Ministry of Justice

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.

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 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 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. 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.

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 understandable circumstances. 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.  

Leave to appeal to High Court – s 162(1) of the Accident Compensation Act 2001. Whether the decision to revoke deemed cover and decline cover for a treatment injury related to an untreated sacral pressure wound was correct. No question of law was raised; the appeal was based on disagreement with factual findings which is not a valid ground for appeal under section 162. Leave to appeal to High Court was 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.

Claim for personal injury – ss 20, 25, 26 Accident Compensation Act 2001. Whether Corporation correctly declined cover and surgery and suspended existing entitlements on basis Appellant’s covered right shoulder sprain had resolved. Whether Appellant’s accident caused a physical injury that caused or contributed to his post-accident incapacity. Held: Corporation’s decision was incorrect. Sufficient factual and medical evidence to draw robust inference that Appellant’s injury was causally linked to his accident rather than wholly or substantially caused by a degenerative condition. Appellant entitled to cover and entitlements including surgery funding. Outcome: appeal allowed, review decision set aside.