New Zealand Case Law: Decisions & Judgments | LexChat

New Zealand Case Law

Suspension of entitlements under s116

  • 18 Dec 2006

    MICHAEL ERNEST ELLWOOD V ACCIDENT COMPENSATION CORPORATION HC WN CIV 2005-485-536

    Citation
    openlaw-4a8e5c6d_dcaa_4d43_94f0_5e804d28153b.pdf
    Court
    High Court

    s116 must be read with ACC's obligation to act reasonably; ACC must have a sufficient evidential basis before suspending/terminating entitlements. Where the evidence is unclear or in balance suspension is not justified because the 'not satisfied' test is not met. The District Court gave inadequate rational reasons for preferring ACC's experts and the matter is remitted for rehearing with further expert clarification ordered as necessary.

    • Suspension of entitlements under s116
    • Causation between accident and incapacity
    • Onus of proof in suspension/revocation
    • Assessment of competing expert medical evidence

  • 22 Apr 2004

    Spencer v Accident Compensation Corporation

    Citation
    [2004] NZACC 125
    Court
    District Court

    For a review decision made under the pre-1992 (1972/1982) legislation the Corporation can revisit the position where there is error or fresh evidence; on the facts the subsequent medical evidence established the appellant's ongoing pain is due to degenerative spondylolisthesis not attributable to the 1985 accident, so ACC correctly suspended entitlements and the appeal must be dismissed.

    • Review decision binding effect
    • Revision of review decisions
    • Causation and 'but for' test
    • Pre-existing degenerative condition
    • Suspension of entitlements under s116

  • 31 Oct 2003

    Riley v Accident Compensation Corporation

    Citation
    [2003] NZACC 269
    Court
    District Court

    The appellant failed to prove on the balance of probabilities that his current cardiac condition was caused by or meaningfully attributable to the 1990 medical misadventure; the medical evidence demonstrates continuing disease and incomplete revascularisation from pre-existing coronary pathology as the cause of ongoing angina, therefore suspension of entitlements under s116 was correct and the appeal is dismissed.

    • Causation
    • Suspension of entitlements under s116
    • Onus of proof
    • Review of medical decision

  • 30 Sept 2003

    Morresey v Accident Compensation Corporation

    Citation
    [2003] NZACC 240
    Court
    District Court

    The Court preferred the musculoskeletal medicine specialist's contemporaneous hands-on findings (localized tenderness on palpation at left L5/S1) supported by other treating opinion that a soft tissue injury occurred; the orthopaedic experts' radiology-focused examinations were insufficient to exclude ongoing soft tissue pathology. On the balance of probabilities the appellant's current incapacity was substantially caused by the compensable soft tissue injury from the 12 April 1999 accident, so Catalyst's suspension was unlawful and entitlements must be reinstated.

    • Suspension of entitlements under s116
    • Causation of incapacity
    • Weight of competing medical expert evidence
    • Review of agency decision

  • 30 Jan 2003

    Lockyer v Accident Compensation Corporation

    Citation
    [2003] NZACC 13
    Court
    District Court

    Court found radiology showed longstanding degenerative changes predating the October 2000 fall, the MRI progression was consistent with chronic degeneration rather than new traumatic arthritic change, and the preferred medical opinion (Mr Jones) established that any traumatic aggravation had resolved and current incapacity is substantially caused by pre-existing degeneration; therefore suspension of entitlements was lawful and appeal is dismissed.

    • Attribution of injury
    • Pre-existing degenerative condition
    • Aggravation versus causation
    • Suspension of entitlements under s116
    • Relevant jurisprudence on cover exclusion

  • 21 Nov 2001

    Wall v Accident Compensation Corporation

    Citation
    [2001] NZACC 322
    Court
    District Court

    Because transitional provisions preserve the 1982 Act definition for injuries covered under the 1982 Act, ACC could only suspend entitlements under s116 if it proved the appellant's incapacity was exclusively caused by disease, gradual process or ageing; the medical evidence relied on by the appellant (Mr Robertson and Mr Thorn) established that the appellant's current condition remains causally connected to the 1987/1990 injuries and the L5/S1 fusion, so ACC failed to establish exclusivity and its decision of 11 July 2000 must be revoked and entitlements reinstated.

    • Suspension of entitlements under s116
    • Definition of personal injury
    • Transitional provisions between 1982 and 1998 acts
    • Causation: exclusive vs substantial
    • Work capacity assessment procedure

  • 31 Oct 2001

    Williams v Accident Compensation Corporation

    Citation
    [2001] NZACC 303
    Court
    District Court

    On the balance of probabilities the appellant remained incapacitated for his pre-injury employment due to ongoing bilateral lateral epicondylitis; the Court preferred the combined evidence of Dr Wigley and GP notes over Dr Haywood's conclusions as of September 1999, concluding ACC was not justified in suspending entitlements under s116 and therefore the decision of 17 September 1999 was unlawful and must be revoked with entitlements restored from that date.

    • Suspension of entitlements under s116
    • Test of incapacity
    • Medical evidence evaluation
    • Transitional application of 1992 act to entitlements
    • Review and appeal procedure

  • 6 Sept 2001

    Faithfull v Accident Compensation Corporation

    Citation
    [2001] NZACC 249
    Court
    District Court

    The suspension of entitlements under s116 was lawful because the preponderant medical evidence established the appellant's current chronic pain syndrome was not causally attributable to the 1 July 1993 physical injury, and speculative theories without requisite diagnostic confirmation did not create the necessary causal nexus to sustain entitlement.

    • Suspension of entitlements under s116
    • Causation between injury and current condition
    • Chronic pain syndrome
    • Weight of medical expert evidence
    • Definition of personal injury

  • 23 Aug 2001

    Ross v Accident Compensation Corporation

    Citation
    [2001] NZACC 230
    Court
    District Court

    On the evidence and on the balance of probabilities the Court found an ongoing causal link between the appellant's 2 July 1997 wrist injury and her present symptoms, preferred the medical opinions of Hopkins, Wigley and Speirs over those of Turner and the ACC advisor, found no pre-existing condition explaining the symptoms and concluded ACC's suspension under s116 was not justified, so the review decision was reversed and entitlements reinstated.

    • Causation
    • Suspension of entitlements under s116
    • Onus of proof
    • Weight of medical evidence
    • Review of administrative decision

  • 22 Aug 2001

    Harrigan v Accident Compensation Corporation

    Citation
    [2001] NZACC 226
    Court
    District Court

    The appellant established on the balance of probabilities that the injuries from the earlier accidents remain causative of his present back complaints, so there was no legal basis for ACC to discontinue payments under s116; the Corporation's decision to suspend entitlements was therefore quashed and entitlements reinstated effective 25 August 2000.

    • Causation
    • Suspension of entitlements under s116
    • Review officer decision
    • Weighing of medical evidence
    • Standard of proof