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Impairment assessment - clause 54, Schedule 1 Accident Compensation Act 2001. Grant cover for concussion, contusion of left knee and abrasion of lower leg. Whole person assessment conducted. Appellant sought review of assessment. No breach of natural justice by the Reviewer in the conduct of the review process, as full opportunity was given to Appellant to present her application for review. Outcome: appeal dismissed.
Late filing of an appeal to the District Court - s 151 Accident Compensation Act 2001. Late filing of appeal against decision declining cover for post-concussion syndrome, major depressive disorder and any other diagnoses. Delay of six weeks but no prejudice or hardship to others. Appeal is significant to Applicant. Interests of justice require the exercise of the Court's discretion to sustain application for leave to appeal of out of time. Outcome: appeal granted.
Leave to appeal to the High Court - s 162 Accident Compensation Act 2001. Applicant claimed costs for time and preparation for the review and appeal and also for Baigent costs. Not awarded costs as she was self-represented. No question of law arises capable of bona fide and serious argument in the High Court. Outcome: application dismissed.
Leave to appeal to the High Court - s 162 Accident Compensation Act 2001. Applicant's physical file was destroyed between 1993 and 2005 based on retention policies. Applicant seeking $32 million in compensation. Corporation issued a decision which determined that there were no breaches of the Code as the Corporation had acted in accordance with retention policies in place at the time. Appeal dismissed by the District Court. No error of law identified in the District Court decision or question of law capable of bona fide and serious argument. Outcome: application dismissed.
Leave to appeal to the High Court - s 162 Accident Compensation Act 2001. Application to appeal filed outside the statutory time period. Corporation did not waive the late filing. Outcome: application struck out.
Suspension of entitlements - s 117(1) Accident Compensation Act 2001. Whether the Corporation had a sufficient basis to suspend as at the date of its decision. Whether Corporation’s Decision to suspend was correct in light of the evidence now available. Held: The Corporation conducted a thorough investigation into the appellant’s ongoing incapacity and symptoms prior to suspension and subsequently. Numerous reports indicate that the appellant’s ongoing incapacity and symptoms were not caused by the appellant’s covered injuries resulting from the Accident. No error was established in the Corporation’s Decision or the Review Decision Outcome: Appeal dismissed.
Personal injury/Deemed cover decision – ss 26 and 58 Accident Compensation Act 2001. Whether Corporation’s decision declining cover and funding for surgery was correct. Whether Corporation’s determination that Appellant did not have deemed cover was correct. No error established in Corporation’s decisions or review decision. Outcome: appeal dismissed.
Personal injury - s 26 Accident Compensation Act 2001. Appeal against decision to decline cover for acute meniscal tear and declined funding for knee surgery. The evidence establishes on the balance of probabilities that condition is degenerative in nature and that the mechanism of injury is not consistent with the injury to the left knee said to have occurred as a result of the accident. Outcome: appeal dismissed.
Late filing of an appeal to the District Court - s 151 Accident Compensation Act 2001. Issu deals with the determination of whole person impairment and subsequently whether entitled to a lump sum payment. Proposed appeal is significant to the estate of the Appellant and delay was three months. Interests of justice require the exercise of the Court’s discretion to allow the application for leave to file the appeal out of time. Outcome: appeal allowed.
Appeal challenging the review decision. Sections 75-78, Accident Compensation Act 2011. Whether the Individual Rehabilitation Plan (IRP) finalised by ACC was reasonable and appropriately addressed the appellant’s rehabilitation needs. Held: The IRP was finalised prematurely and did not include all necessary and agreed upon actions for Appellant’s rehabilitation. IRP failed to include referral to pain specialist, general surgeon review, and neuropsychological assessment for cognitive decline. The review decision dated 28 June 2023 is quashed. The appeal is allowed, appellant is entitled to costs.
Appeal challenging the corporations’ decision to decline paying weekly compensation. section 117(3B) of Accident Compensation Act 2001. Whether the appellant can satisfy the test under s117(3B) and is therefore entitled to weekly compensation. Held: appellant does not establish exceptional circumstances nor that it would be inequitable for the Corporation to refuse to make any payment for the period. Appeal is dismissed.
Appeal challenging the correctness of the corporation’s decision. Part 3 of Schedule 1 to the Accident Compensation Act 2001. Whether the Corporation was correct to decline an independence allowance for the appellant because his WPI assessment was below the 10% minimum threshold. Held: No error was established in the Corporation’s decision. Outcome: Appeal is dismissed.
