Your world can turn upside down in a few seconds and that is exactly what happened to John. If ACC (Accident Compensation Corporation) accept your accident claim, life goes on as normal, if not…
John has always been active, when he is not working as a senior carpenter, he is out doing something. He’s played sports, he fishes and works in his garden. According to Maree, his wife, he is incapable of sitting still. Working hard is part of his nature.
It was just a normal day at work. John was working on the third floor of a site installing some massive bay windows that were being craned into place. He was helping guide them into position, “that’s when the tear happened in both shoulders, and I was unaware of the damage I had done,” John said.
John is 63, he’s worked all his life and just wants to get on with things. His scans showed that there were tears in each shoulder. John is a carpenter and needs the use of both shoulders to work; he would need an operation. Through work he had Southern Cross Health Insurance*, so getting the operation was not the issue. The loss of earning for him and his family was the real pain.
Disappointment is hard to swallow
The assessment from ACC was that the injury John suffered was primarily degenerative. His age was working against him. John’s application was declined, which was very distressing for John and his family, they thought they would have to postpone surgery in order to save up for the long time off work. John expertise is with wood, not medicine or the technicalities of ACC, he just didn’t know who to turn to until he was thrown a lifeline.
Light at the end of the tunnel
They had almost given hope when John’s wife Maree thought she’d give it one last shot and called Southern Cross to see if they could help. She called and was put through to the Southern Cross Member Advocacy team. This was a huge turning point for them both. This is an advocacy service that Southern Cross provides to its members. There is no charge for this service for members. The team has access to medical and dispute resolution expertise to support members who don’t always have this knowledge. In John’s case, the team were able to pick up the case and go to bat for John.
ACC can only make a decision with the information they are given. In John’s case they did not have the full picture at hand to make an informed decision. The Southern Cross Member Advocacy team were able to get ACC to revise their decision without going through a long drawn-out hearing process.
You just need the right tool for the job
The outcome was that John got the support he needed. He had the operation, got full care and financial support from ACC that he needed while he was off work, and he got back to work faster than he had expected.
* Not all benefits are available on all Southern Cross health insurance plans. You can check our policy documents to see what each plan covers. John Capper has the Wellbeing Two plan with Southern Cross subsidised by Clelands Construction.