Ministry of Justice

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.

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. 

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.

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.

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.

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 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. 

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. 

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.

Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Whether appellant's late filing of appeal against Corporation’s decision to decline cover for PTSD should be accepted. Appellant's delay arose out of error due to significant mental and physical injuries. Corporation did not oppose application and no significant prejudice or hardship to others. Interests of justice required exercise of discretion to sustain Appellant's application for leave to file appeal out of time. Outcome: application granted.