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By Yngvil Mortensen / FriFagbevegelse
Dr Paul Kavli is now awaiting a “verdict” from Nav Kontroll, who in a previous warning has accused him of facilitating the abuse of social security.
– I do my job, says Dr. Paul Kavli.
For 16 years he has worked with patients struggling with complex illnesses such as chronic fatigue syndrome and pain problems.
– It is my professional duty as a doctor to be faithful to my patients. When I feel like Nav is getting in the way of them achieving better health, I say so, Kavli tells FriFagbevegelse.
– I have considered it necessary in a few very serious cases. For example, when Nav has stopped benefiting patients who are not ready to work again. It is a strong psychological stress that can lead to an extremely high degree of despair, hopelessness and depression, sometimes with the risk of developing the risk of suicide, Kavli argues.
Also read: Chief Doctor: – In the worst case scenario, Nav makes people sicker
Nav Control notified navigation office
A year and a half ago, a letter from Nav Fredrikstad was thrown into Kavli’s mailbox.
FriFagbevegelse has read the letter in a skimmed version, without information such as the names of the patients or anything else that allows others to recognize them.
The letter referred to some patient notes that Kavli had already written about a handful of his patients, in which he mentioned Nav. Nav receives these medical certificates when patients apply for benefits.
“We experience that in your dialogue with us in these cases, you act as advocate for users,” wrote Torgeir Bjerke, department manager at Nav Fredrikstad.
Therefore, Bjerke thought it would be difficult for Nav to cooperate well with Kavli, he wrote. He considered reporting Kavli to Nav’s own watchdog if the cooperation between Nav and Kavli did not improve. In the end, Nav Fredrikstad notified Nav Kontroll, who launched an investigation of Kavli.
Nav Fredrikstad will not comment on the case at this time.
Nav Kontroll informs FriFagbevegelse that they expect to conclude the case during October.
Also read: Lawyer: – Nav’s new practice weakens people’s legal security
– The “stress of navigation” interferes with the treatment
Many of Kavli’s patients have reached a point where they are so physically and mentally weakened that they can no longer fully work, while some manage to work a little, Kavli explains. Therefore, they must apply for welfare state benefits to replace lost wages. To apply, you need statements from your GP and other therapists. Sometimes Nav even requests such statements.
Paul Kavli has patients who have been ill for a long time and who have experienced that Nav has stopped receiving their benefits before they can go back to work, he says.
He has been so concerned about these patients that he has mentioned it in patient notes, to which Nav Fredrikstad reacted.
– When I believe that Nav has incorrectly concluded, I have recommended that Nav not suspend benefits or that Nav should award benefits. I then pointed out that financial unpredictability creates strong discomfort and worry, significantly interrupting treatment. I have pointed this out when I mean Nav abuses the patient and my evaluations without professional justification. I have pointed this out when Nav implements therapeutic or work-oriented measures, which interrupt treatment, without coordinating with the therapist, and when Nav communicates very poorly with the patient. Nav must see his role in the patient process, Kavli believes.
FriFagbevegelse asks Nav Fredrikstad what is wrong with a doctor mentioning the above in medical records or doctor’s statements.
“We do not want to comment on this case now, as it has not yet been processed by Nav Kontroll,” Lise Mette Paulsen, Nav Leader in Fredrikstad, responds by email.
Also read: Cuts in benefits: now it will hurt more to leave work (+)
– Conscious people
Kavli worked for many years with orthopedics in various hospitals, treating diseases and injuries to muscles and bones. Later, Kavli himself gained experience with prolonged exhaustion. As it improved, it changed pastures. Many patients come to him for evaluation and follow-up of complex diseases.
– Many of my patients are persistent, hard-working and conscientious people, who for various reasons may have worn themselves out. Many are tired of working life, others are characterized by challenges in their upbringing. The causes of patient ailments are always complex. I have several patients caring for children who are struggling physically, mentally or socially, says Kavli.
“Professional reasons are behind everything I do to get patients back on track,” he says.
– Patients state that “navigation stress” is their greatest mental effort. This triggers serious stress reactions that aggravate patients’ ailments. I have tried to report this in the media and on professional forums, says Kavli.
FriFagbevegelse recently interviewed the chief physician of pain medicine at St. Olavs Hospital, Harald Sundby. He stated that financial insecurity is perhaps one of the worst triggers for triggering stress in people with complex conditions. This increases his symptoms, he said.
Also read: 350,000 Norwegians lose vacation pay
Nav Control sent advance notice
In May of this year, Nav Control East sent an “advance warning” to Paul Kavli. FriFagbevegelse has read a condensed version of the advance warning. It appears that a consulting chief physician at Nav reviewed the medical records of a small number of Kavli’s patients. Nav Kontroll questioned Kavli’s professionalism and accused him of facilitating “the unjustified payment of social security benefits”.
Nav Kontroll wrote that they were considering giving him the right to practice at the expense of the National Insurance Plan.
Paul Kavli runs a private practice and gets all of his income directly from patients, except when Nav asks him to write the doctor’s statements. Then Nav pays you for it, and in his case this is what “exercising at the expense of social security” means. The returns are a negligible part of your income, says Kavli.
– The problem is not economic, but it can damage my reputation in Nav. This, in turn, can affect patients, Kavli says.
Also read: Dad alone, Rune, has fought for ten years to be believed. Now Nav apologizes
Nav: – I can’t comment
FriFagbevegelse asks Nav Kontroll about the background to the Paul Kavli investigation and the allegations against him.
Nav Control Director Ole Johan Heir responds that they cannot comment on this as Nav has not yet finished processing Kavli’s case.
Paul Kavli himself does not want to go into the details of the Nav Control accusations.
– Because I have a duty of confidentiality towards my patients, I cannot go into the details of the accusations against me in public. It is impossible for me to defend myself publicly without violating the duty of confidentiality, says Paul Kavli.
Also read: Nav has spent more than two years processing Irene’s AAP case (+)
– Despair is enormous
Paul Kavli describes windows being almost fogged “when these patients express hopelessness and despair as a result of Nav’s treatment.”
Kavli looks at the large office windows that look out onto the garden, the city, and the fjord below.
– I was surprised when I started working with these patients, he says.
It was not primarily about the patients themselves, but what he believes is the failure of collaboration with the Nav system that patients often depend on.
– Starting in January 2018, it was tightened with the tightening of the workers’ compensation money scheme. It was the first time that I felt powerless even as a result of working with these patients, says the doctor.
Also read: New hearing in the Nav case
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