New Zealand Case Law: Decisions & Judgments | LexChat

New Zealand Case Law

Entitlement to funding for surgery

  • 13 Nov 2015

    Austin v Accident Compensation Corporation

    Citation
    [2015] NZACC 345
    Court
    District Court

    On the balance of probabilities the appellant failed to prove the rotator cuff tear was caused by the 7 February 2011 accident; the court preferred the detailed medical evidence that the tear resulted from a degenerative process or progression between imaging studies rather than acute trauma, therefore ACC's decisions to decline funding for surgery and weekly compensation were correct.

    • Causation
    • Entitlement to funding for surgery
    • Weekly compensation
    • Assessment report and treatment plan
    • Weight of medical expert evidence

  • 19 Dec 2014

    Brunt v Accident Compensation Corporation

    Citation
    [2014] NZACC 350
    Court
    District Court

    On the balance of probabilities the expert opinion of the orthopaedic shoulder specialist (Mr Ball), supported by the radiological record, established that the rotator cuff pathology predated and was attributable to age-related degenerative change and that the lifting event was temporally related to symptoms but did not cause the underlying tear; accordingly ACC was not liable for cover for the tear or funding for surgery and the appeal is dismissed.

    • Cover for gradual process
    • Causation
    • Entitlement to funding for surgery
    • Medical expert evidence

  • 12 Jul 2013

    Accident Compensation Corporation v Fitzsimons

    Citation
    [2013] NZACC 213
    Court
    District Court

    The Court preferred the evidence and analysis of the treating orthopaedic surgeon (Mr Coleman), found that the articular-sided partial supraspinatus tear was causally linked to the accident described and not shown to be predominantly degenerative, and concluded that ACC's reliance on degeneration and delay was insufficient to displace the surgeon's opinion; accordingly the appeal was dismissed and ACC must fund the surgery.

    • Causation
    • Gradual process / degeneration exclusion
    • Medical expert evidence evaluation
    • Entitlement to funding for surgery
    • Delay in presentation

  • 28 Jan 2011

    Michelle v Accident Compensation Corporation

    Citation
    [2011] NZACC 29
    Court
    District Court

    On the balance of probabilities the court accepted the treating surgeon's opinion that an acute L4/5 disc protrusion occurred as a result of the 16 June 2008 accident and that the protrusion was the cause of the L5 nerve compression and the need for surgery; the surgery was not required wholly or substantially because of degenerative disease and ACC must fund the surgery and the review decision is quashed.

    • Causation for entitlement to treatment
    • Degenerative condition exclusion
    • Review of acc decision
    • Entitlement to funding for surgery