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My workers compensation battle is turning into a WorkSafe carnivale

Author:
Medical questions

It’s been a huge few weeks for WorkSafe and injured workers in Victoria.

I’ve always encouraged anyone who contacted me with their frustrations and horrid experiences of being an injured worker in Victoria to call their Ombudsman.

The Ombudsman’s role, as it was explained to me, was to gather complaints and if/when the complaints amounted in one specific matter, the Ombudsman would have reason to report the complaints to our Government and possibly investigate.

Clearly there have been many complaints and the Ombudsman just recently released this report about Worksafe’s ‘oversight’.

After finally gathering myself from the last blow that left Theo and I having to sell our home and start all over again, I resubmitted a 93CD application (that’s an application for part payments). Actually Theo is managing the application as I was unable to navigate the trauma of it all again but I also couldn’t bring myself to accept the insurer and our Government had gobbled up my compensation. Both very difficult when you have a chronic health issue and when you feel you’re being responsible for it but the other parties are trying to bury you instead of help.

I’ve seen the ad, ‘getting back, we’ll get you back, it’s good to be back, get you back, nothing like getting back.’ Hogwash! No one tried to help me get back to work! Nor did they advise us as self employers either!

Worksafe promises alot when they take our insurance premiums.

So, we’ve sent, what’s called a 93CD application to the insurer accompanied with: Continue Reading

Act 3 – explained

Author:

Big day for me today. Thank you to the Victorian Ombudsman and to all the injured workers who spoke up.

…Sadly too late – won’t bring our beautiful home and life back.

Act 3: Home lost to these vile insurer (and WorkSafe Victoria supported), unjust actions:

‘At interview, one former agent employee said that management placed pressure on staff to maintain decisions at conciliation and to not pay compensation past a certain date. This was to ensure the agent did not ‘breach’ their ‘targets’.

Read the article and full investigation, Investigation into the management of complex workers compensation claims and WorkSafe oversight on the Victorian Ombudsman’s website

Also worth reading: WorkSafe: complex claims process needs fixing

Worksafe’s Dirty tactics – finally realised

Author:

I woke up crying last night. I hardly ever cry. My boiling point hits when I’m feeling that I’m in a situation where I see no hope in sight and that I’m being treated unfairly and disrespectfully.

My boiling points have been few during the minute-to-minute demands of chronic pain management (over the last 9+ years) because it makes sense to me that you can have an accident and things can go wrong in life – that’s understandable although very upsetting and very difficult to deal with.

However, in respect to managing as a self employed injured worker with a workers compensation claim, I am unable to accept and understand the unfair and unjust treatment our Victorian system delivers.

I’ve felt the treatment from the insurer managing my claim (I don’t need to name them because they’re all the same!), Worksafe, the Independent Medical Examiners (IME’s), the Accident Compensation Conciliation Service (ACCS) and the Medical Panel IME’s has been unfair, unjust and throughout the 9+ year ordeal, I have sensed a corruptness about it.

Why? Because the system has no way of assessing chronic pain. No one asks the neuropathic pain related questions and given chronic pain is invisible, it makes it almost impossible for me to explain the injury.

That means it makes it really easy for the insurer to make me look like there’s nothing wrong with me and that I have more ability than I state.

Why was I in tears of frustration last night?

Because the insurer monster handling my claim has rejected the previous  Medical Panel Opinion from 2014 (yes the document that is meant to be binding in Federal court) for a reason I still don’t understand and no one can explain. In the next couple of months, I have to return to the ACCS for yet another horrific examination by yet another 5 IME’s who know they have no means of assessing neuropathic pain but who still require me to undress and who measure my scars (having no place to put the evidence) in order to somewhat respond to the insurer’s pathetic cluster of misconstrued information that they use to dispute my right to compensation.

The insurer has the right to do this. Worksafe loves them for it – in fact I believe they encourage it with incentives. Continue Reading

This injured worker is about to burst

Author:

Art & Chronic Pain - A Self Portrait

(Image from my book, Art & Chronic pain – A Self Portrait)

I’m going to erupt!

I feel I’ve been left without any avenue to vent the poor treatment I’ve experienced as an injured worker. I can’t make it any simpler :

I had a work accident and after declaring I had a p/t work capacity, I’m now left with $0.

That’s $0.

  • $0 financial help for any future treatment (currently undergoing thousands worth)
  • $0 wage top up
  • $0 superannuation
  • 0% return to work training or assistance
  • 0% guidance, and
  • 0° (except for this blog) to reasonably seek the promised help that I personally paid a 100% premium for in Victoria.

