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Claim for personal injury - ss 20, 25, and 26(1)(b) Accident Compensation Act 2001. Appeal against decision declining cover for a lower lip injury caused by playing an unfamiliar trumpet mouthpiece. Found that the Appellant suffered a personal injury by accident. Appellant entitled to cover for his personal injury. Outcome: appeal allowed.
Leave to Appeal to High Court – s 162 Accident Compensation Act 2001. Legal issue raised by Appellant was one of wider importance, and capable of bona fide and serious argument. Outcome: leave to appeal granted.
Claim for personal injury – ss 20, 25, 26, Accident Compensation Act 2001. Appeal against decision dismissing the review of the Corporation's determination. Whether the Corporation correctly declined cover and funding for surgery to remove loose bodies in the appellant’s right knee; and whether it was justified in revoking and denying cover for a right meniscal tear. Held: The medical evidence did not support the appellant was entitled either to cover and funding for surgery or the right meniscal tear. Outcome: appeal dismissed.
Appeal challenging the Corporation and Reviewer’s earlier decision. Sections 79 and 81 of the Accident Compensation Act 2001. Whether the Corporation’s decision to decline funding for air conditioning equipment and voice-activated computer software was correct. Held: Corporation’s decision to decline funding request was correct. Medical evidence did not support a causal link between injury and the need for requested equipment. Treatment provided to appellant was reasonable and appropriate, no departure from the standard of care. Appeal is dismissed.
Appeal challenging the Reviewer’s decision. Section 32 of the Accident Compensation Act 2001. Whether the delay in diagnosing septic arthritis in the appellant’s shoulder constitutes a treatment injury under the Accident Compensation Act 2001. Held: Corporation’s claim to decline the claim was correct/ Medical evidence did not support a causal link between the shoulder sprain and septic arthritis. Treatment provided to appellant was reasonable and appropriate, no departure from the standard of care. Appeal dismissed.
Leave to appeal to the High Court – s 162 Accident Compensation Act 2001. Whether sufficient grounds as a matter of law to sustain applications for leave to appeal. Applicant failed to establish error of law capable of bona fide and serious argument. Outcome: applications dismissed.
Appeal challenging the Reviewer’s decision. Sections 32 and 149 of the Accident Compensation Act 2001. Whether the delay in performing an MRI scan, which led to a delayed diagnosis and treatment of metastatic colon cancer, constitutes a treatment injury under the Accident Compensation Act 2001. Held: Corporation’s decision to decline the claim was too simplistic given the complexity of the case and multiple factors contributing to the delay in diagnosis. Subsequently, the Corporation issued a new decision, granting cover for the treatment injury. The current appeal is dismissed as the Corporation’s new decision granted cover for the treatment injury, making this appeal moot.
Leave to appeal to the High Court – s 162 Accident Compensation Act 2001. Whether sufficient grounds, as matter of law, to sustain applications for leave to appeal. Applicant failed to establish any error of law capable of bona fide and serious argument. Outcome: applications dismissed.
Claims process – s 134(1), Accident Compensation Act 2001. Whether Reviewer correctly dismissed application for review for alleged unreasonable delay in the Corporation issuing a decision, on the basis that the Corporation had made a determination on the entitlement sought. Reviewer correctly declined jurisdiction. Outcome: appeal dismissed.
Appeal from the decision of a Reviewer. Sections 65 and 161 of the Accident Compensation Act 2001. Whether Court had jurisdiction to determine appellant’s appeal from review decision. Corporation had since revoked the decision under review and decided to fund the appellant’s new spectacles. Corporation’s new decision rendered current appeal moot. In absence of live issue, Court does not have jurisdiction to decide appeal. Outcome: appeal dismissed.
Physical Injury – s 26(1)(c) Accident Compensation Act 2001. Appeal against the Corporation’s decision declining cover for mild neurocognitive disorder (NCD). Whether the appellant had a mental injury under s 27 of the Act, requiring a medically established diagnosis of NCD. Only if NCD was proven would causation under s 26(1)(c) require examination. Held: The diagnosed mental injury was not established; causation was therefore irrelevant. Outcome: Appeal dismissed.
Claim for personal injury – ss 20, 25, 26 of Accident Compensation Act 2001. Whether the appellant’s cervical disc pathology at the c3/4, c5/6, and c6/7 levels is causally linked to the motor vehicle accident on 5 March 2015? Held: Medical evidence supports that her multilevel cervical disc pathology was not related to a single-event trauma in her accident but was likely a gradual process condition. Proposed surgery was not necessary and appropriate for the appellant’s condition. Outcome: Appeal dismissed.
