004_ACC_April_2016
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1<br />
<strong>ACC</strong>IDENT<br />
COMPENSATION<br />
Empowering Business<br />
CORPORATION<br />
Employer Guide<br />
1
PLEASE NOTE: All information in this publication is correct as at <strong>April</strong> <strong>2016</strong> and subject to change.<br />
This is only a guide. It should not be used as a substitute for professional advice.<br />
CONTENTS<br />
INTRODUCTION................................................................................................. 5<br />
WORK-RELATED PERSONAL INJURY................................................................ 5<br />
Motor vehicle injuries..................................................................................................... 5<br />
Work-related.........................................................................................................................................5<br />
Non work-related...............................................................................................................................5<br />
Heart attacks and strokes............................................................................................... 6<br />
Medical treatment of work-related injury.................................................................... 6<br />
Gradual process, disease, or infection........................................................................... 6<br />
Injuries occurring between 1 August 2008 and 30 June 2010...........................................6<br />
Injuries occurring before 1 August 2008, or after 1 July 2010............................................6<br />
Date on which a work-related gradual process injury suffered.........................................7<br />
Non work-related...............................................................................................................................7<br />
Work-related mental injury............................................................................................ 7<br />
Date on which work-related mental injury suffered............................................................. 8<br />
MONETARY ENTITLEMENTS............................................................................. 8<br />
Claimant’s responsibilities............................................................................................. 8<br />
First week compensation................................................................................................ 8<br />
Entitlement to weekly compensation........................................................................... 9<br />
Entitlement where claimant no longer employee...................................................... 10<br />
Calculation of weekly earnings.................................................................................... 10<br />
Shareholder employees.................................................................................................11<br />
Treatment costs..............................................................................................................11<br />
Lump sum compensation............................................................................................. 12<br />
Holiday entitlements.................................................................................................... 13<br />
Public (statutory) holidays............................................................................................................ 13<br />
Sick Leave........................................................................................................................................... 13<br />
Annual holidays................................................................................................................................ 13<br />
REHABILITATION.............................................................................................. 13<br />
Employer’s obligation................................................................................................... 13<br />
Individual rehabilitation plan...................................................................................... 13<br />
Social rehabilitation...................................................................................................... 14<br />
Vocational rehabilitation.............................................................................................. 15<br />
Matters considered in providing vocational rehabilitation...................................... 15<br />
Initial occupational assessment................................................................................... 16<br />
Medical assessor............................................................................................................ 16<br />
Changing circumstances................................................................................................17<br />
2
VOCATIONAL INDEPENDENCE....................................................................... 17<br />
Assessment.....................................................................................................................17<br />
If vocational independence is established..............................................................................17<br />
If vocational independence is lost............................................................................................. 18<br />
DISENTITLEMENTS.......................................................................................... 18<br />
