Claim process - s 6 Accident Compensation Act 2001. Appeal against the Corporation's decision declining a subscription. No evidence offered to substantiate claim. Outcome: appeal dismissed.
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Claim process - s 6 Accident Compensation Act 2001. Appeal against the Corporation's decision declining a subscription. No evidence offered to substantiate claim. Outcome: appeal dismissed.
Work-related gradual process injury - s 30 Accident Compensation Corporation Act 2001. Appeal against Corporation's decision declining cover for a work-related gradual process injury. Medical evidence did not establish that the Appellant's lung condition was an occupation disease. Corporation correctly declined cover. Outcome: appeal dismissed.
Personal injury - ss 20, 25, 26 Accident Compensation Corporation Act 2001. Appeal against Corporation's decision declining cover for the Appellant's traumatic arthropathy joint injury. Weight of medical evidence did not establish that the Appellant's accident caused the traumatic arthropathy injury. Outcome: appeal dismissed.
Weekly compensation - ss 42(7), 54 Accident Compensation Act 2001. Appeal against the Corporation's decision determining the Appellant's weekly compensation. Decision determining Appellant's entitlement to weekly compensation was not made on reasonable grounds. Corporation did not consider Appellant's prospective employment. Outcome: appeal allowed.
Treatment injury - s 32 Accident Compensation Act 2001. Appeal against decision to decline cover for a treatment injury. Insufficient medical evidence to explain the causation of the injury to the treatment. Legislative criteria for treatment injury not met.Outcome: appeal dismissed.
Personal injury - ss 20, 25, 26 Accident Compensation Act 2001. Appeal against a decision of a Reviewer. Medical evidence suggested knee injury was likely due to underlying condition not accident. Decision of the Reviewer correct. Outcome: appeal dismissed.
Late filing of an appeal to the District Court - s 151 Accident Compensation Act 2001. Delay due to issues navigating ACC process. Whether interests of justice required the exercise of discretion to sustain his application for leave to file his appeal out of time. Delay arose out of an understandable error or inadvertence. Interests of justice established for appeal. Outcome: appeal granted.
Claim for entitlements – ss 68, 67 Accident Compensation Corporation. Whether Corporation correctly declined to pay reimbursement of surcharges, travel costs to the Appellant, and whether Reviewer was entitled to quash Corporation’s decision to decline cover for treatment injury and order further investigation of injury. Legislation did not provide for the Corporation to refund surcharges. Appellant could not establish she was entitled to travel costs claimed. Reviewer entitled to quash Corporation’s treatment injury decision after finding injury not sufficiently investigated. Outcome: appeals dismissed.
Appeal regarding entitlement to weekly compensation following surgery for a historical back injury. section 100(1)(a) of the Accident Compensation Act 2001. Whether appellant was an “earner” at the time of his incapacity. Held: appellant was not an “earner” at the time of his incapacity. The causal link between the original injury and incapacity at the time of surgery was not established. Outcome: Appeal dismissed.
Claim for Treatment Injury - s 32 Accident Compensation Act 2001. Whether Corporation correctly declined Appellant's claim for treatment injury on basis that claim did not meet legislative criteria because absence of identified physical injury. No medical evidence to establish delirium and other symptoms were a physical injury caused by treatment for prostate concerns. Corporation correctly declined cover. Outcome: appeal dismissed.
Appeal regarding entitlement to weekly compensation for incapacity following a work-related accident. Section 100 and 103 of the Accident Compensation Act 2001. Whether appellant entitled to weekly compensation for the period following his accident. Held: medical evidence supported appellant’s covered injuries had not resolved and were the material cause of his ongoing headaches and incapacity. Outcome: appeal allowed, appellant entitled to weekly compensation.
Rehabilitation - Sch 1 21 Accident Compensation Act 2001. Appeal against decision declining funding for an adjustable bed. Appellant claimed she had an injury related need for an adjustable bed. Objective needs assessment did not recommend an adjustable bed. Appellant did not establish a need for the bed given the safety and comfort issues were addressed in other ways. Corporation's decision was correct. Outcome: appeal dismissed.
Mental injury - s 21 Accident Compensation Act 2001. Appeal against decision declining cover for sexual abuse. Claim was considered to be a duplicate of an existing covered sensitive claim. Cover granted for injury not instances of abuse. Corporation's decision was correct. Outcome: appeal dismissed.
