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Appeal from a review decision regarding the Corporation’s decision declining the appellant’s request for weekly compensation. Claim for weekly compensation – s 105. Whether the appellant’s current symptoms and incapacity are causally linked to the covered head injury thereby entitling her to weekly compensation. Held: the weight of expert medical evidence did not support a material causal connection between the injury and the appellant’s symptoms. Outcome: appeal dismissed.
Impairment assessment – Schedule 1(4) of Accident Insurance Act 1998, and Schedule 1(3) of Accident Compensation Act 2001. Whether Corporation’s decisions regarding Appellant’s whole person impairment (WPI) for independence allowance and lump sum purposes were correct. Whether Appellant had demonstrated a material flaw in the WPI assessment such that the assessment could not be relied upon. On available evidence, Corporation’s decisions were correct. Appellant had not demonstrated a material flaw in the WPI assessments. Outcome: appeal dismissed.
Impairment Assessment – Part 3 Schedule 1 Accident Compensation Act 2001. Whether the 20% whole person impairment (WPI) assessment was correct. Appellant failed to establish on a balance of probabilities, the assessment was incorrect. There was no clear, credible, cogent expert evidence to establish a flaw in the assessment or a failure to take relevant considerations into account. The 20% WPI assessment was correct. Appeal dismissed.
Claim for treatment injury - ss 32-33 Accident Compensation Act 2001. Whether the Corporation correctly declined the appellant’s claim for cover for a treatment injury arising out of a delay in treatment for sensorineural hearing loss. Appellant failed to establish, on the balance of probabilities, that an alternative treatment that would have prevented the injury she suffered could and should have been given, having regard to the clinical indications at the time of the alleged failure/delay in treatment. The Corporation correctly declined cover for the appellant’s sensorineural hearing loss as a treatment injury. Review decision upheld. Appeal dismissed.
Claims process; deemed cover – ss 48, 58, 145, 149 Accident Compensation Act 2001. Whether there was a Review Decision/right of appeal/whether claim for cover/whether deemed cover decision. Appeal against Review Decision determining that Corporation’s decision declining appellant’s claim was reviewable and substantive merits of review would be heard and determined on future date; and determining Appellant did not have deemed cover. No right of appeal from Reviewer’s decision. No error established in the Review Decision. Outcome: appeal dismissed.
Impairment assessment – Schedule 3(1); rehabilitation and treatment – Schedule 1(1), Accident Compensation Act 2001. Whether Corporation’s decision declining to proceed with assessing Appellant’s entitlement to permanent injury compensation was correct. Point at issue had been overtaken by a new decision, therefore no longer a live issue to be determined by Court. Whether Reviewer had jurisdiction to consider application for review against alleged unreasonable delay in finalisation of an individual rehabilitation plan (IRP). No jurisdiction to seek review of a draft IRP in terms of unreasonable delay. Whether Corporation’s decision declining to fund weight loss drug was correct. Corporation correctly declined funding on basis there were too many potential medical risks associated with the medication. Reviewer’s decision upheld. Outcome: appeal dismissed.
Claims process: applications for recall of judgment and reinstatement of appeal. Whether Court’s Minute dismissing the Appellant’s appeal due to Appellant’s failures to prosecute the appeal should be recalled and the appeal reinstated. Justice did not require recall of the Minute. Grounds provided by Appellant to support reinstatement of her appeal were far outweighed by the lost opportunities to hear the Appellant’s appeal, the overall procedural history of the appeal, the requirements of the ACC Practice Guidelines, the lack if any identified merits in the appeal, and the interests of the Corporation and the public. Outcome: applications for recall of the Minute and for reinstatement of the appeal dismissed.
Personal Injury - ss 25, 26 Accident Compensation Act 2001. Appeal against cover for injuries suffered giving birth. Found injury not caused by an accident but as a result of internal forces generated during birth process. Outcome: appeal dismissed.
Leave to appeal to the High Court – s 162 Accident Compensation Act 2001. Grounds for leave to appeal raised by Applicant did not raise questions of law capable of bona fide and serious argument which would justify a further appeal to the High Court. Outcome: application dismissed.
Appeal challenging the Corporation's decision to decline cover and suspend entitlements - ss 20, 26, and 117(1) of the Accident Compensation Act 2001. Whether the evidence supported that the appellant suffered a personal injury. Held: The appellant suffered a personal injury (lumbar disc injury with radiculopathy). Consequently, the Corporation's decision to decline cover was incorrect, and the suspension decision falls away. Outcome: The appeal is dismissed. The appellant is entitled to reasonable costs and disbursements.
Suspension of entitlements - s 117 of the Accident Compensation Act 2001. Wether the Corporation's decision to suspend appellant's entitlement was correct, based on the determination that his condition was no longer the result of his covered injuries. Held: Corporation had sufficient basis to suspend appellant's entitlements, as medical evidence supported that his incapacity was due to degenerative changes. Covered injuries from the 2021 accident had resolved and appellant's ongoing symptoms were not related to those injuries. Outcome: Appeal dismissed.
Preliminary Decision as to Jurisdiction - Accident Compensation Act 2001. Appellant had several discrete claims, past and current reviews, and appeals. Whether the Court has jurisdiction has jurisdiction to hear appeal. Found Court had jurisdiction to hear appeal. No reason for the Appellant to be limited in the appeal to arguments raised in the review or in her notice of appeal. Outcome: appeal allowed.
Interest - s 114 Accident Compensation Act 2001. Appellant appeals against decision regarding entitlement to interest on backdated weekly compensation payments. No live issue remained in respect of interest entitlement. No evidence provided to substantiate costs for phone, printing, internet, or travel costs. No basis on which they can be awarded. Outcome: appeal dismissed.
Personal injury/causation – s 26 Accident Compensation Act 2001. Whether Employer’s decisions revoking cover and suspending entitlements, and subsequent Review Decision declining Appellant’s application for review, were correct. Whether Appellant’s injury was caused by accident or by a pre-existing degenerative condition. On balance of probabilities Appellant’s accident caused the injury. Employer’s decisions revoking cover and declining entitlements for the injury and the subsequent Review Decision were incorrect. Outcome: appeal allowed. Orders made quashing Employer’s decisions and directing Employer to reinstate entitlements from date of suspension, including weekly compensation, the provision of aids and appliances and surgery.
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 his appeal out of time. Interests of justice established for appeal. Delay arose out of error or inadvertence rather than indecision. Outcome: appeal granted.
Claims for costs on appeal. Outcome: Respondent ordered to pay Appellant $5,513.35, $2,234.70 in costs and disbursements of $3,278.65.
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.