New Zealand Case Law: Decisions & Judgments | LexChat

New Zealand Case Law

Suspension of entitlements under s117

  • 7 Feb 2019

    McKay v Accident Compensation Corporation (Suspension of Entitlements)

    Citation
    [2019] NZACC 9
    Court
    District Court

    The Court held that ACC had a sufficient evidential basis both at the time of suspension and on review to be 'not satisfied' that entitlements should continue because specialist opinion (Mr Pai) supported that the appellant's ongoing incapacity was substantially due to longstanding lumbar spondylosis with only possible aggravation from the fall; the contrary opinion (Mr Rao) lacked adequate medical reasoning regarding an acute far lateral L3/4 prolapse; accordingly the suspension under s117 was upheld and the appeal dismissed.

    • Suspension of entitlements under s117
    • Causation
    • Medical expert conflict
    • S26(2) gradual process exclusion
    • Ellwood test

  • 31 Aug 2016

    K v Accident Compensation Corporation

    Citation
    [2016] NZACC 243
    Court
    District Court

    Suspension under s117(3) requires that a claimant unreasonably refuse or fail to comply with a statutory requirement. The appellant had substantively complied with s72 by providing a GP medical certificate and case‑by‑case information authorisation pursuant to an earlier mediated agreement; the amended ACC18 declaration was supported by clinical reasons and was not an unreasonable refusal to comply. Accordingly ACC's suspension of weekly compensation was unjustified and must be set aside.

    • Suspension of entitlements under s117
    • Claimant obligations under s72
    • Use and scope of acc18 medical certificate
    • Consent and information authorisation

  • 18 Dec 2013

    Emery v Accident Compensation Corporation

    Citation
    [2013] NZACC 413
    Court
    District Court

    On the balance of probabilities the appellant's ongoing back pain was caused by bilateral pars interarticularis defects and the medical imaging and multiple specialist reviews establish those defects pre-existed the 11 June 2007 accident; because the causative pathology was not caused by the covered accident ACC had a sufficient basis to suspend entitlements and the suspension was upheld.

    • Suspension of entitlements under s117
    • Causation of injury
    • Pre-existing condition
    • Weight of expert opinion
    • Standard of proof - balance of probabilities

  • 19 Apr 2013

    MacDonald v Accident Compensation Corporation

    Citation
    [2013] NZACC 101
    Court
    District Court

    The Court accepted the infectious disease specialist Dr Everts' opinion that the appellant developed post-leptospirosis chronic fatigue syndrome, found no comparable specialist contrary evidence, concluded causation was established on the balance of probabilities, and held the accredited employer's suspension under s117 was unjustified; therefore the review decision was quashed and entitlements must be restored from the date of suspension.

    • Causation
    • Chronic fatigue syndrome
    • Medical expert evidence
    • Suspension of entitlements under s117
    • Accredited employer decision-making

  • 26 Oct 2012

    De Waal v Accident Compensation Corporation

    Citation
    [2012] NZACC 350
    Court
    District Court

    Where ACC sought to replace a clear, long‑standing specialist‑by‑specialist consent arrangement without meaningful negotiation or allowance for a run‑out, that peremptory implementation was disproportionate and unreasonable; the claimant's refusal in those circumstances was not objectively unreasonable and ACC's decision of 21 July 2009 to suspend entitlements was unlawful and set aside.

    • Consent to disclose medical information
    • Suspension of entitlements under s117
    • Reasonableness of statutory requirements
    • Proportionality
    • Functional capacity evaluation (fce)

  • 24 Nov 2010

    Anderson v Accident Compensation Corporation

    Citation
    [2010] NZACC 213
    Court
    District Court

    The Judge accepted the medical evidence that the rotator cuff tear was degenerative and not causatively linked to the 26 June 2005 fall; the appellant failed to prove on the balance of probabilities that the tear and resulting incapacity were caused by the accident, therefore the respondent correctly declined weekly compensation and validly suspended entitlements under s117(1).

    • Causation
    • Entitlement to weekly compensation
    • Suspension of entitlements under s117
    • Medical evidence and contemporaneous investigation
    • Review of administrative decision

  • 10 Jun 2010

    Beveridge v Accident Compensation Corporation

    Citation
    [2010] NZACC 80
    Court
    District Court

    Conflicting expert medical opinions left causation too finely balanced; under Ellwood ACC failed to establish the required satisfaction under s117 to suspend entitlements. Therefore the suspension decision was unlawful and must be quashed and entitlements reinstated from the date of suspension.

    • Suspension of entitlements under s117
    • Causation and pre-existing condition vs injury
    • Onus of proof for termination of benefits
    • Weight of expert medical evidence

  • 26 Nov 2009

    Simpson v Accident Compensation Corporation

    Citation
    [2009] NZACC 206
    Court
    District Court

    Based on the independent specialist report of Mr Dunbar, the judge found the appellant's current symptoms remained causally linked to the 1987 and 2000 injuries and that ACC did not have a reasonable and sufficient basis under s117(1) to suspend entitlements on 22 October 2003; the appeal was allowed and suspension set aside.

    • Causation
    • Suspension of entitlements under s117
    • Degeneration versus traumatic injury
    • Onus/balance of probabilities

  • 20 Apr 2009

    Bishop v Accident Compensation Corporation

    Citation
    [2009] NZACC 55
    Court
    District Court

    Leave to appeal refused because the District Court correctly treated the matter as a factual assessment of competing medical evidence under s117, the Reviewer legitimately modified the primary decision to a suspension, and no question of law arose that would justify High Court leave under s162.

    • Suspension of entitlements under s117
    • Leave to appeal under s162
    • Assessment of medical evidence
    • Decision modification by reviewer
    • Revocation versus suspension of cover

  • 21 Jan 2009

    O'Neill v Accident Compensation Corporation

    Citation
    [2009] NZACC 3
    Court
    District Court

    On the evidence, particularly the consistent orthopaedic and spinal specialist opinions, the court found it more probable that the appellant's continuing condition was caused wholly or substantially by a longstanding idiopathic scoliosis and its decompensation rather than by a continuing effect of the 2004 gardening strain; accordingly the Corporation was entitled to be 'not satisfied' that the gardening accident remained a substantial cause and lawfully suspended entitlements under s117.

    • Causation
    • Suspension of entitlements under s117
    • Weight of medical expert evidence
    • Burden and standard for suspension (not satisfied test)