10 Jul 2019
On the balance of probabilities the L3/4 disc changes were chronic degenerative and unlikely caused by the 8 November 2010 accident, and there is no compelling causal link between the covered L4/5 injury (including post‑surgical changes) and the need for the proposed two‑level fusion; accordingly ACC properly declined funding and the appeal is dismissed.
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.
19 Feb 2019
On the totality of the medical evidence, including CAP and treating specialists, the appellant failed to prove on the balance of probabilities that her current condition and need for further osteopath treatment were caused by the 12 May 2012 accident rather than being wholly or substantially the result of pre-existing age-related degenerative change; accordingly ACC's decision to decline further funding was correct and the review decision was upheld.
10 Aug 2018
On the balance of probabilities the need for surgery was causally linked to the covered 28 May 2012 injury. The Court accepted the temporal link, the appellant's detailed mechanism of injury, the treating surgeon's opinion supported by operative findings of a reactive bursa and scuffing, and found CAP had erred by misunderstanding the mechanism; therefore ACC's decision declining surgery was set aside.
10 Jul 2018
On the balance of probabilities the medical evidence (independent advisor reports and Clinical Advisory Panel) showed the shoulder pathologies were more likely the result of a longstanding internal impingement/gradual process related to sporting activity and pre-existing symptoms, not substantially caused by the covered accident(s); accordingly ACC correctly declined funding and the review decision was upheld.
17 May 2018
Medical evidence including imaging and specialist advice established pre-existing degenerative pathology (pars defects and facet arthropathy) that became symptomatic after the event but was not caused by the single lifting event; therefore no causal link existed between the covered accident and the surgical treatment sought and ACC's decision declining funding was correct and must be upheld.
16 Mar 2018
Appeal dismissed because appellant did not demonstrate a personal injury by accident: medical evidence did not establish tissue damage or causation from lead/arsenic attributable to the property, exposure was a gradual process not a specific occasion as required by s25 and was not work-related, and hair analysis was insufficient to prove poisoning causally linked to the injury.
22 Nov 2017
On the balance of probabilities the appellant did not prove the need for surgery was caused by the covered accident of 6 June 2015; objective evidence (radiology reports), the appellant's early return to dancing and CAP's analysis showed the accessory navicular was a developmental variant rendered symptomatic by a chronic/repetitive process rather than an acute injury to the synchondrosis, so ACC's decision to decline funding was correct and the review decision was upheld.
26 Oct 2017
The appellant failed to prove on the balance of probabilities that the 14 August 2014 accident caused the scapholunate tear that produced the advanced SLAC degeneration requiring surgery; independent medical evidence established the SLAC was longstanding and pre-existing the 2014 event and, in any event, entitlements cannot be founded on a 2012 injury for which no cover was claimed; accordingly ACC's decline and the review decision were correct and are upheld.
17 Nov 2016
On the balance of probabilities the contemporaneous clinical records and imaging (ultrasound 06/01/2014 and MRI 25/09/2014), supported by CAP review, demonstrate longstanding degenerative AC joint arthropathy, subacromial impingement and multi‑tendinopathy rather than discrete traumatic rotator cuff injury caused by the covered accidents; appellant failed to establish the required causal link and therefore ACC's refusal to fund surgery was correct.