Wilfully inflicted injuries............................................................................................... 18<br />
CLAIMS PROCESS............................................................................................. 18<br />
DISPUTE RESOLUTION.................................................................................... 19<br />
How to apply for a review............................................................................................. 19<br />
Once a review application is received......................................................................... 20<br />
Costs on review.............................................................................................................. 22<br />
APPEALS............................................................................................................ 22<br />
Bringing an appeal........................................................................................................ 22<br />
Further appeals............................................................................................................. 23<br />
LEVIES............................................................................................................... 23<br />
Experience rating.......................................................................................................... 24<br />
No-Claims Discount Programme............................................................................................... 24<br />
Experience Rating Programme................................................................................................... 24<br />
Classification for levy purposes................................................................................... 25<br />
Risk adjustment of employer levies............................................................................. 25<br />
Criteria for upward adjustment of levies.................................................................... 25<br />
Workplace safety management practices (WSMP)..................................................... 26<br />
<strong>ACC</strong> Workplace Safety Discount Programme.............................................................. 26<br />
WORK <strong>ACC</strong>OUNT.............................................................................................. 27<br />
Promotion of employer involvement.......................................................................... 27<br />
<strong>ACC</strong>REDITED EMPLOYERS............................................................................... 27<br />
Reporting and information.......................................................................................... 28<br />
COVER FOR NON-WORK RELATED PERSONAL INJURY................................29<br />
Earners’ account............................................................................................................ 29<br />
Non-earners’ account................................................................................................... 29<br />
Motor vehicle account.................................................................................................. 29<br />
Treatment injury account............................................................................................. 29<br />
3
CODE OF <strong>ACC</strong> CLAIMANT’S RIGHTS...............................................................29<br />
TERMINATION OF EMPLOYMENT...................................................................30<br />
DEFINITIONS....................................................................................................30<br />
Accident.......................................................................................................................... 30<br />
Employee....................................................................................................................... 30<br />
Employer.........................................................................................................................31<br />
Incapacity........................................................................................................................31<br />
Personal injury...............................................................................................................31<br />
Place of employment.................................................................................................... 32<br />
<strong>ACC</strong> AS A NO FAULT SYSTEM.......................................................................... 32<br />
APPENDIX......................................................................................................... 33<br />
Occupational diseases.................................................................................................. 33<br />
4
BACK<br />
INTRODUCTION<br />
New Zealand has had a system of 24-hour no-fault cover for accidents since the first<br />
Accident Compensation Act came into force in <strong>April</strong> 1974. A number of statutes have<br />
followed this initial legislation, all focusing on the word ‘accident’. The new Act changes<br />
that focus while retaining the original administering body, the Accident Compensation<br />
Corporation (‘the Corporation’). Under the Accident Compensation Act 2001 much more<br />
than in the past the emphasis is on preventing injury and, if an accident injury does occur,<br />
on rehabilitating the injured person. With injured employees, the aim, if at all possible, is<br />
to get them back to work as soon as practicable.<br />
WORK-RELATED<br />
