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Personal injury/Deemed cover decision – ss 26 and 58 Accident Compensation Act 2001. Whether Corporation’s decision declining cover and funding for surgery was correct. Whether Corporation’s determination that Appellant did not have deemed cover was correct. No error established in Corporation’s decisions or review decision. Outcome: appeal dismissed.
Personal injury - s 26 Accident Compensation Act 2001. Appeal against decision to decline cover for acute meniscal tear and declined funding for knee surgery. The evidence establishes on the balance of probabilities that condition is degenerative in nature and that the mechanism of injury is not consistent with the injury to the left knee said to have occurred as a result of the accident. Outcome: appeal dismissed.
Late filing of an appeal to the District Court - s 151 Accident Compensation Act 2001. Issu deals with the determination of whole person impairment and subsequently whether entitled to a lump sum payment. Proposed appeal is significant to the estate of the Appellant and delay was three months. Interests of justice require the exercise of the Court’s discretion to allow the application for leave to file the appeal out of time. Outcome: appeal allowed.
Appeal challenging the review decision. Sections 75-78, Accident Compensation Act 2011. Whether the Individual Rehabilitation Plan (IRP) finalised by ACC was reasonable and appropriately addressed the appellant’s rehabilitation needs. Held: The IRP was finalised prematurely and did not include all necessary and agreed upon actions for Appellant’s rehabilitation. IRP failed to include referral to pain specialist, general surgeon review, and neuropsychological assessment for cognitive decline. The review decision dated 28 June 2023 is quashed. The appeal is allowed, appellant is entitled to costs.
Appeal challenging the corporations’ decision to decline paying weekly compensation. section 117(3B) of Accident Compensation Act 2001. Whether the appellant can satisfy the test under s117(3B) and is therefore entitled to weekly compensation. Held: appellant does not establish exceptional circumstances nor that it would be inequitable for the Corporation to refuse to make any payment for the period. Appeal is dismissed.
Appeal challenging the correctness of the corporation’s decision. Part 3 of Schedule 1 to the Accident Compensation Act 2001. Whether the Corporation was correct to decline an independence allowance for the appellant because his WPI assessment was below the 10% minimum threshold. Held: No error was established in the Corporation’s decision. Outcome: Appeal is dismissed.
Appeal against a reviewer’s decision. s 58 and 67 of the Accident Compensation Act. Whether the Corporation correctly determined the appellant’s weekly compensation for a kidney stone injury should be paid from the date from when cover was deemed rather than the date of his incapacity. Held: appellant not entitled to backdated weekly compensation prior to the period of deemed cover because he did not hold cover for the kidney stone that incapacitated him for work. Reviewer’s decision upheld. Appeal is dismissed.
Appeal against a reviewer’s decision. s 114 of the Accident Compensation Act. Whether the earlier decision declining the appellant from receiving interest on weekly compensation arrears payment was correct. Held: reviewer correctly declined jurisdiction over appellant’s application for review, because issue estoppel applied in regard to the interest payments claimed. Decision of reviewer is upheld. Appeal is dismissed.
Appeal against a reviewer’s decision. ss 107-112 of Accident Compensation Act 2001. Whether the appellant had achieved vocational independence and was therefore not entitled to further weekly compensation. Held: the Corporation’s decision that the appellant had achieved vocational independence was not supported by sufficiently strong evidence. Appeal is allowed.
Claim for treatment injury – ss 32-33 Accident Compensation Act 2001. Acute injury to right wrist while working as a caregiver. Persistent lump later found on hand. Initially diagnosed as a cyst but later discovered to be an atypical fibro histiocytoma. Applicant underwent surgery. Applicant argued that series of events comprises a treatment injury. Held: initial cyst diagnosis reasonable. Standard medical practice was followed. Outcome: appeal dismissed.
Claim for work-related gradual-process injury – s 30, Accident Compensation Act 2001. Whether Corporation correctly declined Appellant’s cover for accidental poisoning as a work-related gradual process injury. Appellant did not qualify for cover for neurotoxic injury in terms of ss 30(3) and 60 of the Act. Corporation correctly declined cover. Outcome: appeal dismissed.
Interpretation of decision – s 6, Accident Compensation Act 2001. Whether Corporation’s letter confirming earlier cover decision and clarifying condition was covered as a physical injury and not a mental injury constituted a reviewable decision. Letter was not a reviewable decision. Outcome: appeal dismissed.
Appeal of an earlier decision by Accident Compensation Corporation. Appeal under s 149 of the Accident Compensation Act 2001. ss 26, 32, and 33 of the Accident Compensation Act 2001. Whether the appellant is entitled to cover for a treatment injury for leg length discrepancy? Held: the leg length discrepancy was not an ordinary consequences of the right hip joint replacement injury, therefore the appellant is entitled to cover for treatment injury under the Act. Appeal is allowed.
Claim for cover for occupational noise-induced hearing loss (ONIHL) - ss 26, 20(2)(e) Accident Compensation Act 2001. Appellant's ONIHL was assessed at 4-5%, below the 6% threshold required for cover to be accepted. Appellant challenged this calculation. Held: material flaws in the assessments of both assessors. Did not undertake a clinical examination and take a careful history to underly the analysis. Outcome: appeal allowed.
Claim for cover. ss 20,25,26 Accident Compensation act 2001. Whether the appellant’s left inguinal hernia is an injury caused by an accident. Held: appellant will have cover for his left inguinal hernia as an injury caused by the accident. Appeal is allowed.
Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Appellant's application to review weekly compensation entitlement was dismissed. 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.
Impaired assessment, lump sum compensation - Schedule 1, Part 3, Clause 57 Accident Compensation Act 2001. Appellant declined lump sum compensation for coccyx sprain. Subsequent application for review of this decision declined. Held: Appellant now undergoing desired impairment assessment so there is no live issue before the Court. Corporation acted entirely properly and lawfully. Outcome: appeal dismissed.
Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Appellant declined cover for lumbar disc prolapse. Late filing resulted from error or inadvertence of Appellant’s 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 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.