Appeal against a reviewer’s decision. s 58 and 67 of the Accident Compensation Act. Whether the Corporation correctly determined the appellant’s weekly compensation for a kidney stone injury should be paid from the date from when cover was deemed rather than the date of his incapacity. Held: appellant not entitled to backdated weekly compensation prior to the period of deemed cover because he did not hold cover for the kidney stone that incapacitated him for work. Reviewer’s decision upheld. Appeal is dismissed.
Appeal against a reviewer’s decision. s 114 of the Accident Compensation Act. Whether the earlier decision declining the appellant from receiving interest on weekly compensation arrears payment was correct. Held: reviewer correctly declined jurisdiction over appellant’s application for review, because issue estoppel applied in regard to the interest payments claimed. Decision of reviewer is upheld. Appeal is dismissed.
Appeal against a reviewer’s decision. ss 107-112 of Accident Compensation Act 2001. Whether the appellant had achieved vocational independence and was therefore not entitled to further weekly compensation. Held: the Corporation’s decision that the appellant had achieved vocational independence was not supported by sufficiently strong evidence. Appeal is allowed.
Claim for treatment injury – ss 32-33 Accident Compensation Act 2001. Acute injury to right wrist while working as a caregiver. Persistent lump later found on hand. Initially diagnosed as a cyst but later discovered to be an atypical fibro histiocytoma. Applicant underwent surgery. Applicant argued that series of events comprises a treatment injury. Held: initial cyst diagnosis reasonable. Standard medical practice was followed. Outcome: appeal dismissed.
Claim for work-related gradual-process injury – s 30, Accident Compensation Act 2001. Whether Corporation correctly declined Appellant’s cover for accidental poisoning as a work-related gradual process injury. Appellant did not qualify for cover for neurotoxic injury in terms of ss 30(3) and 60 of the Act. Corporation correctly declined cover. Outcome: appeal dismissed.
Interpretation of decision – s 6, Accident Compensation Act 2001. Whether Corporation’s letter confirming earlier cover decision and clarifying condition was covered as a physical injury and not a mental injury constituted a reviewable decision. Letter was not a reviewable decision. Outcome: appeal dismissed.
Appeal of an earlier decision by Accident Compensation Corporation. Appeal under s 149 of the Accident Compensation Act 2001. ss 26, 32, and 33 of the Accident Compensation Act 2001. Whether the appellant is entitled to cover for a treatment injury for leg length discrepancy? Held: the leg length discrepancy was not an ordinary consequences of the right hip joint replacement injury, therefore the appellant is entitled to cover for treatment injury under the Act. Appeal is allowed.
Claim for cover for occupational noise-induced hearing loss (ONIHL) - ss 26, 20(2)(e) Accident Compensation Act 2001. Appellant's ONIHL was assessed at 4-5%, below the 6% threshold required for cover to be accepted. Appellant challenged this calculation. Held: material flaws in the assessments of both assessors. Did not undertake a clinical examination and take a careful history to underly the analysis. Outcome: appeal allowed.
Claim for cover. ss 20,25,26 Accident Compensation act 2001. Whether the appellant’s left inguinal hernia is an injury caused by an accident. Held: appellant will have cover for his left inguinal hernia as an injury caused by the accident. Appeal is allowed.
Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Appellant's application to review weekly compensation entitlement was dismissed. Late filing resulted from error or inadvertence by counsel. Interests of justice required exercise of Court’s discretion to sustain application for leave to file appeal out of time. Outcome: application granted.
Impaired assessment, lump sum compensation - Schedule 1, Part 3, Clause 57 Accident Compensation Act 2001. Appellant declined lump sum compensation for coccyx sprain. Subsequent application for review of this decision declined. Held: Appellant now undergoing desired impairment assessment so there is no live issue before the Court. Corporation acted entirely properly and lawfully. Outcome: appeal dismissed.
Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Appellant declined cover for lumbar disc prolapse. Late filing resulted from error or inadvertence of Appellant’s counsel. Interests of justice required exercise of Court’s discretion to sustain application for leave to file appeal out of time. Outcome: application granted.
Appeal against the decision of a reviewer declining cover for a work related injury. s 149 Accident Compensation Act 2001. Whether or not the reviewer’s decision should be upheld. Held: parties agree the first respondent’s claim does not meet the criteria for cover for a work related gradual process injury. Earlier review decision is set aside.