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Insurer acts under WorkCover’s big circus tent

April 17, 2014 (shared post from Theo to Soula’s Chronic Pelvic Pain Story Facebook page)

This SICK system has to be stopped…Soula Theo Walking Combi InvestigationSoula Theo Walking Combi Investigation
This makes me sick….!Ever been filmed when you didn’t know it? These are a couple of stills of surveillance footage from a WorkSafe Victoria agent (who I can’t mention… but there are only a few – from 2012 mind you) attempting to catch out Soula.Guess what WorkSafe Victoria agent??? Soula can walk!!! She never said she couldn’t.

This is very poor, extremely disgusting and a waste of time. The WorkSafe Victoria agent is trying so hard to make our life a misery but it’s only making us fight harder.

Anyway…., at least our dog Zephyr looks good in the clip!

April 16, 2014

I got some mail today. Theo had to carry and open it, the pile of papers were too heavy to lift!ConciliationMail-04

It’s astounding the levels the WorkSafe Agent will stoop too (which are the levels WorkSafe obviously set) in order to avoid their responsibility with my WorkCover claim. I’m going to keep up with this documenting as I want to encourage other injured workers to fight these pathetic insurer circus acts. It’s unacceptable, not to mention, not what my WorkCover premium was paid for. Where’s my ‘quality income protection’, where is my return to work help, and where is my income and medical financial help?

This is what the conciliation process looks like and for those of you who missed the full story read about it here. The conciliator assigned to my conference on May 13, has so kindly taken the time to photocopy and send me the copies of what the WorkSafe Agent has sent through in support of their case to reject my part payments and medical reimbursements. I’d like you all to give me your opinion actually. The shots below include copies of the public information I’ve posted about The Design Files media Theo and I had, my Doug Moran Semi Finalist entry, my drawings of Lynn, other artwork etc… I know the insurer is showing great faith in my art career and somehow trying to state I’m actually making some kind of wage from my art (how lovely of them to do so), but I’m wondering what the insurer is trying to say by posting images of my home? Clearly not including the info as a positive information, so why is that in here? Is an injured worker meant to have a certain appearance/home, are they not allowed media… I’m a bit confused?

ConciliationMail-03What is most disgusting though, is that this is acceptable behaviour and fitting with Victoria’s WorkSafe Legislation, and that in the process of this circus act, I have to withstand no payment, for what is now, 14 months while attempting to return to work.

I don’t know about you, but all I can see are ruthless attempts to block my paths to work rather than encouraging them (and that I have a really nice place!). Isn’t this system about getting injured workers back to work, and yet now that I’m finally able to try, it’s cutting down my every attempt. I’m sorry but what am I missing here?

I won’t be intimidated by this circus, I’ve been through it before with income protection. The more the insurer and this WorkSafe system ramp up their acts, the louder my voice is going to get. I would really appreciate you joining in too by sharing my post. Conciliation Mail-01 ConciliationMail-02

By |2016-05-15T21:27:57+11:00April 16th, 2014|Blog, My rants, system, Work / System, Workcover|15 Comments


  1. John Quintner May 3, 2014 at 11:11 am - Reply

    Sue, when WorkSafe Victoria outsourced claims management to the private commercial sector, the empathy that they professed to value so highly in their dealings with everyone was not part of the deal. I remain to be convinced that there is any likelihood of system improvement and I fear that people like you and Soula who are already burdened by persistent pain and associated health problems do not stand a chance of obtaining a fair hearing, let alone justice. I wish I could be more optimistic!

