A BALLARAT woman is incensed due to her treatment by WorkCover.
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She is one of hundreds of people who claim to have been unfairly treated by the system, which was set up to pay injured workers weekly payments to make up for loss of income and to cover costs associated with medical treatment and rehabilitation relating to their injury.
Jennifer Bearham said WorkCover has "put her through hell" and has chosen to share her story to be a voice for the many others she knows are unable to speak up publicly.
Given her devastating experience, she will be at the forefront of a major campaign led by the Victorian Trades Hall Council and the Injured Workers Support Network, to try to change the system.
"I was employed in my career as a disability advocate," Ms Bearham said. "I plan to advocate for myself and those less able to."
This is her story.
Injured at work
Ms Bearham has been receiving WorkCover payments and personal care services since she was injured at work on February 16, 2010.
After studying at University, in 2000 she began working as a primary school relief teacher and around 2004 she picked up supplementary work as a personal care attendant for adults with disabilities through Healthscope Operations.
She had been employed on a permanent part-time basis with the provider for seven years in a role she enjoyed when one night she was moving an unresponsive patient from a bed to a shower trolley when she overreached and injured her lower back.
The initial pain was debilitating and developed into severe back pain, radiating into both legs.
While the pain slowly improved during the following weeks, the slightest movement could aggravate her back and trigger severe pain and spasms. Attending her general practitioner, she was prescribed medication and treated with physiotherapy.
Prior to 2010 she had no history of lower back pain.
A month or so afterwards she returned to work with modified duties but catching public transport to work and office tasks such as filing triggered her back pain and eventually she was directed to take leave for three months.
In the years afterwards, consistently using Nospan patches and other strong medications for pain relief, her back pain stabilised somewhat and she was able to return to work.
She continued attending physiotherapy appointments and also took up Pilates, which helped significantly.
However as back spasms became more frequent and the pain incessant, she began to suffer from falls. This, in turn, resulted in further injuries, including to her knees and elbows. Some of these falls have been so dire she spent time in hospital to recover.
She was later diagnosed with drop foot.
Ongoing effects
Today she is more often than not in intense pain and is constantly fatigued. She has been unable to work as of December 2016, making her socially isolated and catapulting her into intense depression and feelings of severe anxiety.
"I am in chronic pain nearly all the time. I have lost my marriage, my home, I suffer [ongoing] falls causing further damage and I had to leave a flourishing career that I loved and have grieved for," she said.
I was useful. I helped people in need. I made a difference to people's lives. Now I barely exist, unable to even be the parent I want to be to my sons.
- Jennifer Bearham
With rising financial pressures, being unable to work and separating from her husband, Ms Bearham decided to move to Ballarat to access cheaper rent.
She lives in a rental property with her youngest son Christopher, 17, who is autistic, but is required to be her primary carer, though he also requires care.
The constant and ongoing battle with WorkCover has impacted the family greatly, especially as Christopher is currently being treated for a large vascular tumour.
Planning how to live on just $600 a week to cover rent, food, bills, medication and other costs is a cause of stress but pales in comparison to the treatment she said WorkCover, and the agent it has outsourced her case to, has subjected her to.
Ensuring the payments and her subsidised personal care services continue is an ongoing feat.
She feels like "a mouse on a wheel" being asked to prove her eligibility for services and payments every six to 12 months and the stress of constantly having to defend herself from what she describes as "bullying tactics" has taken its toll on her mental health.
The process of dealing with Workcover is horrific. You are treated as if you are a criminal first and denied everything you require until they can no longer refuse due to the conciliation process."
- Jennifer Bearham
Proving eligibility
Following two independent medical examiner (IME) reviews in July 2012 and December 2012, concluding that Ms Bearham's 'work related aggravation had ceased' and that ongoing WorkCover would no longer be required to pay for her physiotherapy, her payments were ceased.
Her case went to the conciliation process and a medical panel opinion, in September 2013, refuted the suggestion she was fit for pre-injury duties and her entitlements were reinstated.
It was not the last time she was required to visit an IME or to prove her eligibility for financial support due to her workplace injury.
Following extensive injuries from a fall in March 2017, which resulted in her losing function in her left foot and caused two further disc prolapses and soft tissue damage, Ms Bearham was admitted to hospital and rehabilitation for three weeks.
