has a right to be supported, so if one support person is rejected, a reasonable alternative must be accepted. It is advised to inform the medical professional beforehand of a support person to come along.

The support person may be an advocate, a caregiver, a friend, a relative, or 


whosoever, but having a witness, who may ideally also take notes, that will ensure that a doctor or other health professional will not be misled or tempted to make any wrong or biased decisions. Medical practitioners and psychologists will be prompted to act carefully, be diligent, thorough and listen to the client/applicant and conduct a truly professional, evidence based, fair and reasonable examination and following assessment.

4. When facing a Medical Appeal Board (see section 53A of the Act) for hearing an appeal against a decision by a “designated doctor” and WINZ, the possible input into who may be appointed to the 3 member panel is not so great, but when presented with the panel, a client/applicant should seriously think again: Is there personnel on the panel, that is expert and qualified enough in the areas of ill health that I suffer from? Do I feel the members are all competent, with the appropriate and sufficient skills and qualifications needed to re-assess my health situation and ability to work or not? If in doubt, this should be raised with M.S.D.’s Medical Appeals Coordinator.

In any case, if there are any serious problems arising from taking these precautions and making such demands, then it will certainly pay to consult a beneficiary advocate. But sections 44 (1) and 54B (3) of the Act should be clear.

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Sadly most clients/applicants do not think enough about all these important questions, and the possible harmful, negative consequences. Taking those precautions can protect from much wrongdoing and suffering down the line, and thus ensure a fairer treatment by medical practitioners, other health professionals and consequently also WINZ staff.

There may well be changes coming with the new proposed welfare reforms, to be announced by the present government soon. So this space will need to be watched and adjustments to new legal interpretations may become necessary.
What is of a great concern to all affected, is also the fact, that since 2008 the “designated doctors” used by Work and Income and M.S.D. have been TRAINED by the Ministry, which happened under the directions and management of the since 2007 employed Principal Health Advisor, Dr David Bratt (a general practitioner). This is also widely not know, and as the examples with some ACC cases have shown, it pays to be highly alert and cautious about medical examinations conducted by the designated doctors that Work and Income and M.S.D. choose and commission!







































5 comments:

gabe said...

Hi, thanks for this, that is very useful.

On what grounds can a doctor legitimately object to a client taking a support person?

president said...

HI there, I'm not the author of the article. I will try to contact the author and get their view. I don't think that WINZ can stop you taking a support person, so if you are seeing one of their designated doctors you should be able to take one. I don't see why any doctor would be allowed to refuse you either.

HC said...

gabe: A doctor may object to a support person who may not have been announced as coming along, as a "surprise" to bring one along without informing a designated doctor beforehand may be seen as a bit unreasonable.

I would suggest to always make an effort to let the doctor know beforehand that a support person will accompany a client facing an examination.

Usually a doctor should not have any issues with a support person being brought along, as even WINZ allows clients to come and see their case managers with support, same as clients are allowed to bring support before a Medical Appeal Board hearing an appeal.

I think that a doctor should not have any reason to object, unless she/he may be able to perhaps argue that a particular support person may be inappropriate, e.g. for fear of "intimidation" (with clear stated reason and justification for this).

Otherwise one rejection may be acceptable, so another support person than a first suggested one is even harder to "reject".

Just argue your case, that you or anyone as a client facing a designated doctor exam or appeal hearing simply feel "afraid", "insecure" and "vulnerable" on your own, then there is hardly any reason for being reasonably rejected.

Hugo Veedee said...

Hi, I am trying to find the author of the author of the above article and I have, could you refer me to them?

president said...

Hugo, if you email unitewaitemata@gmail.com with your contact details including email address then I will try to put you in touch with the author of the article. Or the author may see your comment here and respond.