PERSONAL INJURY<br />
A work-related personal injury is one that occurs to<br />
an employee while:<br />
• he or she is at any place for the purposes<br />
of his or her employment, including, for<br />
example, a place that itself moves or a place<br />
to or through which the claimant moves; or<br />
• while he or she is having a break from<br />
work for a meal or rest or refreshment<br />
at his or her place of employment.<br />
If an employee is off work because of the injury,<br />
the employer in whose employment the injury<br />
occurred must, for the first week of incapacity, pay<br />
80 per cent of all lost earnings as earnings-related<br />
compensation. This includes 80 per cent of earnings<br />
lost from any other job the employee might hold.<br />
Later entitlements are funded by an employer levy<br />
payable into a Work Account. It is irrelevant to the<br />
decision whether the person suffered a work-related<br />
personal injury that, when the event causing the<br />
injury occurred, he or she:<br />
• may have been acting in contravention of<br />
any Act or regulations applicable to the<br />
employment, or in contravention of any<br />
instructions, or in the absence of instructions; or<br />
• may have been working under<br />
an illegal contract; or<br />
• may have been indulging in, or may<br />
have been the victim of, misconduct,<br />
skylarking, or negligence; or<br />
• may have been the victim of a force of nature.<br />
Motor vehicle injuries<br />
WORK-RELATED<br />
Work-related personal injuries involving the use of a<br />
motor vehicle are those that occur:<br />
• at the start or finish of the day’s work<br />
when employees are being driven by<br />
their employer, or by another employee,<br />
in employer-provided transport;<br />
• to an employee who is travelling by the most<br />
direct practicable route between the workplace<br />
and some other place to obtain treatment<br />
needed for a work-related personal injury. The<br />
subsequent injury will not be classified as workrelated<br />
if the route taken interrupts, or deviates<br />
unreasonably from the journey for purposes<br />
unrelated to the employment or treatment.<br />
NON WORK-RELATED<br />
Motor vehicle injuries not classified as work-related<br />
(but which nevertheless carry an entitlement to<br />
first-week earnings-related compensation from the<br />
employer) occur in circumstances where:<br />
• the employee’s ‘place of work’ is a place that<br />
itself moves or through which the claimant<br />
moves. An example of an injury in a ‘place<br />
that itself moves’ would be injury to a bus or<br />
taxi driver. A supermarket employee run over<br />
while collecting trolleys from the supermarket<br />
car park would be an example of an injury in<br />
a place through which the claimant moves;<br />
• an employee is at work but is having a<br />
break from work for rest or refreshment.<br />
5
BACK<br />
Except for first week compensation, these kinds<br />
of motor vehicle accident injuries will be funded<br />
from the Motor Vehicle Account, not from the Work<br />
Account (see under ‘Motor Vehicle Account’ heading).<br />
Heart attacks and strokes<br />
Cardio-vascular or cerebro-vascular episodes (heart<br />
attacks or strokes) are work-related if caused by<br />
physical effort or physical strain experienced by the<br />
employee in the course of employment. The physical<br />
effort or strain will be excessive or abnormal for the<br />
particular employee, even though another employee<br />
would not have found it too great.<br />
Medical treatment of<br />
work-related injury<br />
Treatment for a work-related injury where the<br />
treatment results in an injured employee suffering<br />
further injury, (the injury is a treatment injury as<br />
per section 32), will also be treated as a work injury.<br />
This not only applies to hospital treatment but to<br />
treatment given by any registered health professional<br />
such as an occupational health nurse acting in the<br />
workplace on the employer’s behalf.<br />
Gradual process, disease,<br />
or infection<br />
Gradual process, disease, or infection resulting in<br />
injury will be work-related if the employment involves<br />
or used to involve exposure to certain agents, dust,<br />
compounds, substances or radiation, and the disease<br />
contracted is one of the occupational diseases listed in<br />
Schedule 2 of the Act (set out in the appendix to these<br />
guidelines). It will also be work related if the employee<br />
is employed in an occupation, industry, or process<br />
described in Schedule 2. An employee who contracts<br />
such a disease while working (or having worked) in an<br />
industry or occupation where listed substances are<br />
used, or where the disease is known to occur, does<br />
not have to establish that it was caused by the work<br />
performed (see below). The fact that the employee<br />
worked in such circumstances is sufficient to put the<br />
disease into the ‘work-related’ category. Under section<br />
30(4A) cover will only exist if the exposure occurred in<br />
New Zealand or the person was ordinarily resident in<br />
New Zealand when the exposure occurred.<br />
Other gradual process injuries and infections need<br />
to meet certain criteria to be considered work related.<br />
There are two different tests, depending on when the<br />
injury occurred.<br />
INJURIES OCCURRING BETWEEN 1 AUGUST<br />
2008 AND 30 JUNE 2010<br />
The employment task must have (or have had) a<br />
particular property or characteristic causing, or<br />
