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Social rehabilitation: claim for funding for a vehicle – ss 81, 84, Accident Compensation Act 2001. Whether Corporation correctly declined to fund purchase of a vehicle for the Appellant, who has covered personal injuries. Corporation did not conduct proper assessment of whether Appellant’s request for funding for vehicle was required as direct consequence of covered personal injuries. Corporation incorrectly declined to fund vehicle purchase. Outcome: appeal granted.
Claim for work-related gradual process injury – s 30 Accident Compensation Act 2001. Scapholunate advanced collapse (SLAC) injury to wrist. Appeals against decision to decline cover for a work-related-gradual process injury and decline weekly compensation. Court satisfied on the basis of medical evidence that Appellant performed an employment task that had a particular property or characteristic that caused, or contributed to the cause of, his personal injury. Outcome: both appeals allowed.
Appeal challenging the Reviewer’s decision. sections 25 and 32(1) of the Accident Compensation Act 2001. Whether the appellant suffered a physical injury caused by treatment during her surgery. Held: appellant did not establish she suffered a physical injury caused by treatment. Appellant’s ongoing pain was due to nerve hypersensitivity and not a physical injury. Court upheld reviewer’s decision to decline to provide cover to appellant. Appeal is dismissed.
Lack of Jurisdiction – s 54, 64 and 134(1)(b) Accident Compensation Act 2001. Appeal against review decisions dismissing Appellant’s applications regarding unreasonable delay and lack of decision by the Corporation. Reviewer correct to conclude no jurisdiction to proceed with reviews as decisions had been issued before hearings. Corporation’s communications lacked clarity and caused uncertainty, therefore Appellant acted reasonably in applying for review. Outcome: first Decision as to costs quashed and costs awarded in Appellant’s favour. Appeal from Second Decision dismissed.
Claim for weekly compensation – ss 52-53, Accident Compensation Act 1982. Whether historical benefit of motor vehicle provided to Appellant for employment purposes was correctly incorporated into Corporation’s calculation of earnings for weekly compensation entitlement purposes. Corporation received advice on full value of vehicle. Corporation used apportioned rather than full value in calculating weekly compensation. In absence of any other independent valuation, full valuation fairly and reasonably represented value of vehicle. Outcome: appeal allowed.
Backdating of attendant care payments - ss 81, 83, 374 and 376 Accident Compensation Act 2001. Appeal from a review decision upholding the Corporation’s decision declining to backdate attendant care payments for the first appellant. Whether the Corporation has the statutory ability to make a retrospective payment of compensation for attendant care for the first appellant for the period prior to 1 April 2002. Held: Where cover has been provided under the 2001 Act, there is no retrospective entitlement to compensation for attendant care provided prior to 1 April 2002. Outcome: Appeal dismissed.
Claim for a treatment injury - s 32 of the Accident Compensation Act 2001. Appeal against decision dismissing an application for a review of the Corporation’s decision to decline the appellant’s claim for a treatment injury. Whether the appellant’s melanoma constituted a treatment injury. Held: The appellant’s melanoma was not a treatment injury. The Corporation correctly declined cover for a treatment injury. Outcome: Reviewer’s decision is upheld, and the appeal is dismissed.
Impairment assessment – clause 54, Schedule 1, Accident Compensation Act 2001. Whether Corporation entitled to rely on whole person impairment assessment of Appellant by medical assessor. Appellant failed to establish that assessment was in some way flawed or incorrect. No breach of natural justice by Reviewer. Corporation was entitled to rely on whole person impairment assessment, and review process was conducted fairly and appropriately. Outcome: appeal dismissed.
Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Delay of 10 days. Delay arose out of error or inadvertence rather than change of mind or indecision. Interests of justice required exercise of Court’s discretion to sustain application for leave to file appeal out of time. Outcome: application granted.
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.