Ministry of Justice

Claim for cover for mental injury - s 21 Accident Compensation Act 2001. Whether the Corporation correctly declined Appellant's cover in relation to offending committed by her ex-partner on her daughter. Corporation correctly declined Appellant's cover as a secondary victim. Not appropriate to apply tikanga principles against express statutory words in the section of the Act. Outcome: appeal dismissed.

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.

Claim for cover for mental injury – s 26 Accident Compensation Act 2001. Whether Appellant suffered mental injury as result of a physical injury during treatment. Insufficient evidence of causal link between mental injury and a physical injury. Corporation applied correct approach to causation. Outcome: appeal dismissed.

Appeal from a review decision regarding the Corporation’s decision that the appellant was not entitled to a lump sum payment based on his whole person impairment rating of seven percent. Held: the Corporation correctly declined lump sum compensation for the appellant on the basis of expert medical assessment. Appellant has not established that the impairment assessment conducted on him was flawed or incorrect. Outcome: appeal dismissed.

Appeal from a review decision regarding the Corporation’s decision suspending appellant’s entitlements and determination of non-entitlement to deemed cover. Whether appellant was entitled to deemed cover for trochanteric bursitis/gluteal tendinopathy. Held: the Corporation lacked sufficient basis to suspend entitlements, as ongoing medical evidence supported continued incapacity linked to the original injury. Outcome: allowed in part.

Claim for independence allowance – Schedule 1, Accident Insurance Act 1998. Whether Corporation correctly declined Appellant’s application for permanent injury compensation. Corporation correctly declined application on basis that Appellant’s doctor stated his impairment had not changed since his last assessment. Decision of reviewer upheld. Outcome: appeal dismissed.

Appeal from a review decision regarding the Corporation’s decision declining appellant’s cover for somatic symptom disorder as a mental injury caused by physical injuries. Whether appellant’s somatic symptom disorder was caused by the physical injuries he sustained during an assault and thus qualifies for cover under the Act. Held: appellant did not legally establish mental injury was caused by physical injuries. The mental injury stemmed from pre-existing vulnerabilities. Outcome: appeal dismissed.

Appeal from a review decision regarding the Corporation’s revoking deemed cover for lateral epicondylitis, suspending entitlements and declining surgery funding for lateral epicondylitis. Whether Corporation’s decisions were correct. Court held the Corporation had sufficient medical evidence to revoke deemed cover, decline surgery, and suspend entitlements. Outcome: appeal dismissed.

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.

Appeal against decision of Corporation agreeing to pay increased rates for attendant care and home help to the appellants. Rates of social rehabilitation entitlements – s81 – 83 of the Accident Compensation Act 2001. Whether ACC’s decisions to increase exceptional circumstances rate were correct in denying backdated increases to 2017.  Held that the 2022 decisions were limited to periods explicitly stated and did not constitute decisions on backdating to 2017. Outcome: the Corporation’s appeal was granted.

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 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 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.