contributing to the cause of the personal injury. For<br />
the period between 1 August 2008 and 30 June 2010,<br />
the claimant must establish that it is more likely the<br />
personal injury was caused by the employment tasks<br />
or environment, than by their non-employment<br />
activities or environment.<br />
However, despite that threshold being reached,<br />
the Corporation has the discretion to decline the<br />
claim if the Corporation establishes the risk of<br />
suffering the personal injury is not significantly<br />
greater for persons who:<br />
• perform that employment task than<br />
for persons who do not, or<br />
• are employed in that type of environment<br />
than for persons who are not<br />
INJURIES OCCURRING BEFORE 1 AUGUST<br />
2008, OR AFTER 1 JULY 2010<br />
For gradual process injuries which occurred before<br />
1 August 2008, or after 1 July 2010, a more stringent<br />
test must be satisfied for the injury to be considered<br />
work related. There is the same requirement that the<br />
employment task must have (or have had) a particular<br />
property or characteristic causing, or contributing to<br />
the cause of, the personal injury. However this must<br />
be a property or characteristic not found to any great<br />
extent in employee’s non-employment activities<br />
or environment. For the gradual process injury to<br />
be considered work related it must be shown that<br />
the risk of suffering the gradual process injury is<br />
significantly greater for persons who:<br />
• perform that employment task than<br />
for persons who do not, or<br />
• are employed in that type of environment<br />
than for persons who are not.<br />
Injuries that can be attributed to workplace airconditioning<br />
systems and passive smoking are<br />
classified as work-related gradual process injuries.<br />
6
BACK<br />
An employee who deliberately misinforms the<br />
employer about previous occupational deafness<br />
still retains coverage if hearing is further damaged.<br />
DATE ON WHICH A WORK-RELATED<br />
GRADUAL PROCESS INJURY SUFFERED<br />
The date when a work-related personal injury is<br />
suffered will be the earlier of the date when:<br />
• treatment is first received from either<br />
a registered medical practitioner<br />
or nurse practitioner; or<br />
• the injury first results in incapacity.<br />
For gradual process injuries suffered before 1 <strong>April</strong><br />
1974, the injured person will be regarded as having<br />
suffered the injury on a date later than 1 July 1992,<br />
determined as above.<br />
NON WORK-RELATED<br />
Personal injury caused by a work-related gradual<br />
process, disease, or infection does not include:<br />
• personal injury related to non-physical stress.<br />
(A mental (non-physical) injury resulting from<br />
one of the criminal acts (mostly of a sexual<br />
nature) listed in Schedule 3 of the Act is covered<br />
and, if the criminal act occurred at work, could<br />
be classified as work-related. However in<br />
such a case, the person suffering the mental<br />
injury can choose, for privacy reasons, to have<br />
the injury regarded as a non-work injury.)<br />
• any degree of deafness for which<br />
compensation has been paid under the<br />
Workers’ Compensation Act 1956;<br />
• an injury occurring to someone who, before<br />
1 <strong>April</strong> 1974, worked outside New Zealand<br />
at a job or in an environment conducive<br />
to the development of a gradual process<br />
injury and was not ordinarily resident in<br />
New Zealand at the time (even if ordinarily<br />
resident when the injury was ‘suffered’);<br />
• an injury occurring to someone who, before 1<br />
<strong>April</strong> 1974, worked at a task or in an environment<br />
conducive to the development of a gradual<br />
process injury, but who died before 1 July 1992.<br />
The Minister responsible for the Act’s administration<br />
may appoint an expert advisory panel on gradual<br />
process, disease, or infection to give advice on<br />
whether the Act’s occupational disease schedule<br />
should be amended, on how gradual process<br />
claims should be dealt with, and on the definition<br />
of gradual process injury.<br />
Work-related mental injury<br />
A person will have cover for a personal injury that is<br />
a work-related mental injury suffered on or after 1<br />
October 2008 if they meet certain criteria.<br />
To obtain cover the person must have actually<br />
suffered a mental injury. Mental injury is defined<br />
in the Act as a clinically significant behavioural,<br />
cognitive or psychological dysfunction. The mental<br />
injury must also be caused by a single event in the<br />
following circumstances:<br />
• The person experiences, sees, or<br />
hears that event directly; and<br />
• They must experience the event in<br />
circumstances which deem an accident to<br />
be work-related (See under ‘Work-related<br />
personal injuries’. These are injuries incurred<br />
while working in a place that itself moves<br />
or through which the employee moves, or<br />
while having a break from work for rest or<br />
refreshment at the place of employment); and<br />
• The event could reasonably be expected to<br />
cause mental injury to people generally; and<br />
• The event must have occurred in New<br />
Zealand, or outside New Zealand to a<br />
person who is ordinarily resident in New<br />
Zealand at the time the event occurred.<br />
For the person to have experienced, seen, or heard<br />
the event directly the person must have been<br />
