'A wall designed to look like a door' - hundreds of brain injury victims lose compensation

• 270 ACC claimants with traumatic brain injury had claims "closed" after three years in 2024 - nearly three times the average number over the previous four years
• Dramatic spike in work ready assessments
• Head injuries just 1 percent of ACC claims, but 8 percent of reviews against ACC's decision to suspend or stop entitlements
• Claimants less likely to "win" appeals
• ACC says numbers fluctuate - but focus is on recovery

The number of long-term ACC claimants with a traumatic brain injury who lost their weekly compensation payments jumped nearly three-fold last year.

ACC says numbers fluctuate over time - but advocates say the data released under the Official Information Act shows support is being cut for many vulnerable, brain-injured people.

Taylor Curd has no memory of the night he suffered two traumatic brain injuries during a night out with friends in 2017.

The first was when he tried to "land a flip" and hit the concrete with his head. An hour later, he was hit by a car.

"I went to bed, woke up two days later, thought I just had the worst hangover ever.

"I went to work and then the next thing I knew, someone was waking me up because I had fallen asleep at my desk the minute I sat down."

At Wellington Hospital, he was diagnosed with concussion.

"My eyes didn't track together, I couldn't balance."

After a couple of months of trying and failing to return to work, he was forced to quit his job and move back in with his parents.

ACC covered physiotherapy for his balance problems, but he also suffered tunnel vision, headaches, fatigue and other issues.

For his family, the most distressing symptom was his "complete lack of emotional capacity", which did not show up in ACC's psychological and neuropsych assessments.

"Psychologically I was 'normal' but I was like a robot," he said.

"That was hardest on my poor Mum."

It took two years for feelings to return.

"It was like a switch. I was doing the dishes and then suddenly it was like 'Oh! Feelings!'.

"I had to decide about how I felt about doing the dishes now, and if I didn't want to do the dishes, I had to decide how I felt about walking away from the dishes.

"Everything came with feelings at first, which was exhausting."

Meanwhile, within a year of his injuries, ACC had cut his weekly compensation.

"ACC had three reports saying I was fine. So I went to my doctor and said 'I can't even read, there's something wrong with my vision, I think'."

His GP sent him for more specialist assessments, which identified damage to the visual systems in his brain.

He appealed ACC's decision, and won an independent review six months later, in November 2018.

Curd, who is now in his early 30s, has been unable to return to a full-time job, but does volunteer work while his rehabilitation continues.

He has founded an online support group for people with concussion and post concussion syndrome, which advocates for changes to the way ACC deals with head injuries.

Data obtained by the group under the Official Information Act shows the agency last year stopped weekly compensation for 470 brain injury victims who had been receiving help for more than three years, compared with fewer than 162 a year on average over the previous four years.

That was a 290 percent increase.

In the first half of this year, a further 104 long-term traumatic brain injury claims were "closed" after three years, which means they were found to no longer require assistance from ACC.

ACC has also ramped up the number of Section 103 "vocational independence" assessments for people with brain injury claims, to determine whether they are ready to return to work.

Between 2020 and 2024, there were an average of just under 123 such assessments of brain injury clients a year, but by August 28 this year, there had already been 116.

More people were also losing weekly compensation as a result: 36 already so far this year, compared with fewer than 20 on average in each of the previous five years.

Curd said the data showed the review system was "a wall designed to look like a door".

Traumatic brain injury clients made up 1 percent of ACC claims, but were eight times more likely to lodge a review of entitlements being suspended or stopped, he said.

"This year, we're only likely to win 8 percent of them.

"A growing number will end in withdrawal or 'settled' - ACC doesn't separate the two in the data.

"But many of us withdraw because the process is too long. On average, we'll spend 50 more days than other injuries in the review process.

"They're complex, they're intense and the burden of proof is on us."

Curd said the numbers accelerated following previous ACC Minister Matt Doocey's directive to cut long-term claims growth.

