Ministry of Justice

Appeal against decision of Corporation agreeing to pay increased rates for attendant care and home help to the appellants. Rates of social rehabilitation entitlements – s81 – 83 of the Accident Compensation Act 2001. Whether ACC’s decisions to increase exceptional circumstances rate were correct in denying backdated increases to 2017.  Held that the 2022 decisions were limited to periods explicitly stated and did not constitute decisions on backdating to 2017. Outcome: the Corporation’s appeal was granted.

Appeal under s 149 regarding the decision of a reviewer to refuse cover for a mental injury as a treatment injury as a result of repeated injections Appellant received to treat hypopituitarism. Whether appellant’s mental injury was caused by a physical injury resulting from treatment and whether that physical injury was not an ordinary consequence of the treatment. No causal link between the physical injury and the mental injury as required under the Act. Appeal dismissed.

Appeal from the decision of a reviewer regarding the refusal to approve cover for a treatment injury. s 32 Accident Compensation Act 2001. Whether the cataract surgeries performed on Appellant caused a treatment injury which resulted in worse vision for driving and loss of reading vision. Held: Corporation correctly declined appellant’s claim for cover for a treatment injury. Medical evidence indicated surgeries performed appropriately and the issues appellant experienced were due to pre-existing conditions and not a result of the surgeries. No departure from standard of care in the treatment provided to appellant.

Appeal from the decision of a Reviewer. Ss 20, 25, 26 Accident Compensation Act 2001. Whether the Corporation correctly declined cover for the injuries and entitlements claimed by appellant, including weekly compensation and treatment costs. Held: Corporation correctly declined cover for lumbago with sciatica, right rupture of tendon, and L5/S1 facet joint osteoarthritis- medical evidence did not establish a causal link to the accident. Reversed Corporation’s decision to decline weekly compensation for right gluteal strain. Granted appeal in relation to Corporation’s decline of cover for sprain injury of the facet joint and directed further funding for treatment costs. Appeal partly granted.

Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Delay in filing Notice of Appeal in complete form was nearly six months, which was not insignificant. However, responsibility for delay lay not with appellant but with his counsel. No history of non-cooperation or delay be Appellant himself. Corporation did not oppose leave being granted. Interests of justice required exercise of Court’s discretion to sustain application for leave to file appeal out of time. Outcome: application granted.

Appeal of the decision of a reviewer declining Appellant’s claim for cover for treatment injury. s 32 Accident Compensation Act 2001. Whether the delay in treating Appellant’s ulcer and circulatory problems led to the above-knee amputation. Held: Corporation correctly declined Appellant's claim for cover for treatment injury. medical evidence indicated appellant’s health issues were the primary causes of his condition and earlier intervention would not have prevented the need for amputation. No departure from the standard of care in treatment provided to appellant. 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 his appeal out of time. Interests of justice established for appeal. Delay arose out of circumstances partly out of the Appellant's control. Outcome: appeal granted.

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 not established for appeal. Length of delay was significant. Adequate reasons not provided for delay. Grounds of appeal not strongly arguable. Outcome: appeal dismissed.  

Personal Injury, s 26; Work Related Gradual Process Injury, s 30; Suspension of Entitlements, s 117 – Accident Compensation Act 2001. Whether Appellant’s back pathology was coverable either as a personal injury by accident or a work-related gradual process injury (WRGPI). Weight of medical opinion supported Appellant’s symptoms being caused by multi-level degenerative disc disease, not the accident. Section 30 criteria for WRGPI not fulfilled. Corporation’s decisions declining cover and suspending entitlements correct. Outcome: appeal dismissed.

Cover and Suspension - ss 20, 25, 26, 27 and 11(7)(1) Accident Compensation Act 2001. Appeal against decision declining cover for SSD and PCS. Appeal against decision suspending entitlements for head injury. Evidence did not support claim for cover for SSD and PCS. Decision to suspend entitlements arising from head injury was incorrect. Evidence to support ongoing symptoms causally related to head injury. Entitlements reinstated. Outcome: appeal allowed in substantial part.

Claims process – s 135 Accident Compensation Act 2001. Whether Reviewer correctly dismissed Appellant’s review, on the basis of a lack of jurisdiction in view of the defective nature of the review application. Appellant did not identify decision or decisions in respect of which her purported application for review was made. Reviewer correctly dismissed review. Outcome: appeal dismissed.

Claim for mental injury as a treatment injury – ss 26 and 32 Accident Compensation Act 2001. Whether Corporation correctly declined Appellant’s claim on basis that it did not meet the criteria for a treatment injury. Available factual and medical evidence did not establish Appellant suffered a mental injury because of a physical injury causally linked to treatment by a registered health professional. Corporation correctly declined Appellant’s claim. Outcome: appeal dismissed.

Claims process - s 146 Accident Compensation Act 2001. Appeal against decision to decline funding for 26 items requested by the Appellant.  Reviewer correctly declined jurisdiction to determine application for review, in light of later deemed review decision. Outcome: appeal dismissed.