involved in or witnessed the event and have been<br />
in close physical proximity to the event. A person<br />
will not be considered to have experienced, seen or<br />
heard an event directly if they absorbed it through<br />
a secondary source, such as through television, the<br />
media, radio or the telephone.<br />
7
BACK<br />
To meet the circumstances for obtaining cover<br />
an ‘event’ is described as:<br />
• An event that is sudden; or<br />
• A direct outcome of a sudden event; or<br />
• A series of events that arise from the<br />
same cause or circumstance and together<br />
comprise a single incident or occasion<br />
A gradual process is excluded from being<br />
considered an ‘event’.<br />
DATE ON WHICH WORK-RELATED MENTAL<br />
INJURY SUFFERED<br />
The date on which the work-related mental<br />
injury will be considered to have been suffered<br />
will be the date on which the person first receives<br />
treatment for that injury.<br />
MONETARY ENTITLEMENTS<br />
Monetary entitlements provided under the Act are:<br />
• employer-paid first week compensation;<br />
• weekly compensation after the first week;<br />
• lump sum compensation for<br />
permanent impairment;<br />
• funeral grants, survivors’ grants, weekly<br />
compensation for the surviving spouse,<br />
children and other dependants, and<br />
child care payments, where a claimant<br />
dies as the result of a personal injury.<br />
Injured employees are also entitled to rehabilitation,<br />
comprising treatment and, where necessary, social<br />
and vocational rehabilitation. Entitlements for workrelated<br />
personal injuries are funded by a levy on<br />
employers which is paid into a Work Account.<br />
Claimant’s responsibilities<br />
A claimant who has received any entitlement, if<br />
reasonably asked to do so by the Corporation, must:<br />
• provide a certificate from a registered health<br />
professional or treatment provider;<br />
• provide any other information required;<br />
• authorise the Corporation to obtain medical<br />
and other information relevant to the claim;<br />
• be assessed, at the Corporation’s expense,<br />
by a registered health professional<br />
specified by the Corporation;<br />
• undergo assessment at the<br />
Corporation’s expense;<br />
• co-operate with the Corporation in the<br />
development and implementation of an<br />
individual rehabilitation plan, where necessary;<br />
• have present and likely capabilities<br />
assessed for rehabilitation purposes,<br />
at the Corporation’s expense;<br />
• participate in rehabilitation;<br />
• provide a written statement about any<br />
matters relating to any entitlement.<br />
(The Corporation may ask for this in the<br />
form of a statutory declaration.)<br />
First week compensation<br />
Anyone who was employed immediately before being<br />
incapacitated as the result of a work-related personal<br />
injury is entitled to 80 per cent of all earnings lost<br />
during the first week of incapacity. This first week<br />
payment will be paid by the employer at whose<br />
workplace the injury occurred. The Corporation<br />
pays any subsequent weekly earnings-related<br />
compensation except where an employer has chosen<br />
to become an ‘accredited employer’. Again payment<br />
is at the rate of 80 per cent of previous earnings (see<br />
under ‘Calculation of weekly earnings’ for the way in<br />
which these are calculated) but to a set maximum.<br />
The employer is liable to pay all the first week<br />
compensation for a work-related personal injury,<br />
including one suffered in a motor vehicle accident<br />
which, though not classified as work-related,<br />
carries an entitlement to employer-paid first week<br />
compensation. (See under ‘Work-related personal<br />
injuries’. These are injuries incurred while working in a<br />
place that itself moves or though which the employee<br />
moves, or while having a break from work for rest or<br />
refreshment at the place of employment). In all other<br />
respects such injuries will come into the motor vehicle<br />
category and be paid for from the Motor Vehicle<br />
Account. To challenge a decision by <strong>ACC</strong> that an<br />
injury is work-related, an employer should follow the<br />
disputes resolution process outlined later in this guide.<br />
8
BACK<br />
The employer at whose workplace the injury<br />
occurred also pays 80 per cent of any earnings<br />
the employee has lost from any other job, if the<br />
employee has more than one job.<br />
In calculating first week compensation it is presumed<br />
that the amount lost because of incapacity is the<br />
difference between earnings in the 7 days before the<br />
incapacity commenced and earnings in the first week<br />
of incapacity. For example, if an employee earned<br />
$500 in the 7 days prior to incapacity and $100 in the<br />
week of incapacity, the amount lost, and therefore<br />
payable by the employer, is 80 per cent of $400.<br />
However, this presumption can be rebutted by proof<br />
to the contrary, as in the case of a shift worker injured<br />
on the first day of a new shift after several days when<br />
not required to work. Earnings in the previous seven<br />
days will be less than the employee would normally<br />
receive, making the presumption inappropriate.<br />
Evidence of the employee’s situation will rebut<br />
the presumption so that first week compensation<br />
can then be calculated as 80 per cent of shift work<br />
earnings. Similarly, a part-time employee may not<br />