"While correlation doesn't prove causation, the timing and pattern strongly suggest the Minister's directive to reduce long-term claims has intensified exit strategies for TBI claimants - the very population the directive claimed to protect."

In February, Doocey's short-lived replacement in the portfolio, Andrew Bayly, said half the claimants who had been on ACC for more than year - about 12,000 people - should be back at work.

ACC later said they had no record of giving the Minister any advice about how many claimants could be back at work.

Numbers 'fluctuate' but focus is on recovery, says ACC

ACC deputy chief executive Michael Frampton said its focus was on achieving the best possible outcome for injured New Zealanders by supporting them to get back to work, "and this is a priority shared by our minister".

"In mid-2024, we changed the way we managed some long-term claims to ensure these clients were getting the dedicated, interdisciplinary support they needed to get back to independence."

This resulted in more long-term claims being closed as clients were able to return to their pre-injury roles or other types of work, "or in some cases identifying that covered injuries had resolved".

"There is strong evidence that getting back to, or staying engaged in, work has a positive impact on the person's mental and physical health.

"Additionally, making sure clients get the right support at the right time helps ensures the sustainability of the ACC scheme into the future."

In a written response to RNZ, ACC head of client recovery Matthew Goodger said the agency's focus was on supporting people to get well and "get back to their everyday life".

Anyone was able to lodge a review about a decision ACC had made on their claim, but nearly half of all reviews were withdrawn or settled, thanks to ACC's focus on early resolution, he said.

"We know the review process can be difficult for some clients, and we focus on early resolution to resolve their concern before proceeding to a formal review where possible.

"This can be as simple as discussing the decision with the client and answering their questions when they request a review."

ACC also funded free, independent navigation services for clients, and paid the costs of an independent review.

"We have no evidence that people with a TBI are more likely to 'give up' on the review process than people with other injuries."

The numbers of clients having a Section 103 assessment, or "exiting" ACC after this assessment, tended to "fluctuate depending on where they are in their recovery journey and what support they still need from ACC".

ACC did not track post-exit outcomes for all clients, except for return to work numbers.

"However, if a client has an ongoing issue due to their injury, they or their healthcare can contact us so we can re-engage with them and provide any further support needed."

System 'harming' brain injured people, say advocates

Brain Injury Association spokesperson Cheryl Hollis said however the system was "a nightmare to navigate" for people with head injuries.

"So many complex things happen for people with brain injury. Even if it's 'mild to moderate', like a concussion, the recovery can be very different.

"And ACC is just exiting people left, right and centre."

Brain injured clients were "not listened to by ACC or the wider health system in general", she said.

"It's complex, it's invisible, and without hearing from the person affected, services will risk inappropriate and inadequate service."

Hours of her day were spent on the phone to various agencies about individuals, who did not have the capacity to advocate for themselves.

"I've got an ACC case manager that's not responded to anything for weeks, a young girl who was assaulted by her partner and now she's being targeted by Oranga Tamariki as she's not able to look after her kids.

"She was kicked in the head 14 times, her throat was stood on, but she's the one struggling to get help.

"It just makes me angry, all of it. ACC makes me angry because they are harming these people more than helping them."

According to advocates, many people fall between ACC, the health system and social welfare, with no agency prepared to meet all their needs.

Headway chief executive Stacey Mowbray, who leads the Auckland-based advisory service, said it was an up-hill battle for people who were unable to claim ACC, or who lost their entitlements.

Sometimes ACC decided their ongoing problems were due to "a pre-existing condition" or unrelated to the original injury.

People with other mental health problems in particular struggled to get appropriate support, which was doubly disabling, as they were both more likely to suffer head injuries, and more likely to take longer to recover.

"We've got one young man at the moment, who's not covered by ACC, he's on remand, needs to find a home, has nowhere to go - who can support him?

"And these are not 'one off' cases, they're becoming increasingly common."

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