New Zealand Case Law: Decisions & Judgments

Topic

Cover/entitlement

Legal area

Court

7 Sept 2017

Paea v Accident Compensation Corporation (Weekly Comp/Treatment Injury/Review Jurisdiction)

Citation

[2017] NZACC 94
Court

District Court

Medical evidence established that the amputations were predominantly caused by the claimant's poorly controlled diabetes and related comorbidities rather than the August 2012 cut, the GP's antibiotic choice, or the December 2014 burns; accordingly the Corporation's decisions declining weekly compensation, declining treatment injury cover, and declining consequential cover were correct, and the reviewer lacked jurisdiction to reopen the 2006 MRSA decision or treat the complaint about delay as a reviewable decision.
14 Jul 2017

Wright v Accident Compensation Corporation (Cover for Hearing Loss)

Citation

[2017] NZACC 77
Court

District Court

The expert evidence, supported by pre- and post-incident audiograms, established only 2.9% binaural hearing loss attributable to the November 2015 incident (below the 6% threshold), and there was no reliable expert evidence that tinnitus was a distinct physical injury; therefore the appellant is not entitled to ACC cover under s26(1A) or s26(1)(b).
4 Jul 2017

Hart v Accident Compensation Corporation (Decline Cover)

Citation

[2017] NZACC 74
Court

District Court

Contemporary medical records and multiple assessments from 2001–2004 contain no evidence of right shoulder injury; first record of right shoulder pain appears in 2011; on balance of probabilities claimant failed to establish the labral tear was caused by the 2001 accident, so cover properly declined.
30 Jan 2015

Daly v Accident Compensation Corporation

Citation

[2015] NZACC 18
Court

District Court

The appeal is dismissed because, although there was a temporal link to the beach incident, the available medical evidence does not establish on the balance of probabilities that the incident caused the stress fracture; the medical opinion indicated a gradual onset/repetitive strain process and s 26(2) principles exclude cover absent a demonstrated causal nexus.
27 Nov 2014

Phillips v Accident Compensation Corporation

Citation

[2014] NZACC 313
Court

District Court

On the balance of probabilities the rotator cuff tear and need for surgery were attributable to an underlying progressive degenerative process rather than an acute injury caused by the recorded accidents; the delay in presentation and imaging supported a non-traumatic aetiology, and there was no evidence the 11 July 2011 tool trolley incident caused a new injury or functional loss, therefore ACC correctly declined cover and the appeals are dismissed.
21 Oct 2014

O'Brien v Accident Compensation Corporation

Citation

[2014] NZACC 271
Court

District Court

The Corporation's declinature of cover for the 12 March 2012 accident was correct because there was insufficient evidence to establish on the balance of probabilities a causal link between that accident and the appellant's right shoulder condition: absence of contemporaneous medical records, delay in presentation, medical opinions favoring a gradual condition and attribution of symptoms to the 27 March 2012 accident. However, imaging costs arranged by the GP are payable as treatment for the covered 27 March 2012 injury.
15 Aug 2014

Maguire v Accident Compensation Corporation

Citation

[2014] NZACC 182
Court

District Court

On the balance of probabilities the appellant's wrist injury was caused by the identified sparring accident; the MRI and the treating specialist's operative findings and subsequent reasoned opinion that the injury was traumatic outweighed the delays in presentation and the unsupported suggestions of degeneration, therefore ACC's decision to decline cover was not justified and must be set aside.
19 Feb 2014

Carter v Accident Compensation Corporation

Citation

[2014] NZACC 33
Court

District Court

On the balance of probabilities the appellant failed to prove he suffered a covered right middle finger injury in 1977 that caused subsequent osteoarthritis, and there were no extenuating circumstances to justify late review of the 2003 thumb decision; accordingly ACC's refusals stand and the appeal is dismissed.
1 Nov 2013

Grimes v Accident Compensation Corporation

Citation

[2013] NZACC 371
Court

District Court

The prior District Court judgment concluded NSIP was not caused by occupational exposure and that causation could not be established; that decision is binding and therefore the respondent's decision of 10 December 2010 declining cover for NSIP is correct and the appellant cannot reinstitute that claim.
17 May 2013

Topless v Accident Compensation Corporation

Citation

[2013] NZACC 140
Court

District Court

On the balance of the evidence, including detailed expert reports and the claimant's credible history, the 1992 truck accident was the substantial cause of the claimant's current L4/5 disc pathology; the broad 1992 cover description suffices to confer entitlement to funding for the spinal fusion, so ACC's decision to decline funding was quashed.