Ministry of Justice

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 circumstances partly out of the Appellant's control. 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.  

Personal Injury, s 26; Work Related Gradual Process Injury, s 30; Suspension of Entitlements, s 117 – Accident Compensation Act 2001. Whether Appellant’s back pathology was coverable either as a personal injury by accident or a work-related gradual process injury (WRGPI). Weight of medical opinion supported Appellant’s symptoms being caused by multi-level degenerative disc disease, not the accident. Section 30 criteria for WRGPI not fulfilled. Corporation’s decisions declining cover and suspending entitlements correct. Outcome: appeal 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.

Claims process – s 135 Accident Compensation Act 2001. Whether Reviewer correctly dismissed Appellant’s review, on the basis of a lack of jurisdiction in view of the defective nature of the review application. Appellant did not identify decision or decisions in respect of which her purported application for review was made. Reviewer correctly dismissed review. Outcome: appeal dismissed.

Claim for mental injury as a treatment injury – ss 26 and 32 Accident Compensation Act 2001. Whether Corporation correctly declined Appellant’s claim on basis that it did not meet the criteria for a treatment injury. Available factual and medical evidence did not establish Appellant suffered a mental injury because of a physical injury causally linked to treatment by a registered health professional. Corporation correctly declined Appellant’s claim. Outcome: appeal dismissed.

Claims process - s 146 Accident Compensation Act 2001. Appeal against decision to decline funding for 26 items requested by the Appellant.  Reviewer correctly declined jurisdiction to determine application for review, in light of later deemed review decision. Outcome: appeal dismissed.

Impairment assessment – Schedule 1(4) of Accident Insurance Act 1998, and Schedule 1(3) of Accident Compensation Act 2001. Whether Corporation’s decisions regarding Appellant’s whole person impairment (WPI) for independence allowance and lump sum purposes were correct. Whether Appellant had demonstrated a material flaw in the WPI assessment such that the assessment could not be relied upon. On available evidence, Corporation’s decisions were correct. Appellant had not demonstrated a material flaw in the WPI assessments. Outcome: appeal dismissed.

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: 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.