It caused her health to decline and it was recommended she receive increased care assistance. As a result, from December 2017 she has been receiving funded services: assistance to get ready each morning, two hours of cleaning in her rental home each week and two hours of gardening each fortnight. She is also assisted for an hour each fortnight with grocery shopping.
Just last year she received another blow: her car, with mobility aids inside, was stolen as she slept. They were not replaced by the agent for almost two months.
Read more: Thieves target Wendouree mum with disability
While she has always maintained she can walk a few metres unaided if she can steady herself with objects in her path, it was photos and video collected as part of surveillance in July last year, as she bent over in her driveway to pick up her keys, that were used against her.
Surveillance footage was also gathered of Ms Bearham in February, July, throughout August, and then later in October 2018. Further surveillance was gathered in January this year.
She said the frequency and intensity of how the investigators attempted to take the photographs, including through her bedroom window, frightened her to the point she stopped sleeping in her bedroom.
In June this year, Ms Bearham was asked to travel to Coolaroo, near Craigieburn, to attend an appointment with an IME to review her case once again.
In the IME report, seen by The Courier, there are clear factual errors. Most obvious is that the doctor repeatedly and incorrectly refers to her injured leg, on which she was wearing a splint at the time of examination, as her right when it is in fact her left.
In his report following the examination, the doctor concludes that while she has developed chronic back pain as a result of her injury and "her symptoms have persisted and indeed deteriorated" and that "the falls have resulted in a number of injuries to her right elbow, right knee, left hip and thoracic spine" after examining her history, reviewing documentation and the surveillance footage, he believed the injury to be "resolved".
He stated he did not believe the falls to be a result of her compensatable injury and so Ms Bearham no longer required treatment or personal care support, despite the reports from several doctors including her general practitioner, occupational therapist and a neurologist stating otherwise.
He then proceeds to state he is of the belief she could return to her pre-injury work and hours, given what he had viewed in the surveillance footage.
In a follow-up report in early October the doctor again highlights the emphasis on which the surveillance footage played in his decision.
In a follow-up letter of apology after Ms Bearham lodged a complaint with WorkCover regarding her treatment during the examination and the errors contained in the report, the doctor apologised and said he incorrectly noted her injured leg as he conducted the examination "in front of her".
However, it is this report, despite all of the evidence in her favour, which the agent used to cancel her claim for physical injury on November 13.
"[The doctor] is of the opinion that you suffered from a mechanical injury to the lumbar spine aggravating degenerative disease of the lumbar spine; this is now resolved.
"[The doctor] is also of the opinion that you no longer require treatment that includes medications, physiotherapy as well as domestic support and assistance with activities of daily living for your physical injury," the report reads.
"[The doctor] also noted that you have a capacity for work and you could return to unrestricted pre-injury duties working pre-injury hours."
With the psychiatrist report, she was able to retain psychological support (funding), but was left without physical support to shower or clean her house.
This, she said, was both degrading and humiliating and severely impacted her mental health.
In the month she was cut off from services she had to resort to cleaning herself with wipes as she could only travel to Melbourne to be showered on two occasions.
She said she was "too embarrassed to leave the house", believing she smelled, was in tears daily and had no friends in Ballarat to turn to.
Following contact with Minister for Workplace Safety, Jill Hennessy, a request was made for an urgent review and the decision was overturned.
This was not long after the release of the Ombudsman's report earlier in the week and contact from The Courier. Ms Bearham's claim, including support services, were reinstated before it went to conciliation, though she knows she will have to go through the process again.
Ombudsman's report
Earlier this week ombudsman Deborah Glass handed down a scathing follow-up report into the management of complex workers compensation claims - for people who have been receiving compensation due to being unable to work for more than 130 weeks - stating she had continued to receive an influx of complaints, evidence that "not enough had changed" since the recommendations in her initial report were accepted by WorkSafe.
Ms Glass' initial report was tabled in 2016, concluding that the handling of complex claims required 'fundamental reform'.
Despite all 15 recommendations being accepted at the time, Ms Glass said complaints had continued: "agents are still unreasonably terminating complex claims: cherry picking evidence, doctor shopping, relying on IMEs over treating doctors even when evidence is unclear, contradictory or inconclusive - or ignoring it if it didn't support termination," the report reads.
"Many of the decisions and actions we saw were not only unjust, unreasonable and wrong... Some were downright immoral and unethical."
A WorkSafe spokesperson said it could not comment on individual cases.
Contact the Injured Workers Support Network for further information about the campaign.
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