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Appeal against the decision of a reviewer declining cover for a work related injury. s 149 Accident Compensation Act 2001. Whether or not the reviewer’s decision should be upheld. Held: parties agree the first respondent’s claim does not meet the criteria for cover for a work related gradual process injury. Earlier review decision is set aside.
Suspension of weekly compensation - s 117 Accident Compensation Act 2001. Appeal against decision to suspend weekly compensation for lumbar injury. Whether causal link between injury by accident and ongoing pars defect condition. No evidence to support the view that the injury event caused a fracture or injury to a pre-existing pars defect. Outcome: appeal dismissed.
Leave to appeal to the High Court - s 162 Accident Compensation Act 2001. Appellant seeking leave to appeal decisions relating to backdated compensation and rate of weekly compensation for injuries from motor accident and injuries to his thumbs. Whether calculations were made correctly. Held: Appellant has not established that there was an error of law capable of bona fide and serious argument. Outcome: appeal dismissed.
Claim for interest on backdated weekly compensation - s 114(1) Accident Compensation Act 2001. Appellant challenges decisions relating to backdated weekly compensation. Court found that it does not have jurisdiction to reconsider the calculation. Previous incorrect calculation has been corrected. No provision in the Act for interest to be paid on backdated weekly compensation from the date of injury. No unreasonable delay by the Corporation. Outcome: appeal dismissed.
Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Appellant declined cover for supraspinatus tear. Late filing resulted from error or inadvertence by counsel. Interests of justice required exercise of Court’s discretion to sustain application for leave to file appeal out of time. Outcome: application granted.
Appeal against impairment assessment. s 149 of the Accident Compensation Act 2001. Whether appellant has established the Corporation’s earlier decision assessing his whole person impairment was incorrect? Whether the Corporation’s email relating to choice of whole person impairment assessor is a decision capable of review and appeal? Held: No evidence as to flaws or errors in the process or content of the whole person impairment assessment conducted on appellant. The email was in relation to an administrative question and does not constitute a decision under the Act. Decision of reviewer is upheld. Appeal is dismissed.
Impairment assessment - Part 3 Schedule 1 Accident Compensation Act 2001. Appeal against whole-person impairment assessment rating. Appellant did not provide any medical evidence from suitably qualified experts or otherwise to dispute the assessment. Outcome: appeal dismissed.
Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Appellant declined cover and weekly compensation. Late filing resulted from understandable error or inadvertence. Interests of justice required exercise of Court’s discretion to sustain application for leave to file appeal out of time. Outcome: application granted.
Transport for independence - s 79, 81-84, Clauses 21 and 22 First Schedule Accident Compensation Act 2001. Appeal against declined funding for 4-wheel drive vehicle to participate in certain recreational activities. Held: no evidence to show that a replacement vehicle is necessary to maintain independence. Existing 2WD vehicle allows him to undertake the essential injury-related transport needs. Outcome: appeal dismissed.
Impairment Assessment: independence allowance – Injury Prevention, Rehabilitation and Compensation (Lump Sum and Independence Allowance) Regulations 2002. Whether Corporation correctly assessed Appellant’s whole person impairment as 20%. Appellant failed to establish impairment assessment was flawed or incorrect. Corporation correctly assessed Appellant’s whole person impairment and resultant independence allowance. Outcome: appeal dismissed.
Claim for personal injury - s 20, 25, 26 Accident Compensation Act 2001. Appeal against decline of application for weekly compensation, treatment and rehabilitation for lumbar disc prolapse. Suffered accident at work when lifting heavy item and felt pain in back. Held: cover incorrectly declined on basis that it was likely a pre-existing degenerative condition. Found sufficient lay and medical evidence to draw inference that prolapse was caused by the accident. Outcome: appeal allowed.
Impairment Assessment – clauses 58-61, Schedule 1, Accident Compensation Act 2001. Whether Corporation correctly advised Appellant he was not eligible for a further lump sum payment because his assessed level of impairment had decreased since previous assessment. Appellant failed to establish impairment assessment was flawed or incorrect. Outcome: appeal dismissed.
Claim for mental injury by sexual abuse – s 21, Accident Compensation Act 2001. Whether Corporation correctly declined cover on basis Appellant did not suffer from any psychiatric disorder, and event described did not cause mental injury. Appellant failed to establish he suffered from a mental injury, or that his mental condition was caused by criminal act under Schedule 3 of the Act. Corporation correctly declined cover. Outcome: appeal dismissed.
