A man disabled by a workplace accident is horrified dozens of ACC staff looked at his sensitive claim file on childhood sexual abuse, viewing it more than 350 times after it was closed. The file of his wife, who acts as his advocate, was also accessed. The couple say their rights and privacy have been breached, but ACC says every access was justified. Anusha Bradley reports.
Photo: RNZ/Vinay Ranchhod
It was something they said that sent a shiver down Matthew's spine.
It was a few days before Christmas and Matthew* was in a Zoom meeting with ACC. It had been organised to discuss the hold up in getting a mobility aid that his doctors said he needed.
But when the meeting started, that wasn't what ACC wanted to discuss. Two senior managers started talking about an old sensitive claim that Matthew had closed four years prior.
That file, Matthew thought, was supposed to have been kept under lock and key, to be accessed only by ACC's sensitive claims staff. But Matthew soon realised the senior managers were talking about things in that file. Things they would only have known if they had read his medical notes. Notes that detailed the horrific sexual abuse he'd suffered as a child.
Matthew panicked. He didn't understand why ACC staff who were supposed to be dealing with his claim for a workplace accident that left him severely disabled, had been able to access this information, or why they had.
"I had to leave the meeting. I just couldn't cope."
Matthew would later discover that those ACC staff at that meeting had logged into his sensitive claim file the morning of the Zoom call. He would also discover that since closing his claim in February 2017, more than 90 ACC staff from all over the country had accessed it a total of more than 350 times.
***
Matthew, 29, had always been an active person. He grew up rurally and went on to live on a farm on the outskirts of Auckland, where he thrived in the outdoors. "I love the bush and the beach. I'd always be heading to the beach to go camping with friends, or go hunting, spearfishing and diving."
But that all came to a halt in 2013 when he injured his back while working. Following a series of complications he developed Complex Regional Pain Syndrome, which is described as one of the most painful chronic conditions known. The McGill Pain Index ranks it as being more painful than childbirth, or having a toe or finger amputated without anaesthetic.
It means Matthew is in constant pain and he struggles to walk, stand or even sit for too long. "It's like laying down on a rock and having a sharp piece of the rock stabbing up into your back and no matter what you do, or how you move, it just won't move or stop or go away."
No medications were helping and the pain prevents him sleeping and can make him so queasy he doesn't want to eat. "I can go for days without eating sometimes."
The once fit and active man is now clinically malnourished and suffers from depression. He relies on his wife or his eldest son for help with basic tasks. He barely leaves the house.
***
It was a big deal for Matthew to file a sensitive claim with ACC. He'd never told anyone about the sexual abuse - only Kate*, his wife, knew. The abuse started when he was a young child, but like many survivors, he sealed the dark memories in a box and buried it in the depths of his mind, and got on with his life.
But now, disabled, stuck at home and alone with his sleep-deprived thoughts, the trauma of his early years began to resurface. "I had a lot of time just having to sit there and go through my own mind and what was in there. All the techniques and strategies that I had built my life around to carry on were gone, and I wasn't able to put it in its place like I normally would."
Matthew accepted he needed help. While he was initially hesitant to open a sensitive claim, he was reassured by his psychologist that only a handful of staff at ACC's Sensitive Claims Unit would be able to see his records. So with Kate's encouragement, he filed a claim in 2016.
Kate decided to file her own sensitive claim at the same time for sexual abuse she had experienced. The thought of them both going through this together gave Matthew some comfort. "I didn't feel alone in the dark."
Matthew had about 10 pre-cover sessions and a formal sensitive claim assessment with a therapist before calling it quits. "Effectively through that process we figured out that it wasn't the sensitive [claim] that was the problem. It was the physical injury causing him to relive that [experience]," explains Kate, who acts as Matthew's advocate.
Instead Matthew, who had been diagnosed as clinically depressed following the accident, started to receive help for his depression from a psychiatrist under his physical injury claim with ACC. In February 2017, he closed the sensitive claim and forgot about it.
He now regrets ever making that claim. "It's caused more harm than good."
***
That's because more than three years later it would become a painful sticking point for Matthew's recovery and the cause of "multiple breakdowns," including attempts to take his own life.
It started in June 2020. A few days after Matthew met with ACC staff to discuss the possibility of getting a mobility aid that would help him leave the house, he got an email. It said a report by an ACC-appointed physiotherapist advisor, tasked with reviewing Matthew's requests for the scooter and housing modifications, suggested the sexual abuse Matthew had suffered as a child could be relevant to his current injury and he should be reassessed by a neuropsychiatrist.
