20 May 2022
Special leave to appeal was refused because ACC was statutorily empowered to review and suspend or revoke entitlement when subsequent evidence undermined the factual basis for earlier payments; ACC was not estopped by earlier payments and the applicant had no reasonable prospect of success or issue of principle warranting leave.
16 May 2019
On the balance of probabilities the evidence established chronic rotator cuff pathology predating the 13 September 2016 quad bike accident; imaging and intraoperative signs of chronicity (tendon retraction, muscle atrophy, ACJ arthropathy, high riding humeral head) indicate attritional tears. The quad bike event at most aggravated pre-existing disease and did not cause new tendon rupture; therefore the condition is excluded as a gradual process and ACC's decision to decline cover is upheld.
29 Jan 2019
The District Court allowed the appeal because there was insufficient evidence that the annular tear was caused by a series of accident events within the period identified by the Reviewer; the medical evidence did not establish that repeated lifting/twisting events were each substantially causative rather than constituting a gradual process, rendering the Reviewer's finding erroneous and requiring reinstatement of Inghams' decision declining cover.
7 Sept 2018
The reviewer's decision to uphold ACC was correct because the appellant failed to prove on the balance of probabilities that the L4/5 disc prolapse and resultant radiculopathy were caused by the 5 September 2014 fall rather than by pre-existing degenerative stenotic disease; inconsistencies in expert reports, the temporal and treatment history, and radiological findings supported a degenerative origin or unmasking of pre-existing pathology, so ACC's exclusion applied.
30 Jul 2018
The court allowed the extension of time for filing the appeal but, on the substantive issue, gave greater weight to the treating specialist and internal medical advice concluding the MRI and clinical reasoning supported longstanding cam-type FAI and related cartilage change not caused by the December 2012 incident; Dr Brick's opinion was equivocal on timing and causation and therefore insufficient to establish on the balance of probabilities that the accident caused the pathology, so the appeal was dismissed and cover declined.
11 Jul 2018
The Court held that to obtain cover under s26(1)(c) the mental injury must be caused by a physical injury; evidence did not establish that the applicant's PTSD was caused by a physical injury (smoke inhalation) from the fire, so ACC's decision to decline cover and revoke the earlier grant was correct; appeal dismissed.
2 Feb 2018
Appeal dismissed because the evidence did not establish that the hernia was caused by an accident on 5 November 2014: contemporaneous medical records and specialist reports do not support a traumatic, single-event onset, the Smith criteria were not met, and medical witnesses relied on late, inconsistent recollections not contemporaneous with presentation.
8 Jun 2017
The appellant failed to establish on the balance of probabilities that he sustained a personal injury caused by an accident on 3 January 2016 because contemporaneous medical records and independent medical review do not support an injury or causation, therefore ACC correctly declined cover.
29 Jan 2016
On the balance of probabilities the need for surgery was not caused by the covered accident of 14 November 2010 but by a pre-existing degenerative chronic impingement process; impartial clinical advice (Medlicott and Ball), supported by imaging and history, established no causal link to the covered injury, so ACC's refusal to fund surgery was correct.
31 Jul 2015
On the balance of probabilities the court found credible evidence (sworn witness, GP/specialist reports including Dr Rajapaksha and Mr Rao and radiology) that a compensable 1986 injury occurred and, together with subsequent injuries, substantially caused the appellant's current lumbar condition; the 2011 event substantially caused incapacity certified from August 2011; chronic pain syndrome may be related to covered injury and requires further investigation by ACC.