Leave to appeal to the High Court. Section 162 of the Accident Compensation Act 2001. Whether the Corporation’s decision to decline funding to the appellant for a four-wheel drive (4WD) vehicle for social rehabilitation and independence was correct. Held: Court upheld the Corporation’s decision. Corporation had reasonably exercised its discretion, and appellant had not established an injury-related need for a 4WD vehicle. Appeal is dismissed.
Claim for costs, Accident Compensation Act 2001. Outcome: Corporation directed to pay Appellant $3,929.50, being costs of $3,169.50 and disbursements of $760.
Late filing of an appeal to the District Court - s 151 Accident Compensation Act 2001. Whether interests of justice required the exercise of discretion to sustain her application for leave to file her appeal out of time. Interests of justice established for appeal. Delay arose out of error or inadvertence by the Appellant's advocate. Outcome: appeal granted.
Claim for Cover - ss 20, 25, 26 of the Accident Compensation Act 2001. Appeal against the Corporation’s decision to decline cover. Whether the accident caused the appellant’s right inguinal hernia. Held: the weight of the evidence does not support that appellant’s hernia was caused by the single accident on or about 7 December 2022. Outcome: The appeal is dismissed. The Court directs the Corporation to investigate whether the appellant’s right inguinal hernia was caused by a work- related gradual process injury.
Suspension of weekly compensation – s 117(1), Accident Compensation Act 2001. Whether Corporation correctly suspended Appellant’s weekly compensation. Corporation did not have sufficient basis to be not satisfied that Appellant was entitled to continue receiving weekly compensation. Corporation was not entitled to suspend Appellant’s entitlement. Outcome: appeal allowed. Corporation directed to reinstate Appellant’s entitlement to weekly compensation from the time it was suspended.
Independence Allowance – Part 4, Schedule 1, Accident Compensation Act 2001. Whether the assessment of the appellant’s level of impairment was flawed. Held: assessment did not adequately analyse the appellant's pain in relation to the covered injuries of chronic pain due to trauma, nor did it sufficiently consider the covered injuries. Outcome: Review decision quashed. The Corporation is directed to conduct a further reassessment of the covered injuries. The appellant is entitled to reasonable costs.
Claim for personal injury – ss 20, 25, 26, Accident Compensation Act 2001. Whether Corporation correctly declined cover and surgery funding. Appellant’s accident did not cause the degenerative changes in his CMC joint, but rather rendered them symptomatic. Appellant not entitled to cover or surgery funding. Corporation correctly declined cover and surgery funding. Outcome: appeal dismissed.
Late filing of an appeal to the District Court - s 151 Accident Compensation Act 2001. Whether interests of justice required the exercise of discretion to sustain his application for leave to file her appeal out of time. Interests of justice established for appeal. Delay arose out of error or inadvertence rather than indecision. Outcome: appeal granted.
Rehabilitation – Aid for Appliance: Part 1, Schedule 1, Clause 12, Accident Compensation Act 2001. Whether Corporation correctly exercised its discretionary powers when declining Appellant’s application for an electric bed to be funded. Corporation clearly correct in concluding need for the bed was not a direct consequence of the covered injuries. Weight of evidence supported Corporation’s conclusion. Outcome: appeal dismissed.
Appeal challenging the Reviewer’s decision. Sections 81-84 of the Accident Compensation Act 2001. What is the correct level of funded home support and community support services for the appellant. Held: Court upheld the Corporation’s decision to provide attendant care based on the assessment by the physiotherapist. Appeal is dismissed.
Impairment Assessment: Part 3 Schedule 1, Accident Compensation Act 2001. Whether Corporation’s decision declining to award lump sum payment on basis Appellant’s level of impairment did not meet statutory minimum of 10% was flawed or incorrect. No basis for setting aside Corporation’s decision, which was clearly correct. Outcome: appeal dismissed.
Claim for personal physical injury - s26(1)(b) Accident Compensation Act 2001. Appeal against decision to revoke deemed cover for acute pericarditis caused by the Pfizer COVID-19 vaccine and declining cover for acute pericarditis as a treatment injury. Weight of medical evidence does not support that the COVID-19 vaccine caused acute pericarditis. Outcome: appeal dismissed.
Work Related Gradual Process Injury – s 30 Accident Compensation Act 2001. Whether glenohumeral joint osteoarthritis was caused by work-related gradual process. On evidence, Appellant’s work tasks did not cause or contribute to cause of glenohumeral osteoarthritis. Necessary elements for work-related gradual process injury not established. Outcome: appeal dismissed.