"Basically, she said, I can see that he has a sensitive claim, but I'm unaware of the details of the claim," explains Kate. "However, [she said] this may influence the condition and it needs to be assessed. So we want permission from him to open this up and give it to someone to be assessed. And until that's done, [we] don't provide any other treatment or rehabilitation."
Matthew was horrified at the thought of anyone else reading his sensitive claim file, but the couple were also baffled about the recommendation he be assessed by a neuropsychiatrist.
So was Matthew's own psychiatrist, who in a letter to ACC, seen by RNZ, described the physiotherapist's recommendation as "unqualified" and "nonsensical".
"As you are aware, Sensitive Claims relate to sexual abuse; whereas neuropsychiatry is a branch of psychiatry dealing with the interface between neurological disorders and psychiatry. For instance, head injury, Parkinson's disease, Huntington's disease and so on. Neuropsychiatrists have no special qualifications in trauma or pain," he wrote.
In another letter, the psychiatrist pointed out Matthew's sensitive claim had nothing to do with his current injury and he was also puzzled that ACC hadn't asked him to do the reassessment, given he had been an ACC-approved sensitive claims provider for many years, and knew Matthew well.
ACC didn't respond to these letters, and Matthew refused to give the agency his permission to bring his sensitive claim into a reassessment. "I refused because it had nothing to do with my physical injury." The thought of more people reading his file also made him sick to his stomach.
His refusal meant ACC continued to withhold the housing modifications, the mobility aid and other treatments he needed even though some had been approved, forcing Matthew to struggle with simple daily tasks like washing, cooking and walking for more than a year. He suffered several falls during this time because ACC delayed installing pre-approved handrails on the couple's staircase.
***
Six months later, during that December Zoom meeting, Matthew realised ACC didn't need his permission to access his sensitive claim file - they'd already read it.
After that meeting, he asked ACC for a copy of the digital footprint on his sensitive claim file. This would allow him to see all the staff who had accessed it. When it arrived, he was shocked. It showed 92 different ACC staff from around the country had logged into Matthew's sensitive claim. It had been accessed 356 times since he closed it four years prior. He believes just a handful of accesses were for legitimate purposes, including accesses after he'd asked for the digital footprint.
The ACC physiotherapist advisor, who had recommended he give permission for his sensitive claim to be opened and that he be reassessed by a neuropsychiatrist, had logged into Matthew's sensitive claim four times in total: twice before she made the recommendation that Matthew give his permission to allow the claim to be read by new assessors, and twice afterwards.
The records also showed the file had been accessed by dozens of different ACC clinical advisors, cover assessors, a former case manager, and administration staff in Auckland, Wellington, Hamilton, Timaru and Dunedin.
He asked ACC to immediately stop staff accessing his sensitive claim. His doctors did too. But it kept happening and he says ACC kept withholding his treatment. Matthew's mental health worsened. "Honestly, I had a breakdown. It was many breakdowns… but one very big and spectacular one."
Kate could only watch as her husband's health deteriorated. "We've been on suicide watch over over this."
In June 2021, Matthew's psychiatrist was so concerned about his mental health he wrote to ACC again: "[His] mental state is very worrying… One of the major issues that is affecting him is the knowledge that his sensitive claim is still being accessed by ACC staff, including a former case manager."
"The breach of his privacy occurring regularly and for unknown reasons is negatively affecting his mental state," he warned.
Again, there was no action from ACC.
***
Kate was determined to get to the bottom of why so many ACC staff were accessing Matthew's old sensitive claim file. She started the painstaking process of matching the log-ins with reams of paperwork and reports she'd obtained from the agency regarding his case to try and figure out the purpose of each access.
By the time she finished, she believed there had been numerous breaches of Matthew's privacy and rights, and staff had breached ACC's Code of Conduct. She made enquiries with ACC's privacy officer and filed Official Information Act requests on ACC's policy and guidelines. She asked so many questions she was put on a "communications plan". This meant she was only allowed to contact Matthew's case manager - no other staff - and he would only reply to her once a week.
With five children and Matthew to look after, the only way Kate could do this detective work was by working through the night. Her study became lined with cardboard files full of ACC documents and Matthew's case notes. The stress of this, and seeing her husband decline, took its toll. "I had a miscarriage because of it," she recalls.
Shocked by how many people had accessed Matthew's sensitive claim file, Kate decided to ask ACC for a digital footprint of her own sensitive claim. In 2017 an ACC investigator looking at allegations of abuse relating to Matthew's physical injury claim had accessed Kate's sensitive claim file twice as part of his investigation.