Wait, I have more to vent and please stay with me because you’re my only avenue remember? Continue Reading

Yet Another Comedy of Errors: Act III, the Outcome

Author:

Those on long term benefits should be cut like 'low hanging fruit', Denis Cosgrove wearing my compensation.Scene I

The long-awaited meeting takes place, as scheduled, 11 months after my lodgement of a 93cd application.

Theo and I, together with my WorkCover Assist representative met with the Conciliator and K – a rather gruff and insensitive guy who is representing my VWA-appointed Agent. We have not met him before nor to our knowledge has he been involved in managing my claim. From the outset, it was obvious that he would fight against us every inch of the way. You can well imagine that the spirit of conciliation was lost upon him. He offered no apology for his rude behaviour.

If you do not know, conciliation is a voluntary, flexible, confidential and interest based process. The parties seek to reach an amicable settlement of disputes with the assistance of the conciliator, who acts as a neutral third-party (whilst still abiding by the system’s own legislation).

Just to recapitulate, we had raised three important disputed issues for conciliation:

(i) that part payments for my medical expenses were still outstanding;

(ii) that contrary to the “expert” opinion of my Agent, my working capacity was still limited to 15 hours a week and had not improved since the Medical Panel had examined me nor had I shown that I possess any new skills believed to be contributing to this added work capacity;

(iii) that my Agent was claiming that the date they are required to begin any payments is the date from when I “completed” the 93cd application (September 2013), and not the date on which I had actually lodged the application (June 2013). Until I had provided a current Tax return (which was a mandatory requirement and for the ATO is March of the following year), the application remained invalid; furthermore they consider my early June capacity date to be irrelevant. Continue Reading

My reply from the Victorian Workcover Authority

Author:

I thought it best to start another post rather than comment below my original post, Formal Complaint to WorkSafe. This really deserves some space and attention. I don’t think I need to say too much other than to explain the image is a copy of the letter I received from the Victorian Workcover Authority accompanied with my reply.

WorkSafe Reply To Soula Pg1WorkSafe Reply To Soula Pg2You can all make what you will of this exchange between me, the injured worker, and the system setup to provide ‘quality income protection’.

Dear Andrew.

Thank you for the belated response to my official complaint. I trust you will not mind if I respond and in so doing make some terse comments about the way in which your organisation has behaved towards me.

  • An injured worker should not have to be disadvantaged (such as held up payments) when a WorkSafe Agent employee is on leave. Your failure to address this complaint means that you do not see it as being an issue of importance. Am I reading you correctly?
  • I don’t appreciate having a valid point and being excluded from the Facebook page or having my posts deleted. Obviously WorkCover does not want to be seen in a bad light, giving the illusion that all injured workers are happy with the way they have been treated in your system.
  • I have asked 6 times where it is stated in the regulations that my WorkSafe Agent (enter WorkSafe Agent name) have 60 days to make a decision after a Medical Panels opinion has been delivered and have still not received an answer. In response you say: ‘These are matters that are outside of (worksafe agent’s name) control’, and ‘it has attributed to both the absence of a staff member and also the receipt of additional information about your capacity subsequent to the return of the Medical Panel opinion’ In fact the member was absent well after the 60 days following receipt of the Medical Panel’s opinion.
  • And the comment that follows constitutes a ‘catch all’ answer: ‘case officers generally have a good understanding of the Act and are able to respond to a broad range of enquiries. I am advised that the information required to respond to your enquiry was contained within the Administrative Law Act 1978.’  Can you please be more specific in order that I can understand your response?
  • I have asked about the surveillance evidence that was provided to the Medical Panel ‘for completeness’. I had previously requested all my surveillance material and was allegedly provided with ‘all of it’. I want to know where the additional information provided to the Panels came from and why it was not provided to me when I asked? The additional information was not provided to me and, as I have specified in previous emails, it relates to details of my travel to Italy posted on my Facebook art page. This information was never provided to me. Nor does it seem necessary for me to have to ask AGAIN for this information.
  • In sum, these responses make it absolutely clear to me just where Victorian Workcover Authority’s priorities lie – they are designed to avoid being seen to take any responsibility for the welfare of compensation claimants and their employers, whatever the cost may be to one or both of them.

And I want to express the following thoughts which are specific to the points I made in my original complaint: Continue Reading

Yet Another Comedy of Errors, Acts I & II

Author:

Prologue:

This is not really a comedy but without a sense of humour and the odd injection of sarcasm this injured worker would explode from the frustration and disappointment that being in this system has created.

I am heading back to conciliation on May 13 to battle for part-payments of compensation since declaring in December 2012 that I have a limited capacity for part-time work. I am also disputing my WorkSafe authorised Agent’s refusal to pay any of my medical expenses over the last 2-3 years.

Acts 1 and 2 can now be written but Act 3 will have to await the outcome of the conciliation conference. But as you will see, the outcome could well provide the comic highlight of the performance.

