New Zealand Case Law: Decisions & Judgments

Topic

Entitlement suspension

Legal area

Court

8 Aug 2019

Miles v Accident Compensation Corporation (Personal Injury)

Citation

[2019] NZACC 92
Court

District Court

The Court found that contemporaneous clinical notes, imaging showing right iliopsoas bursitis, treating clinicians' reports and physiotherapy evidence established that the 25 January 2016 accident caused significant soft tissue injury to the right hip which largely resolved by November 2016; specialist descriptions of decompensation did not negate an accident-related soft tissue injury. ACC therefore did not have a sufficient basis to suspend entitlements from 12 June 2016 and the suspension was quashed.
31 Oct 2017

Siviter v Accident Compensation Corporation (Treatment Injury)

Citation

[2017] NZACC 133
Court

District Court

No specialist opinion established that the treatment caused the chondral defects; the primary and persuasive medical evidence (notably Mr Taine and other orthopaedic assessments and earlier imaging) shows pre-existing osteoarthritis which is the substantial cause and any contribution from treatment, if any, was not the dominant cause; therefore s32 criteria for a treatment injury are not met and cover must be declined.
13 Apr 2017

Andersen v Accident Compensation Corporation (Entitlements)

Citation

[2017] NZACC 42
Court

District Court

The Court upheld ACC's first decision of 16 July 2013 because the contemporaneous specialist assessment (Mr Pai), MRI findings and treating notes provided a sufficient basis to conclude the claimant had substantial capacity and that symptoms reflected aggravation of pre‑existing degenerative change rather than ongoing traumatic pathology; however the second decision of 3 February 2014 was quashed because ACC lacked a sufficient contemporaneous evidential basis and failed to comply with the procedural notice requirement of s117(2).
28 Mar 2017

Prakash v Accident Compensation Corporation (Weekly Compensation )

Citation

[2017] NZACC 29
Court

District Court

On the balance of probabilities the district court found the reviewer did not err: the body of medical evidence, notably Mr Kelman's reports consistent with other medical advisers, established that the appellant's current symptoms were not causally related to the 17 April 2013 accident and therefore suspension of weekly compensation was lawful; appeal dismissed.
30 Sept 2016

Jurisich v Accident Compensation Corporation

Citation

[2016] NZACC 269
Court

District Court

At the time of the decision ACC possessed sufficient evidence (notably Kelman's specialist reports) to be not satisfied that the appellant's ongoing symptoms were caused by the 10 April 2009 injury; subsequent medical evidence confirmed the predominant cause was pre-existing spondylolisthesis/degenerative change and not the 2009 accident, thus the suspension was correctly made and is upheld.
14 Jul 2016

White v Accident Compensation Corporation

Citation

[2016] NZACC 191
Court

District Court

The appellant failed to establish on the balance of probabilities a causal nexus between the October 2010 thoracic sprain and her ongoing mid‑thoracic pain in 2012; contemporaneous and subsequent specialist medical opinions did not identify a persistent structural injury causally linked to the workplace event, therefore the Corporation's suspension of entitlements and refusal to pay weekly compensation were correctly made and are upheld.
29 Apr 2016

DD v Accident Compensation Corporation

Citation

[2016] NZACC 122
Court

District Court

The Court accepted the respondent's expert medical opinion that the appellant's spondylolisthesis and disc disease are due to gradual degenerative change from repetitive stress and constitutional factors rather than a single traumatic event in 2002; the respondent had an adequate evidential basis to be "not satisfied" and suspend entitlements; the appellant failed to prove on the balance of probabilities that the 2002 accident caused the ongoing condition, so the appeal is dismissed.
16 Dec 2015

Gillespie v Accident Compensation Corporation

Citation

[2015] NZACC 390
Court

District Court

The Court concluded that by the date of the challenged decision the respondent had a sufficient evidential basis to be 'not satisfied' that the appellant's ongoing symptoms were causally connected to the 2006 injury; on the balance of probabilities the necessary causal nexus had not been established and the suspension of entitlement was upheld.
25 Sept 2015

Wells v Accident Compensation Corporation

Citation

[2015] NZACC 289
Court

District Court

The Judge preferred the treating orthopaedic surgeon's view that, on the balance of probabilities and given the acute presentation and mechanism, the August 2012 accident was the substantive cause of the shoulder pathology and need for surgery; because medical opinion was not sufficiently certain to permit ACC to be 'satisfied' that entitlement should be withdrawn, ACC's decisions were set aside.
24 Sept 2015

Steel v Accident Compensation Corporation

Citation

[2015] NZACC 281
Court

District Court

The Court accepted the contemporaneous and subsequent expert medical evidence (notably Associate Professor Theis and Dr Wilson) and imaging showing longstanding femoro‑acetabular impingement with degenerative chondral damage predating and revealed by the 2006 incident; therefore the need for total hip replacement was not caused by a covered injury and ACC correctly declined funding and had a sufficient basis to suspend entitlements.