have worked and earned as much as usual in the 7<br />
days prior to incapacity. Here, too, evidence of the<br />
employee’s usual pattern of earnings can be used to<br />
rebut the presumption.<br />
Before paying first week compensation the<br />
employer may reasonably require the employee<br />
to produce independent evidence of the personal<br />
injury, for example, by providing a certificate from<br />
a registered health professional whom the employer<br />
nominates and pays for.<br />
The term registered health professional covers:<br />
chiropractors, clinical dental technicians, medical<br />
laboratory technologists, medical radiation<br />
technologists, midwives, nurses, occupational<br />
therapists, optometrists, pharmacists,<br />
physiotherapists, podiatrists, and registered<br />
medical practitioners all of whom can provide<br />
initial certificates of injury. However, for some later<br />
purposes, for example, when the Corporation is<br />
determining whether someone is incapacitated<br />
for work (see below), the employee will need to get<br />
a certificate from a registered medical practitioner<br />
or nurse practitioner.<br />
First week compensation is payable for the purposes<br />
of the Act itself, the Income Tax Act, the Tax<br />
Administration Act, the laws relating to insolvency,<br />
receivership and the liquidation of companies, and<br />
section 131 of the Employment Relations Act (relating<br />
to wage arrears).<br />
It is an offence for an employer not to pay first week<br />
compensation. The maximum fine is $500.<br />
Entitlement to weekly compensation<br />
Weekly compensation is payable to any eligible<br />
person who was an earner when the personal injury<br />
was suffered or who was on unpaid parental leave.<br />
To determine eligibility the Corporation must decide<br />
whether the injured employee cannot, because of<br />
the injury, continue to do the work he or she was<br />
doing when the injury occurred. An employee who<br />
cannot continue is considered ‘incapacitated’ for<br />
employment. This also applies to self-employed<br />
people and to anyone who has applied to purchase<br />
weekly compensation while still employed, or within<br />
one month of ceasing employment, to cover a period<br />
when not employed—as anyone continuously<br />
employed for the previous 12 months is entitled to do.<br />
In determining incapacity, the Corporation must<br />
consider a registered medical practitioners or<br />
nurse practitioner’s assessment. It may also obtain<br />
professional, technical, specialised, or other advice<br />
from some other appropriate person.<br />
The Corporation may from time to time reconsider<br />
the situation of an employee who is receiving weekly<br />
compensation. If it decides the employee is no longer<br />
incapacitated, entitlement to weekly compensation<br />
will be lost three months after the Corporation has<br />
notified the employee of its decision.<br />
9
BACK<br />
Entitlement where claimant no<br />
longer employee<br />
If a claimant was no longer employed before the<br />
incapacity commenced, they will be deemed to be<br />
an employee, for a short time, for the purposes of<br />
entitlement to weekly compensation. That period is<br />
the longer of:<br />
• 28 days from the date of ceasing to be an<br />
employee, if employed within 28 days before the<br />
incapacity commenced and would have been<br />
employed within three months of the incapacity<br />
commencing, but for the incapacity; or<br />
• the period for which the earner levy is payable<br />
on earnings to which there is entitlement<br />
when employment ceases (i.e. outstanding<br />
holiday pay). Here the ‘employee’ is deemed<br />
to be deriving earnings at the same rate as<br />
immediately before employment ceased.<br />
• In the case of seasonal employment, appropriate<br />
entitlements will be available if the claimant:<br />
• would have been an employee within 12<br />
months of the incapacity commencing; and<br />
• was employed by the same employer in<br />
the two seasons prior to incapacity; and<br />
• The employer confirms that the claimant<br />
could reasonably have expected to be<br />
re-employed in the season after the<br />
claimant’s incapacity commenced.<br />
In the above situations, the start of incapacity for<br />
weekly earnings calculation purposes is deemed to<br />
be the last date of employment, although entitlement<br />
will run from the date of injury.<br />
The employer has no obligation to pay first week<br />
compensation but the Corporation will subsequently<br />
pay weekly earnings compensation, if required.<br />
Payments will come from the Earners’ Account,<br />
Motor Vehicle Account, or Treatment injury Account,<br />
depending on circumstances.<br />
For an employee on parental leave any personal<br />
injury incapacity is deemed, for calculation purposes,<br />
to date from the day on which the leave began.<br />
This means that a claimant is entitled to weekly<br />
compensation for loss of earnings equivalent to<br />
what was earned immediately before going on leave.<br />
However, the commencement date for entitlement<br />
to payment is the date on which the claimant would<br />
otherwise have been required to return to work when<br />
the leave period ends. In other words, no earningsrelated<br />
payment is available for the leave period itself.<br />
Unless the personal injury is a motor vehicle injury,<br />
treatment injury, or work-related personal injury (such<br />
as a gradual process injury), payments will come from<br />