Appeal against revocation of deemed cover - s 58, 62 Accident Compensation Act 2001. Spinal cord injury. Whether weight of medical evidence supports a personal injury by accident. Held: Court able to draw a reasonable robust inference of causation based on the weight of the evidence. No competing specialist evidence of an alternative underlying cause. Effects of the injury are clear and manifest. Outcome: appeal allowed.
Claim for personal injury – ss 20, 25, 26, Accident Compensation Act 2001. Whether Corporation correctly declined Appellant’s cover and surgery funding for left shoulder pathology on basis that need for surgery was not primarily due to covered injury. Corporation’s decision was correct. Outcome: appeal dismissed.
Claim for additional cover/entitlements - s 48, 52, 134 Accident Compensation Act 2001. Ankle injury. Whether the Review Decision was correct in determining there was no claim for or decision relating to cover or entitlements by the Corporation, or no deemed decision under section 58 of the Act. Did not make a claim for further cover or a specific entitlement as required. Outcome: appeal dismissed.
Appeal from the decision of a Reviewer. S 25(1)(ba) Accident Compensation Act 2001. Whether Ms Gilbert’s hepatitis A was the result of a criminal act which is required under the relevant section. Held: s 25(1)(ba) of the Accident Compensation Act 2001 requires the ingestion to be the result of an act which is criminal, as shown by way of a charge, conviction or clear evidence of the commission of tan offence. s 223(1)(b)(ii) of the Food Act 2014 does not create a strict or absolute liability offence. No evidence of any regulatory or criminal investigation, charges, conviction or enforcement action. Decision of reviewer is upheld. Appeal is dismissed.
Leave to Appeal to the High Court – s 162 Accident Compensation Act 2001. Whether appeal grounds raised bona fide question of law. Applicant failed to establish sufficient grounds as matter of law to sustain application for leave to appeal. Outcome: application dismissed.
Claims process – s 149(3), Accident Compensation Act 2001. Whether Court had jurisdiction to hear appeal. No jurisdiction to hear appeal relating to a Code complaint. Outcome: appeal dismissed.
Claims process and costs on appeal. Whether Corporation correctly suspended Appellant’s weekly compensation entitlement and correctly declined cover. Whether costs should be awarded. Corporation’s decisions under appeal had been overtaken by subsequent decisions granting cover and weekly compensation. Issues no longer live, therefore no jurisdiction for appeal. Appellant not successful, therefore no costs or disbursements should be awarded. Outcome: appeal dismissed.
Suspension of entitlements – s 117, weekly compensation – s 103, Accident Compensation Act 2001. Whether decision declining cover for back contusion injury was correct. Whether decision suspending entitlements for treatment and declining weekly compensation for knee injury were correct. Cover for back contusion injury subsequently found, resulting entitlements subject to review proceedings not yet concluded, therefore no jurisdiction for Court to hear and decide on Appellant’s entitlements relating to back contusion injury. Decision suspending entitlements for treatment and weekly compensation for knee injury correct. Outcome: appeal dismissed.
Claim for personal injury – ss 20, 25, 26, Accident Compensation Act 2001. Whether Corporation correctly declined cover and funding for surgery, on basis Appellant’s condition was not caused by accident but instead was related to an unrelated health condition. Appellant’s condition caused by degenerative back condition rather than his accident/s or surgery. Outcome: appeal dismissed.
Appeal - claim for personal injury s 20, 25, 26 Accident Compensation Act 2001. Declined cover for a lumbar disc prolapse. Held: correctly declined cover on the basis that there was not sufficient evidence to show that injury was caused by accident. Accident caused the effects of degenerative changes to become apparent. Outcome: appeal dismissed.
Appeal - vocational independence s 107-112 Accident Compensation Act 2001. Whether Appellant had achieved vocational independence in nine work types, resulting in an end to his entitlement to weekly compensation. Held: evidence for vocational independence is not supported by sufficiently strong evidence. Outcome: appeal allowed and review decision quashed. Weekly compensation reinstated.
Suspension of entitlements – s 117, Accident Compensation Act 2001. Whether Corporation correctly suspended Appellant’s entitlements on basis his current condition was no longer result of personal injury. Corporation had sufficient basis to suspend Appellant’s entitlements. Outcome: appeal dismissed.