10 June 2020
Anthony Jordan
[FYI request #12833 email]
Tēnā koe Anthony
Your Official Information Act request, reference: GOV-004871
Thank you for your email of 12 May 2020, asking for the fol owing information under the Official
Information Act 1982 (the Act):
•
part of the act that permits the ACC to exclude a non-contracted New Zealand qualified
Clinicians medical report or any other advices
•
what process would a Claimant use to submit a non-contracted Clinicians opinion that is felt to
be significant to thier case
•
should a non-contracted clinicians information being previously rejected by the ACC be valid to
be tabled but Claimant under impression such information couldn't be, What liability could a
Claimant hold the ACC to account
•
part of the act that permits an ACC funded reviewer to exclude a non-contracted New Zealand
qualified Clinicians medical report or any other advices
•
what process would a Claimant use to submit a non-contracted Clinicians opinion that is felt to
be significant to thier case in review or conciliation to a ACC funded reviewer, that may have
been omitted by ACC
•
should a non-contracted clinicians information being previously rejected by a ACC funded
reviewer be valid to be tabled but Claimant under impression such information couldn't be, What
liability could a Claimant hold the ACC funded review company to account
ACC decisions on cover and entitlements (Questions 1 – 3)
Section 54 of the Accident Compensation Act 2001 (AC Act) states that the Corporation must make
every decision on a claim on reasonable grounds, having regard to the requirement of the Act, the
nature of the decision, and al the circumstances.
1. Part of the act that permits the ACC to exclude a non-contracted New Zealand qualified
Clinicians medical report or any other advices
There is no section or part of the AC Act that requires or permits ACC to ‘exclude’ medical opinion from
a medical professional on the basis they are not providing services under an ACC contract.
As you are aware, ACC makes decisions on cover and entitlements based on a range of relevant
information and the provisions of the AC Act. From time to time we receive differing medical opinions
and in coming to our decisions, ACC considers all the opinions, alongside other relevant information.
Further to this, in relation to ‘non-contracted clinicians’, I note that we wrote to you on
6 March 2014
advising that treatment providers who provide services to ACC clients are not necessarily party to a
contract. For example, an individual doctor may be employed or engaged by a clinic or a DHB, which
holds the contract with ACC.
GOV-004871
2. What process would a Claimant use to submit a non-contracted Clinicians opinion that is felt
to be significant to their case
Clients can email or post any medical information they consider relevant to their claim to their Case
Manager, a Resolution Specialist or other ACC staff working on their claim.
3. Should a non-contracted clinicians’ information being previously rejected by the ACC be valid
to be tabled but Claimant under impression such information couldn't be, what liability could
a Claimant hold the ACC to account
You are asking ACC to form an opinion on a hypothetical situation. This is outside our obligations under
the Act. Therefore, we are not providing a response to this part of your request. Please refer to page 7
of the Ombudsman’s Guide for requestors ‘Making official information requests’, which is available at
www.ombudsman.parliament.nz.
ACC clients are able to chal enge ACC decisions via the review process. Information on this is available
on our website at th
is link.
Review decisions (questions 4 – 6)
Part 5 of the AC Act deals with dispute resolutions matters, including reviews and Court appeals. You
can view this legislation at this
link.
4. Part of the act that permits an ACC funded reviewer to exclude a non-contracted New Zealand
qualified Clinicians medical report or any other advices
5. What process would a Claimant use to submit a non-contracted Clinicians opinion that is felt
to be significant to their case in review or conciliation to an ACC funded reviewer, that may
have been omitted by ACC
These questions relate to the conduct of the review. I refer you to sections 140 and 141 of the AC Act. If
a client is chal enging an ACC decision through a Review, they may send additional information directly
to the Reviewer.
6. Should a non-contracted clinicians’ information being previously rejected by a ACC funded
reviewer be valid to be tabled but Claimant under impression such information couldn't be,
What liability could a Claimant hold the ACC funded review company to account
This question asks ACC to form an opinion in relation to a hypothetical situation. As explained above,
this is outside our obligations under the Act, and therefore we are not providing a response to this part
of your request.
Noting this, and as you wil be aware, if a client disagrees with a review decision, they can lodge an
appeal with the District Court within 28 days of receiving the decision, or at a later time if the Court
allows it.
Queries about this response
If you have any questions, you can email me a
t [email address].
If you are not happy with this response, you have the right to make a complaint to the Ombudsman.
Information about how to do this is available at
www.ombudsman.parliament.nz or by phoning 0800
802 602.
Accident Compensation Corporation
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GOV-004871
Nāku iti noa, nā
Sasha Wood
Manager Official Information Act Services
Government Engagement & Support
Accident Compensation Corporation
Page 3 of 3
Document Outline