Survivor's call for ACC to fairly cover domestic abuse injuries to teeth prompts minister to order official probe

Friday, 25 March 2022

April Green was overjoyed when the Covid-19 mask mandate came into force because it meant she could go out in public without feeling ashamed.

A survivor of violent relationships, Green’s teeth were in such an awful state, with decay having compounded the damage done by punches, she found it hard to face the world, so being able to pull on a mask was a relief.

She doesn't have to feel that way any more, after having had the last of her teeth removed late last month at the age of 59, and dentures fitted, allowing her to smile her big smiles again.

“Going past the mirror, and seeing me back again. It was, ‘Hello beautiful. Check you out’,” she says. “Everything was washed away. It was like, ‘You’re back’.”

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But the dental work has left her with nearly $3000 in debt to Work and Income, and a burning desire for an overhaul of how ACC responds to claims for dental damage from women with teeth damaged as a result of violence.

She says ACC should treat claims for the dental injuries of survivors of domestic violence with the empathy and flexibility it now brings to handling sensitive claims of mental injury from sexual abuse and assaults because the current system is not working.

“This is my sadness. There are so many women. I know. I've worked with them. There are so many women who are not strong enough to seek the help, to keep pushing,” she says.

In her mid-40s, Green says she sought help from ACC to get her damaged teeth treated after escaping a cycle of 15 years of abuse, during which she was unable to protect her teeth.

But she could not tell ACC investigators the times, places and dates of the assaults that had damaged them, leaving them prone to decay, which ACC does not cover.

Green says her experience with ACC felt so degrading, she gave up trying to get her injuries treated.

“I didn’t want to go anywhere near them again to give me that opportunity to feel so low,” she says.

Her experience has struck a nerve with ACC Minister Carmel Sepuloni, who believes ACC does not respond as well to women’s injuries as to men’s, and she has ordered officials to look into how ACC covers damage to women's teeth caused by domestic violence.

“I believe there is merit in April’s idea, and I will look into it. I’ve asked officials at ACC and [the Ministry for Business, Innovation and Employment] to provide me with advice,” Sepuloni said.

The move mirrors Sepuloni's response to media reports on how few birth injuries were covered by ACC, which led to law changes being put before Parliament aimed at getting a fairer deal for women from ACC.

“We know we have epidemic rates of domestic violence in this country and we know that standard systems will not work for that,” Green MP Jan Logie says.

“Asking April for dates and times is so deeply out of touch with the realities of survivors of domestic violence. I don't know any survivor who could have kept a diary of when and how they were physically abused. Actually, that would be so risky.”

“We know the survivors of domestic violence often won't seek treatment at the time of injury because that could be interpreted as a provocation, or they are actively prevented from seeking treatment,” she says.

Green is repaying her debt to Work and Income at a rate of $10 a week.

Logie says victims of violence should not be left with debts from the injuries inflicted on them.

“We want equitable outcomes. We want it to be covering everybody's injuries. At the moment, there's a bias towards paying out towards men’s injuries,” Logie says.

Green wants to see Work and Income and ACC work closely together.

“There's a boomerang policy. Go to Work and Income, and they will send you to ACC, and they will send you back to Work and Income,” she says.

The Ministry of Social Development says Work and Income does not have a policy specific to domestic violence survivors regarding dental work, and the law prevents it giving grants of more than $300 for dental work, though Labour has pledged to lift the maximum dental grant, which does not need to be repaid, to $1000.

ACC has offered to review Green's claim.

Gabrielle O’Connor, ACC acting chief operating officer, says the state accident insurer “sympathises with the survivors of family violence that have added difficulties accessing medical treatment”.

“We take these circumstances into account and will investigate further to find other evidence that will confirm the date the physical injury occurred so that we can provide cover. This can be things such as police reports or witness accounts,” O’Connor says.

But, she says, the Accident Compensation Act limits ACC’s ability to make “discretionary” payments.

Green recently successfully made a sensitive claim to ACC for historic sexual abuse, and says the much more empathetic process she went through should be applied to dental injury claims from domestic abuse survivors.

“I decided to go back and do it again because I was told the system was a lot less cruel than it used to be,” she says.

“It was that cruel, women just didn't bother,” says Green, who worked for Aviva, helping other women escape violent relationships.

She wants other women trying to rebuild their self-esteem, and build careers, after violent relationships to get the help they need to save their teeth, and their smiles.

“How the heck can they do that when they can't even look people in the eye, and smile, because they are so ashamed of what they look like?” she says.

Because women's dental injuries are effectively not covered by ACC, they are at the mercy of only being able to get Work and Income funding for extraction, Green says.

“Our teeth are only supported for extractions, not left in our mouths, so we can look beautiful and eat for the rest of our lives without dentures, or partials,” she says.

Where to get help for domestic violence

• Women’s Refuge 0800 733 843 (females only)

• Shine Free call 0508 744 633 between 9am and 11pm (for men and women)

• 1737, Need to talk? Free call or text 1737 to talk to a trained counsellor.

• Kidsline 0800 54 37 54 for people up to 18 years old. Open 24/7.

• What’s Up 0800 942 8787 (for 5 to 18-year-olds). Phone counselling available Monday-Friday, noon-11pm and weekends, 3pm-11pm. Online chat is available 3pm-10pm daily.

• Youthline 0800 376 633, free text 234, email talk@youthline.co.nz, or find online chat and other support options here.

• If you or someone else is in immediate danger, call 111.

Need help? If you or someone you know is in a dangerous situation click the Shielded icon at the bottom of this website to contact Women's Refuge in a safe and anonymous way without it being traced in your browser history. If you're in our app, visit the mobile website here to access Shielded.