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Appeal from the Reviewer’s decision. Claim for treatment injury – s32 Accident Compensation act 2001. Whether appellant suffered a personal injury caused by treatment. Held: No evidence of a physical injury caused by the surgery beyond what was necessary or an ordinary consequence of the procedure. Symptoms more likely attributable to appellant’s underlying health condition. Requirements for section 32 not met. Outcome: appeal dismissed.
Reinstatement of appeal - claims for cover and entitlements - Accident Compensation Act 2001. Appellant sought to reinstate an appeal declining cover. Appellant was not an earner at the relevant date. Decision declining cover was correct. Outcome: appeal dismissed.
Recoverability of costs and expenses - s148(2) of the Accident Compensation Corporation Act 2001. Whether the Digital System fee, Technical Specialist fee, and KonnectNet fee are recoverable as expenses. Digital System fee not recoverable as it is a business overhead. Technical Specialist fee not recoverable as they are representation costs. KonnectNet fee may be recoverable, depending on the circumstances. If the fee has been reasonably or necessarily incurred it can be claimed as an expense. Outcome: appeal dismissed, leave to appeal granted.
Definition of decision – s 6 Accident Compensation Act 2001. Whether Reviewer correctly dismissed Appellant's application for review of the Corporation's notification letter on the basis that it was not a reviewable decision. Corporation's notification letter does not constitute a decision. Administrative actions are not subject to review. Outcome: appeal dismissed and no issue as to costs.
Issue estoppel, reviewable decision - s 6 Accident Compensation Act 2001. Appeal regarding whether emails were reviewable decision. Another appeal regarding whether issue estoppel applied for cover or entitlements for osteoarthritis. Emails not reviewable decisions. Decision to decline weekly compensation was reviewable but was not. Osteoarthritis had already been determined so issue estoppel applied. Outcome: appeals dismissed.
Suspension of entitlements – s 117, Accident Compensation Act 2001. Whether Corporation was correct to suspend weekly compensation payments. Medical evidence provided sufficient basis for Corporation's decision. Sufficient basis for Corporation to be not satisfied having regard to all the evidence before the Court. Outcome: appeal dismissed.
Cover – ss 20, 25, 26 Accident Compensation Act 2001. Appeal against decision to decline cover for spinal injury. Corporation’s decision was correct. Weight of medical evidence did not support that annular tear injury was caused by car accident. Outcome: appeal dismissed.
Leave to Appeal to the High Court – s 162 Accident Compensation Act 2001. Leave granted: whether claimant who was deemed to have cover under s 58 entitled to entitlements after cover has been revoked and declined under s 65. Outcome: application allowed.
Treatment Injury - s 32 Accident Compensation Act 2001. Appeal against decision to decline cover for treatment injury. Appellant did not establish failure to treat or to treat in timely manner on medical evidence. Outcome: appeal dismissed.
Entitlements - Backdated attendant care compensation - s 80 Accident Compensation Act 1982. Appeal regarding entitlement to backdated attendant care for injury suffered at birth. Grounds not established. Corporation did not make an error or law declining to backdate attendant care compensation. Outcome: appeal dismissed.
Interpretation of decision – ss 6 and 134 Accident Compensation Act 2001. Whether either or both letters constitute reviewable decisions. Information request letter does not constitute a decision because it does not satisfy ss 6 and 134. Administrative actions are not subject to review. Outcome: appeal dismissed and no issue as to costs.
Disposal of appeal – s 149 Accident Compensation Act 2001. Whether Reviewer's decision on unreasonable delay is correct. Corporation complied with review direction and no substance left in review decision to be appealed from or considered by Court. Outcome: appeal dismissed and no issue as to costs.
Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Whether interests of justice required exercise of Court’s discretion to sustain application for leave to file appeal out of time. Delay of nearly six months. Delay arose out of error. No history of non-cooperation or delay. No real prejudice to Corporation and Corporation did not oppose leave being granted. Outcome: application granted.
