Ministry of Justice

Whole person impairment - Accident Compensation Act 2001. Appeal against Corporation's decision declining entitlement to an independent allowance assessment. Corporation had sufficient evidence to be satisfied of likely payment. Corporation's decision was correct. Outcome: appeal dismissed.

Claim for Personal Injury, Suspension of entitlements - ss 20, 25, 26, 117(1). Appeal of Review decisions dismissing applications to review Corporation's decision to revoke deemed cover and decline cover for rotator cuff tear, and suspend weekly compensation and entitlements. Medical evidence supports rotator cuff tear injury pre-existed date of accident. Sufficient evidence for Corporation to be sure Appellant no longer has right to receive entitlements as current condition no longer caused by personal injury. Review decisions upheld. Outcome: Appeal dismissed.

Incapacity - s 100-103 Accident Compensation Corporation 2001. Appeal against review decision directing Corporation to decide on Appellant's incapacity. Whether correct approach to entitlement when deemed cover arises followed, for what period are entitlements payable, and what jurisdiction is available for Court. Reviewer's decision was reasonable given lack of circumstances before them about incapacity from covered injuries. New evidence available to confirm incapacity allowing Court to modify review decision to direct Corporation to pay weekly compensation from date personal injury causing incapacity first occurred. Outcome: Appeal accepted in part. 

Work-related gradual process injury - s 30 Accident Compensation Corporation Act 2001. Appeal against Corporation's decision declining cover for a work-related gradual process injury. Medical evidence did not establish that the Appellant's lung condition was an occupation disease. Corporation correctly declined cover. Outcome: appeal dismissed.

Personal injury - ss 20, 25, 26 Accident Compensation Corporation Act 2001. Appeal against Corporation's decision declining cover for the Appellant's traumatic arthropathy joint injury. Weight of medical evidence did not establish that the Appellant's accident caused the traumatic arthropathy injury. Outcome: appeal dismissed.

Claims Process, Jurisdiction - s 149 Accident Compensation Act 2001. Appeals against 5 review decisions. Whether the Corporation correctly declined then approved funding.  Whether the Court has jurisdiction to deal with Code complaints. The Court has no authority to deal with Code complaints. Appeal regarding funding is moot as funding has been approved. Outcome: appeals dismissed.

Mental Injury, Suspension of entitlements - ss 26 and 117 Accident Compensation Act 2001. Whether Reviewer correctly dismissed review of declined cover for anxiety states on basis that injuries resolved and ongoing symptoms developed subsequent to injury. Substantial evidence that Appellant's current condition was no longer result of injury so Corporation had sufficient basis to decide to suspend entitlements. Reviewer correctly dismissed applications for review. Outcome: Claim dismissed.

Personal injury - ss 20, 25, 26 Accident Compensation Act 2001. Appeal against a decision of a Reviewer. Medical evidence suggested knee injury was likely due to underlying condition not accident. Decision of the Reviewer correct. Outcome: appeal dismissed.

Claim for entitlements – ss 68, 67 Accident Compensation Corporation. Whether Corporation correctly declined to pay reimbursement of surcharges, travel costs to the Appellant, and whether Reviewer was entitled to quash Corporation’s decision to decline cover for treatment injury and order further investigation of injury. Legislation did not provide for the Corporation to refund surcharges. Appellant could not establish she was entitled to travel costs claimed. Reviewer entitled to quash Corporation’s treatment injury decision after finding injury not sufficiently investigated. Outcome: appeals dismissed.

Claim for Treatment Injury - s 32 Accident Compensation Act 2001. Whether Corporation correctly declined Appellant's claim for treatment injury on basis that claim did not meet legislative criteria because absence of identified physical injury. No medical evidence to establish delirium and other symptoms were a physical injury caused by treatment for prostate concerns. Corporation correctly declined cover. Outcome: appeal dismissed.

Rehabilitation - Sch 1 21 Accident Compensation Act 2001. Appeal against decision declining funding for an adjustable bed. Appellant claimed she had an injury related need for an adjustable bed. Objective needs assessment did not recommend an adjustable bed. Appellant did not establish a need for the bed given the safety and comfort issues were addressed in other ways. Corporation's decision was correct. Outcome: appeal dismissed.

Claim for costs on appeal - s 149 Accident Compensation Act 2001. Whether costs should be awarded against the appellant, and if so, in what amount, given his circumstances and the nature of the appeal. Full claimed amount would be disproportionate and unrealistic. Costs awarded $600 against appellant (significantly reduced from $4,127.50) to reflect fairness and discretion.