You in the audience may laugh, clap or cry as you read my sad little play. Continue Reading

Insurer acts under WorkCover’s big circus tent

Author:

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? Continue Reading

No Partridge in a Pear Tree to be Found, I’m Preparing for Conciliation… Again!

Author:

(Sing with me, to the tune of ‘The 12 Days of Christmas”:

16 points of stimulation,
Multiple case managers,
Too many Independent* Medical Examinations,
Nine anaesthetics,
Several investigations,
Wasted complaints to WorkSafe,
Four conciliation applications,
Three operations,
Two Medical Panel Opinions,
One Impairment Assessment,
and,
No Partridge in a Pear Tree to be found…

AND, still, no financial support. AND, still, no understanding of my Workers Compensation case.

My application for part payments has been rejected on the grounds that the Worksafe Agent feels I have more capacity and has gathered that opinion from my advocacy efforts, the maintenance of this website, and my art projects. So, I’m off to conciliation once again to explain what should be obvious, or rather could be explained with a phone call. But you’re not going to get that kind of service or understanding within our WorkCover system. It’s nothing but doubt and a point of the finger, turning real facts into incorrect assumptions which ultimately block all healing and return to work pathways for an honest injured worker.

Damned if I’m going to keep my mouth shut, or my return to work efforts contained. To be honest, the system is giving me nothing to lose here and every excuse to keep exposing it and its limitations. I want to get back to work and I will use any talent I have to get there, I’m a self employer. Even if that means more conciliation conferences and withstanding 15 months without a single cent. There are other injured workers to think about here too, this isn’t just about me. Continue Reading

Formal Complaint to WorkSafe Victoria

Author:

21st May, WorkSafe’s Andrew calls

My long wait was over, or so I thought, when on 21st May I received a call from a Service Review Analyst working with WorkSafe’s Capability & Service Division.

Yes, it did seem that they had “escalated” my complaint, as promised, and I would at last be given some answers. But my hopes were soon dashed as the guy on the other end of the line tried to explain to me why it was taking so long to deal with my complaint. He told me that WorkSafe was having to seek further information as to whether I was making an additional complaint or was merely hoping for a response to my original one. I made it clear that I was still awaiting a definite response to my original complaint. Having then established that we were both on the same page, the caller said that he was in fact ringing to apologize to me for the delay. No reason for this was given.

When I inquired how he would feel if he was in my situation, he once again apologised to me.

As you might have gathered by now, I found this phone call to have been awkward, uncoordinated, empty and senseless.  It was patently obvious that he had not looked all that deeply (if at all) into my complaint.

Was he inexperienced and being thrown in at the deep end by his manager?  Or had he been told to play “dumb”? I wondered whether WorkSafe really does have a mechanism in place to investigate legitimate complaints! Perhaps their lack of response serves as a tactic to deter most people from pursuing answers to their complaints.

But once more I find myself waiting with “bated breath and whisp’ring humbleness” for some honest answers. Honest answers and compensation payments that I believe are fully justified.

20th May, Soula follows up:

Hi Liz,

Can you give me the ‘relevant person’s’ name and direct contact please? I’m beginning to think they don’t exist. It really shouldn’t take this long.

13th May, from WorkSafe’s, Lizabelle

Hi Soula,

Thanks for your further email.

Please be advised that I have referred your email to the relevant person looking into your complaint for his information and response.

Should you have any further queries…Blah blah

12th May, Soula follows up:

Hello Anthony,

Are you able to follow the ‘escalation’ of my enquiry. I feel it may have been lost on the way…

May I remind you the original enquiry was made on April 4th. Pretty poor on WorkSafe’s behalf I feel.

Soula Mantalvanos

24th April, Soula looks into WorkSafe’s complaint procedure

I was wondering who the Service Improvement Division were after my reply from WorkSafe. I found a WorkSafe Victoria Complaints Handling Policy pdf. I nearly threw up reading this as this is certainly NOT what I’ve experienced in my seven years as an injured worker (or self employer). In fact I can’t believe the words ‘caring’ and ’empathy’ are even used and ‘We live up to our promises’ isn’t true, WorkCover isn’t ‘Quality Income Protection’. Continue Reading

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Definitions of pain

What is Pudendal Neuralgia (PN)?
Most simply put PN is Carpal Tunnel in the pelvis/buttocks. Compression of the Pudendal Nerve occurs after trauma to the pelvis and is aggravated with pressure. The pain is often described as a toothache like pain, with spasms, sensations of tingling, numbness, or burning. It can be very debilitating.

What is Neuropathic pain?
Neuropathic pain is the result of an injury or malfunction in the peripheral or central nervous system. The pain is often triggered by an injury, but this injury may or may not involve actual damage to the nervous system. More…

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