Alan Gordon injured his back and suffers from chronic pain; he is appealing an ACC decision to cut his entitlements. (Video first published December 15, 2018)

ACC has paid a doctor $8 million in fees and expenses for second opinions of beneficiaries' injury diagnoses – despite one judge saying the pain specialist is "flying in the face of the medical evidence".

The agency regularly calls in Christchurch's Dr Bill Turner to reassess patients who have been granted ACC entitlements for chronic pain; court judgments show ACC consistently uses Turner's opinions to cancel entitlements or cover.

In some cases, Turner considers the pain is in the sufferer's head. In most cases, there is no question the patients are in severe pain: the only question is whether the pain is caused by injury – or is a vague "syndrome" as Turner sometimes argues. On numerous occasions he has assessed the pain as a syndrome, and nothing to do with the pig hunting accidents, car crashes and other injuries the claimants suffered.

GEORGE HEARD/STUFF Dr Bill Turner strongly denied ACC was selecting him because case workers expected him to reject their clients' injury diagnoses. "That's nonsense," he said.

Under New Zealand law, if the pain isn't caused by an injury, that means ACC can stop weekly payments to the sufferers. Just this week, a comprehensive OECD report said ACC should be extended to cover all illness to help the mentally unwell keep their jobs or return to work.

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Turner, however, appears to have been dismissive of chronic pain sufferers, describing one as having "abnormal pain beliefs" linked to his anger at the way he had been treated by ACC; describing another's pain as having a "significant psychological overlay, no doubt a function of his victim ideology".

A Stuff analysis shows that since 1999, the District Court has heard appeals against 72 of Turner's chronic pain decisions; in 24 of those cases, the judge found against ACC and granted the sufferer cover. Despite the number of times his assessments have been overturned, and despite repeated criticisms in judgments, ACC has continued to use him when it wants a second opinion on injury diagnoses.

In one case of a 57-year-old boilermaker and welder who hurt his back in a scaffolding fall, the late Judge Martin Beattie found Turner's "bland statement that the appellant does not have an injury-based traumatic cause for his condition to be flying in the face of the medical evidence of the appellant's back injuries".

STUFF Judge Martin Beattie, who died in March 2018, had presided over 20 years of ACC appeals – and was increasingly critical of pain doctor Bill Turner.

In another case of a 23-year-old woman who hurt her shoulder, Beattie said Turner "seemingly sets his face against the accepted medical phenomenon".

And in the case of a 42-year-old Royal NZ Air Force storeman who hurt himself lifting heavy coils, Beattie ruled that Turner had made "a wholly speculative diagnosis [that] does not accord with the clinical facts".

ACC couldn't answer how many cases he had declined or granted cover; the only ones that are publicly disclosed are those that are challenged in court.

When approached at home in Christchurch on Friday afternoon, Turner strongly denied ACC was selecting him because case workers expected him to reject their clients' injury diagnoses. "That's nonsense," he said.

Ask about the determinations that had been over-ruled by the courts, he replied: "I have nothing to say to you whatsoever and it's none of your business. Goodbye."

One man who has suffered chronic back pain for two years says his ACC cover was cut after a case worker referred him to Turner.

STACY SQUIRES/STUFF Christchurch man Alan Gordon injured his back in 2016 and now suffers from chronic pain.

Alan Gordon, 56, was an avid outdoor pursuits enthusiast, but he has been suffering chronic pain since he hurt his back shifting his furniture when moving to Christchurch in 2016, he said. He has since taken his case to the ACC review tribunal but was told his lumbar pain was a degenerative condition and not as a result of trauma. Now, he has lodged an appeal against the decision.

ACC online forums are awash with unsubstantiated complaints about Turner.

Since 2006, ACC has paid Turner up to $8 million, a figure that includes payment of his fees, airfares, vehicles, accommodation and time costs for travel. ACC said Turner's specialty is occupational medicine, whose practitionersare in limited supply across New Zealand.





And according to figures provided by ACC, there are hundreds of doctors who earn as much as Turner, or more. For example, in 2010 Turner was paid between $800,000 and $900,000. At least 221 doctors were paid even more.

By contrast, ACC paid Alan Gordon for two hours of home help a week.

Gordon's appointment with Dr Turner lasted two hours, but the physical examination was less than five minutes. "At the end Turner told me, 'I'll keep my powder dry' instead of telling me his thoughts."

Since then, ACC covered him for appropriate care, and more recently he was covered for two hours a week of home help – a plan devised by his GP to minimise his pain flaring up and keeping him off work.

SUPPLIED Alan Gordon can't do all he once did, but he can still work: "I'm one of the lucky ones ... I can still do my job, and can avoid taking too many drugs."

But just shy of being covered for a year, Gordon's case manager asked him for permission to access his medical records so they could see "how best ACC could support me".

A review of Gordon's ACC file revealed his case manager instead questioned if he was still entitled to cover, and had been acting on an instruction from a technical specialist to "undertake appropriate and necessary investigations" because "ACC cannot simply suspend entitlements due to the passage of time".

"It was nothing to do with trying to find extra ways to support me, it was about cancelling my entitlements. For her to misrepresent the situation as blatantly as that is really disappointing and takes your breath away," said Gordon.

SUPPLIED Alan Gordon was someone who enjoyed the outdoors. But he says the calculated manner his ACC compensation was cut demonstrated the agency was not in the business of helping people.

A former ACC employee told Stuff that ACC branches across the country compete to "exit" clients off their books before they reach 70, 180 or 365 days of cover. A weekly "traffic light" report indicates how the branch is performing and managers encourage case managers to look for people to get off their books.

"I'm one of the lucky ones," Gordon said. "Although I've got this constant chronic pain to deal with, I can still do my job, and can avoid taking too many drugs. But some people would lose a life line with decisions like this and get totally crushed."

LIFE SENTENCE WITHOUT REVIEW

Review decisions are final, often life-changing for the claimant and worth thousands of dollars in compensation and treatment.

ROSS GIBLIN/STUFF Dunedin barrister Warren Forster said some case managers were under pressure to "exit"claimants.

ACC contracts out its dispute resolution responsibility to private company Fairway Resolution Services. But lawyers have questioned its independence and the legal authority of privately-contracted ACC reviewers.

Barrister Warren Forster said the challenge to Fairway could affect thousands of review decisions.

Forster said some case managers, under pressure to "exit" a claimant, attempt to influence medical reports. He even had evidence some ACC case managers had called doctors and asked them to change a report.

Forster's research has found it's causing "unacceptable harm" to many legitimate claimants – injured people who have been denied cover "find themselves pitted against a huge, billion-dollar specialist Crown agency."