20 Dec 2016
Considering lay evidence of post-accident symptoms, the treating surgeon's and a specialist's causal opinions, and the totality of medical evidence, the Court concluded on the balance of probabilities (allowing robust inference) that the appellant's right shoulder pathology was caused by the May 2011 accident; the Corporation's decision declining cover was therefore set aside.
4 Apr 2016
The court accepted the respondent's specialist medical opinions that the cervical disc protrusions were more plausibly the product of multilevel degenerative change rendered symptomatic over time rather than traumatic disc injury from the 2010 accident; the appellant failed to meet the required threshold of proof under Ambros and therefore the review decision declining cover is upheld.
30 Oct 2014
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.
5 Dec 2013
The MRI revealed multiple degenerative and atrophic pathologies inconsistent with a single traumatic event; therefore the surgery sought would treat non-covered degenerative conditions and ACC's refusal to fund was correct, so the appeal is dismissed.
23 Aug 2013
On balance the court found sufficient evidence that physiotherapy treated the appellant's traumatic symptoms and ordered reimbursement for completed physiotherapy, but accepted expert evidence that the rotator cuff tears were chronic degenerative conditions likely pre-existing and merely aggravated by the accident, so cover for the tears was properly refused.
14 Aug 2012
There was insufficient evidence that the waka incident probably caused a structural change producing the appellant's symptomatic left subacromial impingement; on that basis ACC was correct to refuse funding for the surgery and the appeal must be dismissed.
2 Sept 2011
The appeal is dismissed because on the available evidence the appellant failed to prove on the balance of probabilities that the full thickness supraspinatus tear was caused by the skiing accident rather than being wholly or substantially degenerative; the treating surgeon's opinion lacked medical reasoning and the Corporation reasonably relied on CAP advice and literature linking cystic changes to longstanding degenerative tears.
22 Aug 2011
The court accepted the treating surgeon's and independent orthopaedic specialist's opinions that the appellant sustained a patellofemoral subluxation in the 1 May 2010 fall which caused the chondral injury treated by surgery; those specialist opinions established causation on the balance of probabilities and the respondent's degenerative/repetitive micro‑trauma explanation did not rebut that causal nexus; accordingly ACC was liable to fund the surgery under Schedule 1 Clause 1 of the Act.
15 Apr 2010
On the balance of probabilities the court accepted the treating surgeon's opinion that the supraspinatus tear was caused or materially aggravated by the May 2008 accident (and possibly initiated by the February fall) and rejected the Clinical Advisory Panel's conclusion of exclusion by degenerative change; accordingly the appellant established entitlement to ACC‑funded surgery and the respondent's primary and review decisions were quashed.