16 Dec 2015
No question of law was established; the District Court correctly found on the evidence that there was no probative causal nexus between the 2012 surgery and the covered injury, the applicant failed to obtain prior approval and to supply required information, and accordingly the High Court should refuse special leave in the exercise of its discretion.
30 Oct 2014
The ACC's 24 October 2012 decision was an exercise of the s68(3) discretion and, by operation of s68(4) and s134(1A), that exercise of discretion is not reviewable under Part 5; therefore the reviewer correctly declined jurisdiction and the appeal must be dismissed.
20 Feb 2014
Appeals dismissed because claimant failed to supply required medical evidence and a valid consent to enable ACC to determine whether the 2012 surgery and related transport/home help were for a covered injury, and there was no prior approval for treatment or taxi transport; statutory scheme (Act and Regulations) requires prior agreement and evidential causal nexus, which were absent, so ACC had no liability and did not unreasonably delay.
8 Aug 2013
The Court found the appellant's late and inconsistent histories and the consistent earlier specialist reports made it improbable that the 1994 rugby incident caused the L4 fracture; on balance it was more probable the injury occurred in Australia in 1987, which was not covered, so ACC's decision to decline entitlements was reasonable and the Reviewer's refusal of costs was within discretion; appeal dismissed.
9 Jun 2013
On the balance of probabilities the Court accepts the orthopaedic surgeon's evidence that the 11 December 2009 accident caused the rotator cuff tear and consequent need for surgery, and that pre-existing degenerative changes did not wholly or substantially cause the need for surgery under s26(4); ACC's refusal to fund the surgery was therefore unlawful and is quashed.
14 Jul 2011
Section 128 bars ACC from paying for rehabilitation or treatment costs incurred outside New Zealand unless s.129 or a regulation requires payment; no applicable regulation existed, s.129 did not apply, the appellant lacked prior ACC agreement for the treatment, and the facts did not establish a compensable treatment injury. Therefore ACC was correct to decline reimbursement for overseas treatment and travel and the treatment injury claim was not sustainable.
6 Nov 2009
Appeal dismissed because there was no evidence to establish that the requested dental treatment for teeth 32,31,41,42 arose from the covered accident of 24 November 2007 or that medication caused the deterioration; ACC's decision to decline funding was upheld.
22 Apr 2004
Because the treating surgeon described the case as only semi-urgent and there was a five-week interval between assessment and surgery, the treatment did not meet the statutory definition of 'acute treatment' under s7, so ACC's prior agreement was required and ACC was entitled to decline reimbursement.
21 Feb 1995
The Regulations require prior approval for the specified hospital, specialist and anaesthetic procedures; the 'discovered during the course of approved treatment' exception only operates where there is an antecedent approved treatment (i.e. prior approval under the Regulations); acceptance of cover under the Act does not substitute for the statutory prior approval; because no prior approval was obtained, payment was precluded and the Corporation's decision to decline payment was correctly upheld.