Leave to appeal to the High Court - s 162 Accident Compensation Act 2001. Application for leave to appeal against decision dismissing the Applicant's claim that they qualified for cover. Whether Applicant qualified for mental injury cover for offending committed by her ex-partner on her daughter. No error of law capable of bona fide and serious argument. Outcome: application dismissed.
Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Whether interests of justice required exercise of Court’s discretion to sustain application for leave to file appeal out of time. Delay of over two months. Delay arose out of error or inadvertence. No history of non-cooperation or delay. No real prejudice to Corporation and Corporation did not oppose leave being granted. Outcome: application granted.
Late filing of an appeal to the District Court – s 151, Accident Compensation Act 2001. Whether interests of justice required exercise of Court’s discretion to sustain application for leave to file appeal out of time. Delay of one month. Delay arose out of error or inadvertence. No history of non-cooperation or delay. No real prejudice to Corporation and Corporation did not oppose leave being granted. Outcome: application granted.
Treatment injury - s 32 Accident Compensation Act 2001. Appeal against decision to decline cover for treatment injury. Appellant did not establish that his personal injury was a consequence of his treatment. Appellant had underlying health conditions. Outcome: appeal dismissed.
Claim process; deemed cover - ss 48, 58 Accident Compensation Act 2001. Whether claims made in medical certificates for two further injuries are covered as the Corporation failed to make any decisions on cover within the statutory time frame. Court found no valid claim was made for the two additional injuries. The statements were interpreted as reasons for incapacity, not as claims for cover. No deemed cover could arise under section 58. Outcome: appeal dismissed.
Impairment assessment - Sch 1, cls 54 and 59 Accident Compensation Act 2001. Appeal against decision dismissing review of decision to decline entitlement to permanent injury compensation. Corporation not empowered to pay any lump sum compensation to claimant outside New Zealand unless her condition has been assessed by a person approved for the purpose by the Corporation. No longer a live issue in relation to the Corporation's decision. Outcome: appeal dismissed.
Treatment injury - s 32 Accident Compensation Act 2001. Appeal against decision to decline cover for a treatment injury. Claim did not meet required criteria. Evidence indicated medical conditions were underlying and not caused by treatment. Outcome: appeal dismissed.
Impairment assessment – sch 1(3), Accident Compensation Act 2001. Whether Corporation correctly decided hearing loss was attributable to covered causes and whether WPI was 22 per cent. No medical assessment disputing assessment of hearing loss. No expert compelling evidence WPI assessment was flawed or incorrect. Corporation correctly decided that hearing loss was attributable to covered causes and WPI assessment was 22 per cent. Outcome: appeal dismissed.
Claim for weekly compensation - s 15, Sch 1 cls 30-32 Accident Compensation Act 2001. Appeal against decision declining weekly compensation. Corporation correctly declined Appellant's application for weekly compensation. Appellant was not in receipt of any shareholder employee earnings on the date of his accident. Outcome: appeal dismissed.
Review of decision made in error – s 65 Accident Compensation Act 2001. Code of ACC Claimants' Rights jurisdiction – s 149(3) Accident Compensation Act 2001. Whether Court has jurisdiction to determine appeals from a complaint under the Code. Whether Corporation allowed to revise decision. No jurisdiction to hear appeal. Error not established where there is simply credible difference of expert opinion. Outcome: appeal dismissed and no issue as to costs.
Personal injury - s 26(1)(c) Accident Compensation Act 2001. Appeal against decision declining cover for mental injury. Whether mental health issue was caused by physical injury. Physical injury provided circumstances for mental health issue but was not a material cause of it. Outcome: appeal dismissed.
Cover - ss 20, 25, 26, 67, 100-103 Accident Compensation Act 2001. Whether lumbar disc prolapse caused by a fall Appellant experienced. Weight of medical evidence supports disc injury caused by the accident Appellant experienced so Appellant entitled to cover. Appeal allowed.