the Earners’ Account.<br />
Calculation of weekly earnings<br />
Calculation of weekly earnings for a permanent<br />
employee immediately before the commencement<br />
of incapacity:<br />
The Corporation will regard an employee as having<br />
been in permanent employment if, in its opinion, the<br />
employee would have continued to receive earnings<br />
from the employment for more than 12 months after<br />
the incapacity commenced but for suffering the<br />
personal injury. This is the case with every job if an<br />
employee has more than one employer.<br />
For the first four weeks after the first week of<br />
incapacity (the first week being paid by the<br />
employer): weekly earnings are calculated by<br />
dividing earnings in the four weeks immediately<br />
preceding incapacity by the number of full or part<br />
weeks during which they were earned.<br />
After four weeks: weekly earnings are calculated<br />
by dividing earnings in the 52 weeks immediately<br />
preceding incapacity by the number of full or part<br />
weeks during which they were earned.<br />
In calculating weekly earnings, any period<br />
during which the claimant was entitled to weekly<br />
compensation, and any earnings in respect of any<br />
such period, must not be counted.<br />
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If an employee was in permanent, full-time<br />
employment immediately prior to incapacity, but<br />
was previously employed by the same employer<br />
for less than 30 hours a week: weekly earnings will<br />
be the greater of:<br />
• earnings calculated as above; or<br />
• weekly earnings calculated as if the employee<br />
was not in permanent employment immediately<br />
before his or her incapacity commenced. The<br />
first four weeks prior to incapacity are divided<br />
by the number of full or part weeks during<br />
which the earnings were earned to determine<br />
earnings for the 4-week period. Then for any<br />
subsequent period, all earnings in the 52<br />
weeks prior to incapacity are divided by 52<br />
or by any smaller number that might apply.<br />
A smaller number will apply if at any time<br />
during the 52 weeks the employee received<br />
weekly compensation and/or had more than<br />
one week’s continuous period of unpaid sick<br />
leave (such weeks must not be counted in<br />
working out the payment entitlement).<br />
Someone previously employed who suffers an<br />
incapacity but who would not have been expected<br />
to work continuously for a further 12-month period<br />
if the incapacity had not happened, is considered not<br />
to have been in permanent employment immediately<br />
before incapacity commenced. Earnings in such<br />
cases are calculated as set out under the second<br />
bullet point above. This would apply to employees<br />
in fixed term employment.<br />
For certain low-income earners in full-time<br />
employment prior to incapacity special provision<br />
is made in Schedule 1 of the Act for an increase in<br />
weekly earnings. The increase (if an amount has<br />
not been set in regulations made under the Act) is<br />
to the greater of:<br />
• the relevant minimum wage under<br />
the Minimum Wage Act; or<br />
• 125 percent of the relevant rate of invalids<br />
benefit under the Social Security Act, if the<br />
employee remains incapacitated five weeks<br />
from the commencement of incapacity.<br />
Shareholder employees<br />
Shareholder employees may purchase weekly<br />
compensation and if they do, their employer is not<br />
required to pay the Work Account levy in respect<br />
of their earnings. However, this does not affect the<br />
employer’s obligation to pay the portion of the Work<br />
Account levy that is payable in respect of the earnings<br />
of that employee. The Act sets out the way in which<br />
weekly compensation is to be calculated where this is<br />
payable to a shareholder employee.<br />
Treatment costs<br />
The Corporation must pay the cost of treatment<br />
necessary to restore an injured employee’s health<br />
to the maximum extent practicable, but must first<br />
agree what treatment will be provided. Without<br />
prior agreement, the Corporation is not liable to pay<br />
treatment costs, except in the case of an emergency<br />
where acute treatment is required.<br />
Treatment must be necessary and appropriate and<br />
of the required quality. It must be carried out at an<br />
appropriate time and place by a qualified person who<br />
normally does provide that kind of treatment, but not<br />
for any longer time than is necessary to restore health.<br />
In deciding whether or not to pay for treatment, the<br />
Corporation must take into account the nature and<br />
severity of the injury and what, in New Zealand, is<br />
the generally accepted treatment for an injury of<br />
that kind. It must also consider any other available<br />
options, together with the cost of the usual means<br />
of treatment and that of other options compared<br />
with the likely benefit to the injured employee. The<br />
Corporation must pay for any ancillary service that<br />
will assist an employee to obtain treatment. The term<br />
‘ancillary service’ covers things like accommodation,<br />
transport, transport escort for treatment, prescribed<br />
pharmaceuticals, and laboratory tests.<br />
The Corporation may ask injured employees to<br />
supply information about their injury and about the<br />
treatment they want, and unless the information is<br />
provided, may refuse to pay the costs of treatment.<br />
It must not, however, refuse to pay because the<br />