    • soula May 3, 2014 at 11:38 am - Reply

      Sue and John, ’empathy’ is not a word this system could ever align themselves to. The closer I proceed to my May 13 conciliation date, the more let down I feel by this system. Sue I hope you got my reply, it hasn’t appeard here, it has come to your direct email. I hope! I was going to continue and post the details about my conciliation prep but I think it deserves a full post. Stay tuned. And no John, there is no fair hearing…

  2. sue April 23, 2014 at 10:28 pm - Reply

    Your message

  3. sue April 23, 2014 at 10:27 pm - Reply

    Being injured, whether physical’, psychological or both, Workcover and its antics. should be accountable for the
    added misery they cause to workers. I suffered a fall in an unsafe workplace, breaking numerous ribs and puncturing my lung. The physical re covery was very difficult and two years on, i still suffer the effects. I consequently was diagnosed with PTSD and sunsequent depression. This was a direct result of my employer refusing to call an ambulance and after pleading with her to help me, eventually she drove me to the hospital , but not before she asked if she could drive me home and have a member of my family look after me. My life haschanged so much and will never be the same. The amount of drugs i take only mask all the physical and mental pain, but nothing can mask the treatment of case managers and the insurance companies with whom we have to deal with. It is disgusting and apalling that we should be subjected to their treatment of us…. it could be just another case…. against the system.

  4. John Quintner April 18, 2014 at 10:06 am - Reply

    Soula, it is hard to believe that one woman in persistent pain could pose such a grave threat to the financial viability of the Victorian system of Workers’ Compensation. But this may well be the case! If chronic pain is accepted as an assessable impairment (along with psychiatric and psychological conditions that are already accepted as same) then the Act will need to be redrafted accordingly. At present, the WorkCover Guide to Assessment of Permanent Impairment specifically excludes chronic pain as being ratable. Short of overturning the decision of the Medical Assessment Panel that last examined you, I don’t see how WorkSafe Victoria can sweep this issue under the carpet.

  5. Peter Sharman April 17, 2014 at 7:00 pm - Reply

    Hello Soula – it doesn’t make sense not to recognise your own efforts towards rehabilitation. I have see situations where workers on RTW programmes have been filmed doing their RTW duties and that evidence tendered in support of termination of their entitlements. No logic – just a system entrenched in denial of liability – sometimes at any cost!

    • John Quintner April 17, 2014 at 7:27 pm - Reply

      Peter, it seems hard to believe that an employee of the Agent responsible for Soula’s claim received an Injury Support and Service Award from WorkSafe in November 2012. This award was for for Excellence in Return to Work. Obviously the person concerned does not appear to be handling Soula’s claim. I too cannot make any sense of the Agency’s behaviour towards Soula. Perhaps a new WorkSafe award – that for Excellence in Claim Denial – is being offered this year. No guesses as to who might be the front runners for such an Award.

      • Soula April 17, 2014 at 9:14 pm - Reply

        And to add to the confusion, today, the conciliator assigned to my conference sends me a dvd of 2012 surveillance ‘for my perusal’. The medical panel addressed this dvd in the current report so why was it resent to me? (The Panel viewed surveillance video prepared by ***** investigations, and dated 24 February 2012. Ms Soula MANTALVANOS Medical Panels Ref No M****/*** Page 7 of 11:
        “The Panel noted the ‘Summary of Key Observations’ and noted that the worker was observed ‘taking her dog for a walk, collecting coffee from a cafe in the walking back home again, sitting at a cafe talking to an older couple and her boyfriend, eating a meal and laughing, was conversing with her companions and hugging a female’.
        The worker did not wish to view the surveillance video together with the Panel, however she commented that, “I do socialise” … “I do pace myself’ … “I distract myself when I am socialising” … And stated … “I do look okay on the outside … my pain is invisible”.
        The Panel considered that the actions depicted in this video were not inconsistent with the history provided by the worker, and the Panel’s own observations during the examination.
        The Panel considered that no additional medical imaging or other investigations were necessary for it to answer the medical questions.
        The Panel also considered that the worker was a reliable historian and that it could rely on the history she provided, in conjunction with the other material in the referral, in order to formulate its conclusions.”