Matthew was under investigation for driving, even though he'd told his case manager that despite some difficulties driving, some days he could manage to drive short distances. He was also accused of abusing and wasting ACC resources for asking for help with his dyslexia. Matthew was soon cleared of any wrongdoing.
When Kate asked ACC why the investigator had been allowed to access her file while investigating Matthew, she says the agency told her it was because she was his advocate, lived with him and held Matthew's authority to act. "That rang alarm bells," Kate says, "I just don't think there's any good excuse to go into somebody's ACC claim just because they are another's authority to act or as an advocate for someone."
***
ACC won't talk to RNZ about Matthew's case, but in a statement it said every staff member who accessed Matthew's and Kate's sensitive claim was justified.
"All ACC staff who access sensitive claim files do so in order to perform the functions of their job. This could be as simple as a team member reimbursing someone for a taxi or updating contact details. This activity would only involve going into part of a client's file."
It says its employee Code of Conduct sets the expectation that its staff maintain "the highest standards of integrity, discretion and ethical conduct when performing their duties; this includes not accessing claims information that is not required for them to carry out their role".
"ACC is confident sensitive claims information is managed with due diligence and respect."
It says the physiotherapist who recommended Matthew's sensitive claim be re-assessed did not read his medical records. "[She] was asked about her access and confirmed she clicked into the claim, but did not open any of the documentation in the file."
And the reason why the three staff members read his sensitive claim file before the Zoom meeting?
"ACC takes a holistic approach when preparing for mediation so our people can answer any questions raised during the meeting."
The agency says the staff accessed the file to create a timeline and file summary on Matthew and other information to "clarify the diagnosis for any potential assessment".
"These staff were working within ACC's Code of Conduct," the agency says.
Matthew's not swallowing this. "All the advisors should have been looking at my physical claim, not a dead sensitive claim."
***
When Matthew and Kate opened their sensitive claims they were under the impression this meant only their case manager and medically-trained staff would be able to access their files. They now realise ACC has a slightly different view.
On its website, ACC says: "Access to sensitive claims on ACC's claim management system are restricted to only those staff members that require access to support that client."
Last month, unionised ACC staff raised concerns with the Public Servants Association union that they had "inappropriate access" to sensitive claims information. In response, ACC Acting Chief Executive Mike Tully told RNZ he wasn't aware of those concerns, but staff who worked in call centres, claims, payments as well as clinician advisors all had access to sensitive claims information in order to help the claimant.
"People don't look at the whole of the claim, they're really looking at the information that they need. Staff here don't have the luxury to sit and read claim after claim after claim ... they've got enough to do," Tully said.
Kate doesn't think that's good enough: "We don't feel like these accesses are justified at all. And if they are justified then everybody's privacy is being breached. If this is the way sensitive claims are handled then people need to be aware of that."
The couple are disappointed their privacy complaints have been dismissed by ACC and they are now preparing to make complaints to the Privacy Commissioner.
***
Last month, after RNZ began making enquiries into Matthew's case, ACC organised for him to trial a mobility aid and soon after, ACC agreed to buy one for him. "That went through at lightning speed. Like, I've been fighting for this for Matthew for four years. It's amazing, I think everybody was nearly in tears," Kate says.
An 'all-terrain hopper" is expected to arrive from the UK in the next few months. Matthew cannot wait: "The trial was the first time I've been able to get into the farm and go through the bush since forever. It was amazing."
He's still awaiting news of the much-needed home modifications, but ACC says it no longer requires any information from Matthew's sensitive claim to progress with treatment or rehabilitation plan.
Despite this, Kate says Matthew's dealings with ACC are still marred by the sensitive claim.
"The references to the sensitive claim are riddled through his physical claim file, contaminating every step forward. It's still all there. And despite ACC's assurances to Matthew that it is not relevant, it's still being provided to other people, such as reviewers and doctors. And it's still there for the ACC staff to see."
"ACC has yet to tell us how they are going to fix this so Matthew doesn't get dragged through this trauma again and again."
ACC has agreed to put some safe guards around his sensitive claim file. "ACC has agreed to put an alert on [his] file which advises: 'There should be no access of the sensitive claim in relation to supports and entitlements linked to the physical claim'".
Matthew is happy with the move but he still worries other sensitive claimants are unaware their private information can potentially be accessed by so large numbers of ACC staff.
"It's given me a lot of setbacks with the mental health side of things, and nearly a year and a half of absolutely no help."
"I want them to put steps in place that prevent anyone else from having to go through this."
*names have been changed
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