We can pay for counselling services if you have suffered a mental injury as the direct result of a personal injury.
Mental injury is a mental health condition that makes it difficult to function normally. This includes the way you behave, think or act.
You fall from a horse and become a paraplegic (both your legs are paralysed). You then develop depression because you can no longer take part in activities you enjoyed before the injury.
We may ask you to attend an assessment with an ACC registered psychotherapist, psychologist or psychiatrist. This is to diagnose your mental injury (depression). If they consider the injury to be a direct result of the physical injury, we may pay for counselling.
We consider each case on its own merits by looking at the facts and clinical advice.
We pay for counselling under the Cost of Treatment Regulations (CoTR) for:
- mental injuries arising from physical injuries or a work place event
- sensitive claims, ie mental injuries arising from certain criminal acts listed in Schedule 3 of the AC Act 2001.
If your personal injury relates to sexual abuse or assault we call it a sensitive claim. When you are ready to get help you can see a provider of your choice straight away through a service called Integrated Services for Sensitive Claims (ISSC). You don’t have to wait for us to accept your sensitive claim. Go to Find Support for more information or contact ACC’s Sensitive Claims Unit on 0800 735 566 for help.
If you prefer to see a registered ACC counsellor instead of seeking help at Find Support, we cover your first session with them and they can lodge a sensitive claim for you. They must refer you to a provider who delivers ISSC. Existing sensitive claim clients can go back to their preferred ACC registered counsellor for further counselling if we accept their sensitive claim for cover.
If you see an ACC registered counsellor for your sensitive claim the provider may ask you to pay a surcharge per session. If you see a provider under ISSC for your sensitive claim it is a free service.
Anyone in New Zealand, including visitors, can lodge a sensitive claim as long as the event happened in New Zealand.
Help for children and adolescents
We have a team of dedicated staff that works with children and young people under the age of 18 with sensitive claims. We work with other agencies to support the unique needs of our young people and their families.
To access physical injury counselling, you must have a covered physical injury claim with us.
We may need to work out if you have suffered a mental injury as a result of personal injury. We may ask you to attend an assessment with an ACC contracted psychologist or psychiatrist.
Counselling may be requested from referrals by:
- contacting us or using the Find Support website
- general practitioner (GP)
- service provider
- your ACC case owner.
We may ask you to attend an assessment to work out if your mental injury is directly related to the covered personal injury. This happens when we receive clinical advice to support this or your injury related needs show this as necessary.
We cover physical injuries, but if there is a mental injury as a result of the physical we may decide on cover for that at a later stage.
A mental injury assessment may be completed by a psychiatrist or psychologist. They will complete a full assessment report and send it to us.
The assessment report should:
- confirm the mental injury is directly related to the physical injury or sexual abuse/assault suffered
- advise the most appropriate treatment option(s)
- address any rehabilitation issues
- advise of any pre-existing psychological issues.
Your case owner will talk to an ACC Medical Advisor or Branch Advisory Psychologist and perhaps your doctor, to establish your clinical condition before making a referral for treatment.
The help you will get depends on your individual circumstances. Contact us to confirm if you are eligible, or to identify other ways in which we can help.
After we accept cover for your claim, we regard 21 days as a reasonable timeframe for the majority of decisions.
Contact us if you have not heard from us within a reasonable period of time.
Remember if you have a sensitive claim you don’t have to wait to see if we accept your claim. You can access counselling immediately under ISSC or through an ACC registered counsellor who will then refer you in to ISSC.
If you have a physical injury or you have a covered sensitive claim and do not wish to access ISSC instead, your case owner will talk to you about an ACC registered counsellor for you to see. We will provide a list of counsellors in your area or you can download a list of ACC-registered counsellors in your area from our website.
The number of sessions approved is included in your individual rehabilitation plan, which you sign with your case owner. We will arrange to pay part of the cost of your sessions direct to the counsellor. The counsellor may ask you to pay something yourself. Please talk to the counsellor about this.
Counselling must be face-to-face. We can’t pay for missed sessions, other than one emergency session, which you may do by phone.
If you need further counselling sessions after the initial sessions, the counsellor has to give us a comprehensive report:
- recommending that more sessions are required
- advising that the sessions continue to relate to your covered injury claim.
We will then discuss your clinical needs based on the available information with an ACC Medical Advisor or Branch Advisory Psychologist. They will recommend the most appropriate treatment or action.
This could be to:
- arrange a further medical review or psychiatric or psychological assessment
- refer you to another treatment provider
- approve further counselling sessions.
We will tell you about our decision as soon as possible.
If you are unhappy with the decision, you can ask for a review. Go to What if I have problems with a claim?
We may also pay for loss of income and travel to treatment and rehabilitation. For more information go to What support can I get?
Accident Compensation (AC) Act 2001
- Section 27: Mental injury (external website)
- Schedule 3: Cover for mental injury caused by certain acts dealt with in Crimes Act 1961 (external website)
Injury Prevention, Rehabilitation, and Compensation (Liability to Pay or Contribute to Cost of Treatment) Regulations 2003
- Regulation 9: Counsellors’ costs (external website)
Updated: 18 March 2016
Reviewed: 16 March 2016