New Zealand Case Law: Decisions & Judgments

Topic

Coverage of treatment

Legal area

Court

27 Jul 2016

Eyles v Accident Compensation Corporation

Citation

[2016] NZACC 198
Court

District Court

On the balance of probabilities the treating surgeon's causal opinion, supported by a plausible mechanism of injury (fall onto outstretched hands), the treating history and radiological interpretation consistent with progression from an intrasubstance tear, established that the need for supraspinatus repair was causally linked to the 6 June 2009 accident; accordingly ACC's decision declining funding was set aside.
2 May 2016

Craig v Accident Compensation Corporation

Citation

[2016] NZACC 128
Court

District Court

On rehearing the Court preferred the respondent's expert evidence and found the appellant did not prove on the balance of probabilities that the 2009 squash accident caused or was substantially related to the patellofemoral osteoarthritis and need for total knee replacement; therefore the reviewer's decision to decline funding was upheld and the appeal dismissed.
7 Apr 2016

Gill v Accident Compensation Corporation

Citation

[2016] NZACC 89
Court

District Court

On the balance of probabilities the District Court preferred the treating surgeon’s contemporaneous operative opinion over the ACC clinical advisor and concluded that the appellant’s need for surgery was directly caused by the covered workplace injury (17 March 2013) and was not wholly or substantially due to a gradual degenerative process or ageing; accordingly the ACC decision declining cover for the 17 March 2013 incident was set aside while the earlier 5 March 2013 review decision was left undisturbed.
30 Oct 2014

Henderson v Accident Compensation Corporation

Citation

[2014] NZACC 296
Court

District Court

The operative surgeon's uncontested report, supported by other expert evidence, established that the rotator cuff tears were degenerative and were merely rendered symptomatic by the 10 August 2011 incident; causation by accident was not established and the Corporation's decisions declining coverage for the surgery and additional physiotherapy were correct, therefore the appeal was dismissed.
9 May 2014

Turley v Accident Compensation Corporation

Citation

[2014] NZACC 122
Court

District Court

No reliable expert evidence linked the appellant's advanced periodontal disease to the 2001 assault; contemporaneous dental records and expert reports (Dr Morris, Dr Leichter) support that the periodontal disease arose independently after ACC-funded care ceased; therefore ACC's decision to decline funding was correct and the appeal is dismissed.
30 Jun 2004

Ali v Accident Compensation Corporation

Citation

[2004] NZACC 181
Court

District Court

Although medical evidence did not establish the tumour was trauma‑caused, the initial ACC approval for elective surgery was sufficiently wide and remained effective until the respondent revoked it; the appellant relied in good faith and incurred the operation costs before notification of revocation, therefore ACC must reimburse those costs.

New Zealand Case Law

Eyles v Accident Compensation Corporation

Craig v Accident Compensation Corporation

Gill v Accident Compensation Corporation

Henderson v Accident Compensation Corporation

Turley v Accident Compensation Corporation

Ali v Accident Compensation Corporation