        I’m getting a little sick of this poor treatment now…

        • John Quintner April 18, 2014 at 8:04 am - Reply

          Soula, this is one hard-ball tactic known as doing a “snow job”. Such tactics are designed to pressure negotiators (conciliators) to do things they would not otherwise do, and their presence usually disguises the user’s weak case and an unwillingness to follow the rules of fairness, decency and logic. According to the source of my comment, it is not clear exactly how often or how well these tactics work, but they are said to work best against poorly prepared negotiators. They also can backfire, and there is evidence that very adversarial negotiators (such as those already encountered by you) are not effective negotiators. Many people find hardball tactics offensive and are motivated for revenge when such tactics are used against them. This is quite understandable but has to be resisted by those who, like you, are on the receiving end. Many negotiators (conciliators) consider these tactics to be out-of-bounds for any negotiation situation. Hopefully, the person attempting to conciliate in your case will be wise to these tactics and will not at all appreciate being the target of such a crude and poorly conceived “snow job”.

          • Soula April 18, 2014 at 8:41 am

            It’s interesting you mention ‘poorly prepared negotiators’ as I have had 2 of these at the ACCS and 2 very well prepared negotiators. I am already thinking of that. As in any industry, you get great employees and you get poor ones. I’m worried, there was no reason to receive that dvd and if everyone in this system is doing their homework they should have grasped by now Theo and I will not be detered. It feels like the system is stooping lower and making this a longer process which will only give me more to write about and expose. For anyone following, Theo posted some snippets of the investigation dvd that was received, you are welcome to comment and share the post, in fact, you are encouraged: https://www.facebook.com/SoulasChronicPelvicPainStory/posts/561218443993762

  6. John Quintner April 17, 2014 at 3:12 am - Reply

    As I have said before, insurers and their agents are best advised not to become emotionally involved with claimants. This particular one deserves to be named and shamed for carrying out a vendetta against you and your employer. But your voice is now being heard by many people, both in this country and overseas.

    • Soula April 17, 2014 at 9:28 am - Reply

      I am certainly feeling that this is discrimination, more and more John. The many efforts Theo and I are making to get our life back and me to some sort of employment should be something the insurer should work with and encourage not work against. And where is WorkSafe? I’m still waiting for the reply to my complaint regarding the Agent’s behaviour… they’re obviously in no hurry to help an injured worker or the employer. An approach to the UN is looking like a realistic option at this stage…

      • John Quintner April 17, 2014 at 11:39 am - Reply

        Soula, out of interest I took a look at the Annual Report (2013) of WorkSafe Victoria. The Injured Workers’ Level of Service for your agent (….) was 71.4%, an estimate which had deteriorated by more than 4% from the previous year. I am not sure what this figure means but at face value it appears that about 1 in 3 injured workers who dealt with this Agent were dissatisfied with the way in which their claims were handled. As I have said before, this Agent represents the insurer Lloyd’s of London in Australia. When one examines the Mission Statement of WorkSafe Victoria, there does seem to be quite a disconnect between the stated aims of WorkSafe Victoria and the behaviour of the agent in your particular case. Yes, it will be very interesting to see how WorkSafe Victoria responds to your complaint. When one looks at the amount of money that WorkSafe pays to insurers and other agents to administer claims management on its behalf, one wonders whether they are really getting value for money. Is the profit motive the major driver, as opposed to the quality, consistency, empathy, and transparency of service delivery? In your case, the question seems to be a rhetorical one.

        • soula April 17, 2014 at 11:55 am - Reply

          John I feel WorkSafe have a duty toward me and our company definitely. I feel so let down by this system with its failure to assess me accurately, failing to diagnose me, failing to help me return to work, failing to support us as employers… But I am more likely to think that we will both be marking my words, and they will be supporting their Agent.

          • John Quintner April 17, 2014 at 12:41 pm

            Soula, there may be a human heart beating deep inside the Sphinx. If so, then your complaints, along with those of many other injured workers, will be taken into account when the particular Agent’s contract comes up for renewal.

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