Claim for costs on appeal - s 149 Accident Compensation Act 2001. Whether costs should be awarded against the appellant, and if so, in what amount, given his circumstances and the nature of the appeal. Full claimed amount would be disproportionate and unrealistic. Costs awarded $600 against appellant (significantly reduced from $4,127.50) to reflect fairness and discretion.
Claim for costs on appeal - s 149 Accident Compensation Act 2001. Whether costs should be awarded against the appellant after his unsuccessful appeal. Costs awarded against appellant in the sum of $400, significantly reduced from Respondents claim of $2,794, to avoid undue hardship while reflecting the principle that the unsuccessful party pays.
Appeal regarding tax deductions, physiotherapy entitlements and accountant costs around weekly compensation payments. Whether ACC should fund the appellant’s personal accountant to review weekly compensation calculations. Whether the tax component was correctly calculated for backdated weekly compensation payments. Held: ACC not required to fund personal accountant costs, these are not covered entitlements under the Act. ACC correctly calculated the tax component of backdated weekly compensation payments according to NZ tax laws. Outcome: Appeal dismissed.
Late filing of an appeal to the District Court - s 151 Accident Compensation Act 2001. Appeal against decision declining entitlements. Application to file the appeal was late. Not established that interests of justice required the exercise of discretion to sustain his application for leave to file his appeal out of time. Outcome: appeal dismissed.
Appeal against a reviewer’s decision. Appeal regarding declining cover for lymphoedema and reimbursement for related treatment costs – sections 20, 25, 26 of the Accident Compensation Act 2001. Whether appellant’s lymphoedema was causally linked to her burn accident and whether appellant entitled to cover and reimbursement for treatment costs under the Act. Held: Sufficient medical evidence to infer appellant’s burn injury contributed to her lymphoedema. Injury is causally linked to the accident, appellant therefore entitled to cover for lymphoedema and reimbursement for treatment costs. Outcome: Appeal allowed.
Work-related gradual process injury s s20, 26, 30 Accident Compensation Act 2001. Appeal against decision declining cover for a work-related gradual process injury. Injury was not more likely to occur in the Appellant's occupation. Appellant was more susceptible to the condition to his underlying predisposition. Corporation's decision declining cover was correct. Outcome: appeal dismissed.
Cover - ss 20, 25, 26 Accident Compensation Act 2001. Appeal against decision declining cover for tendon rupture as a personal injury. Evidence did not support that the accident caused the tendon rupture. Corporation's decision declining cover was corrected. Outcome: appeal dismissed.
Leave to appeal to the High Court - s 162(1) Accident Compensation Act 2001. Whether sufficient grounds, as a matter of law, to sustain his application for leave to appeal. No question of law capable of bona fide and serious argument. Outcome: appeal dismissed.
Late filing of an appeal to the District Court - s 151 Accident Compensation Act 2001. Whether the District Court should exercise its discretion to file appeal outside the statutory 28-day timeframe. Appeal was filed over two years late. Reasons for delay were reasonable including new evidence from GP and relocation to a different city. No prejudice to respondent in granting leave. The appeal is significant to appellant. Interests of justice favoured granting leave. Outcome: application granted.
Claims process jurisdiction - s 134 Accident Compensation Act 2001. Whether the Respondents letter declining to make a payment outside statutory entitlements is a reviewable decision, giving the Court jurisdiction to hear the appeal. Court held decision was not reviewable. Review rights under s134 apply only to decisions on cover or entitlements. Payments outside statutory entitlements (ex gratia) do not fall within the definition of a “decision” under the Act. Outcome: appeal dismissed.
Leave to appeal to the High Court - 162 Accident Compensation Act 2001. Corporation applied for leave to appeal against a decision granting cover for treatment injury suffered by continuation of a pregnancy. Corporation raised questions of law capable of bona fide and serious argument. Corporation established sufficient grounds to sustain its application for leave to appeal. Outcome: application granted.
Application for leave to appeal to the High Court. Appeal under s 162(1) of the Accident Compensation Act 2001. Whether District Court erred in law by finding that appellant’s mental injury was caused by a gradual process and not a single event as required by s 21B. Whether any bona fide question of law arose justifying leave to appeal to the High Court. Held: District Court correctly applied section 21B. No bona fide or seriously arguable question of law arose. Outcome: Application for leave to appeal dismissed.