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Appeal of Reviewable decision – ss 134, 145 Accident Compensation Act 2001. Whether reviewer correctly dismissed five applications for review for lack of jurisdiction. Review applications were invalid as they were not filed against reviewable decisions. No live issues to be determined. Applications dismissed for want of jurisdiction. Outcome: appeal dismissed.
Late filing of an appeal to the District Court - s 151 Accident Compensation Act 2001. Delay due to illness. Whether interests of justice required the exercise of discretion to sustain his application for leave to file his appeal out of time. Delay arose out of an understandable error or inadvertence. Interests of justice established for appeal. Outcome: appeal granted.
Claim for cover for mental injury – s 26 Accident Compensation Act 2001. Whether Appellant suffered mental injury as result of a physical injury during treatment. Insufficient evidence of causal link between mental injury and a physical injury. Corporation applied correct approach to causation. Outcome: appeal dismissed.
Claims for costs on appeal. Outcome: Respondent ordered to pay Appellant $2,064.00, being costs of $1,550.00 and disbursements of $514.00. Appeal allowed.
Appeal from a review decision regarding the Corporation’s decision that the appellant was not entitled to a lump sum payment based on his whole person impairment rating of seven percent. Held: the Corporation correctly declined lump sum compensation for the appellant on the basis of expert medical assessment. Appellant has not established that the impairment assessment conducted on him was flawed or incorrect. Outcome: appeal dismissed.
Appeal from a review decision regarding declined jurisdiction to consider a review for deemed cover. Whether a reviewer or the District Court has jurisdiction to recognise deemed cover that has arisen by operation of law without a formal decision by the Corporation. Held: reviewers and the District Court have jurisdiction to recognise deemed cover even without a formal Corporation decision. Outcome: appeal allowed.
Appeal from a review decision regarding the Corporation’s decision suspending appellant’s entitlements and determination of non-entitlement to deemed cover. Whether appellant was entitled to deemed cover for trochanteric bursitis/gluteal tendinopathy. Held: the Corporation lacked sufficient basis to suspend entitlements, as ongoing medical evidence supported continued incapacity linked to the original injury. Outcome: allowed in part.
Appeal from a review decision regarding the Corporation’s decision declining appellant cover and surgery funding for a rotator cuff tear. Whether appellant’s shoulder injury and need for surgery were caused by the accident or were the result of a pre-existing degenerative condition. Held: appellant’s fall in 2023 significantly contributed to his shoulder condition. Injury was not wholly or substantially caused by degeneration. Outcome: appeal allowed.
Claim for independence allowance – Schedule 1, Accident Insurance Act 1998. Whether Corporation correctly declined Appellant’s application for permanent injury compensation. Corporation correctly declined application on basis that Appellant’s doctor stated his impairment had not changed since his last assessment. Decision of reviewer upheld. Outcome: appeal dismissed.
Appeal from a review decision regarding the Corporation’s decision revoking deemed cover to the appellant. Whether the meniscus tear and MCL partial tear suffered by Appellant were caused by an accident and therefore qualifies for cover under the Act. Held: Medical evidence did not support a causal link between the accident and the meniscal tear. Injury was not caused by the accident on the balance of probabilities. Outcome: appeal dismissed.
Appeal from a review decision regarding the Corporation’s decision declining appellant’s cover for somatic symptom disorder as a mental injury caused by physical injuries. Whether appellant’s somatic symptom disorder was caused by the physical injuries he sustained during an assault and thus qualifies for cover under the Act. Held: appellant did not legally establish mental injury was caused by physical injuries. The mental injury stemmed from pre-existing vulnerabilities. Outcome: appeal dismissed.
Appeal from a review decision regarding the Corporation’s decision to decline weekly compensation. Whether the Corporation’s decision was correct. Held: Corporation was correct in requiring new vocational independence assessment. Outcome: appeal dismissed.
Appeal from a review decision regarding the Corporation’s revoking deemed cover for lateral epicondylitis, suspending entitlements and declining surgery funding for lateral epicondylitis. Whether Corporation’s decisions were correct. Court held the Corporation had sufficient medical evidence to revoke deemed cover, decline surgery, and suspend entitlements. Outcome: appeal dismissed.
Appeal against decision of Corporation declining cover to appellant and to suspend appellant’s entitlements. Cover for personal injury- s20 of the Accident Compensation Act 2001. Whether Appellant’s cervical spine injury was caused by her accident and whether the Corporation correctly suspended her entitlements. Held: injury was caused by accident rather than age-related degeneration. Outcome: Appellant’s appeal allowed.
Late filing of an appeal to the District Court - s 151 Accident Compensation Act 2001. Delay due to illness. Whether interests of justice required the exercise of discretion to sustain his application for leave to file his appeal out of time. Delay arose out of an understandable error or inadvertence. Interests of justice established for appeal. Outcome: appeal granted.
Leave to appeal to the High Court - s 162 Accident Compensation Act 2001. No point of law capable of bona fide serious argument in the High Court. Court not satisfied as to the wider importance of any contended point of law. Outcome: application declined.
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.
Revocation of cover - s 65(2) Accident Compensation Act 2001. Appeal against decision revoking cover for rotator cuff tear. Not established that injury was caused by the accident. Outcome: appeal dismissed.
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.
Cost of Treatment; Schedule Clause 1 – Accident Compensation Act 2001 and Regulation 13 Accident Compensation (Liability to pay or contribute to cost of Treatment) Regulations 2003. Whether Corporation required to fully fund cost of GP appointments for purposes of providing a medical certificate to determine incapacity as required by the Corporation and/or the purpose of providing treatment. Corporation correctly applied Clause 1 of Schedule 1 and Regulation 13 in declining Appellant’s claim for full GP cost payment. Outcome: 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.
Late filing of an appeal to the District Court – s 151 Accident Compensation Act 2001. Delay due to deteriorating health and caregiving responsibilities for her disabled son. Whether interests of justice required the exercise of discretion to sustain her application for leave to file her appeal out of time. Delay arose out of error or inadvertence. Interests of justice established for appeal. Outcome: appeal granted.
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.
Appeal of the Corporation’s decision to decline cover for a treatment injury. s 32 Accident Compensation Act 2001. Whether the surgery performed on Appellant’s left hand constituted a treatment injury. Held: Corporation’s decision to decline appellant’s claim was correct. Surgery performed was appropriate for the underlying condition and did not deviate from an acceptable standard of care. Appeal dismissed.
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.