injured employee declines to pay any part of the<br />
treatment provider’s fee that the Corporation is<br />
liable to pay, or because the injured employee has<br />
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not agreed to go to a particular treatment provider.<br />
However, if a treatment provider charges more than<br />
the Corporation is liable to pay, the Corporation is not<br />
required to meet the extra charge. The Corporation<br />
can refuse to pay if the employee does not agree<br />
to go to a particular treatment provider and the<br />
treatment is an assessment required under the Act<br />
or is a second opinion.<br />
From 16 November 2009 the free physiotherapy<br />
services through the Endorsed Provider Network<br />
is longer be available. <strong>ACC</strong> pays approximately<br />
one third less to physiotherapists for consultations<br />
with <strong>ACC</strong> clients. Under this client co-charging<br />
scheme, <strong>ACC</strong> reduces the amount which they pay<br />
for treating accident victims. Physiotherapists are<br />
able to charge <strong>ACC</strong> clients a co-payment towards<br />
their consultation fees.<br />
In helping an injured employee to choose a treatment<br />
provider, the Corporation can advise that treatment<br />
from a named provider will mean contributing less, or<br />
paying nothing more, towards the cost of treatment.<br />
If acute treatment has to be given somewhere other<br />
than in a public hospital, an injured employee (or any<br />
claimant) does not have to pay for treatment to which<br />
he or she is entitled.<br />
Where an appropriately qualified treatment<br />
provider decides that treatment requires an acute<br />
admission this must be to a public hospital unless<br />
the Corporation agrees to a private hospital or other<br />
non-publicly funded institution. Prior agreement is<br />
not required if, for clinical safety reasons, treatment<br />
by a publicly funded provider is not practicable.<br />
Lump sum compensation<br />
Lump sum compensation payments relate only to<br />
injuries suffered after 1 <strong>April</strong> 2002 and are not payable<br />
for an injury suffered before that date, or for the<br />
subsequent consequences of such an injury. Lump<br />
sum compensation will be payable if the claimant has<br />
cover under the Act, has survived the injury for not<br />
less than 28 days, and is alive when an assessment for<br />
eligibility purposes is carried out. Eligibility depends<br />
on an assessment establishing a degree of wholeperson<br />
impairment of 10 per cent or more. Payments<br />
under the Act range from $2,500 for 10 per cent<br />
impairment to $100,000 for impairment of 80 per cent<br />
or more. However these rates are subject to change<br />
as they are indexed to the Consumer Price Index. The<br />
sums are reviewed by <strong>ACC</strong> each year to take inflation<br />
into account. Annual changes to lump sum payments<br />
take effect from 1 July each year. Current lump sum<br />
figures can be obtained by contacting <strong>ACC</strong>.<br />
In relation to work-related gradual process injuries,<br />
there is no entitlement to a lump sum payment if<br />
one of the following dates preceded 1 <strong>April</strong> 2002.<br />
The date on which:<br />
• the person last performed the particular task or<br />
was employed in the particular environment;<br />
• treatment was first received for that<br />
particular personal injury.<br />
Someone who suffers a mental injury caused by an<br />
act to which the Crimes Act applies is not entitled<br />
to lump sum compensation if the act last occurred<br />
before 1 <strong>April</strong> 2002.<br />
An acute admission means an admission within<br />
seven days of an appropriately qualified provider<br />
deciding to admit.<br />
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Holiday entitlements<br />
PUBLIC (STATUTORY) HOLIDAYS<br />
If a public holiday falls in the first week following a<br />
work-related accident the employer must pay for<br />
the holiday at the appropriate rate (80 per cent of<br />
earnings for the 7 days’ prior to incapacity). In the<br />
first week of a non-work related injury an employee<br />
will be entitled to payment for a public holiday if<br />
it falls on a day that would otherwise have been<br />
a working day for the employee. After the first<br />
week, payment for public holidays becomes the<br />
Corporation’s responsibility.<br />
SICK LEAVE<br />
An employee may use sick leave in the first week of<br />
incapacity for a non-work related injury. An employer<br />
cannot require an employee to take sick leave during<br />
the first week of employer paid compensation for a<br />
work-related injury or while on weekly compensation<br />
with <strong>ACC</strong>. However, if an employer pays the difference<br />
between the employee’s first week compensation or<br />
weekly compensation from <strong>ACC</strong> and their ordinary<br />
weekly pay, the employer may agree with the<br />
employee that he or she may deduct from the<br />
employee’s current sick leave entitlement, one day<br />
for every five whole days that the employer makes<br />
that payment.<br />
ANNUAL HOLIDAYS<br />
Continuous employment under the Holidays<br />
Act 2003 for the purposes of ascertaining an<br />
employee’s entitlement to annual leave, includes<br />
a period during which an employee is receiving<br />
weekly compensation from <strong>ACC</strong>. Unless and until<br />
employment is terminated, injured workers remain<br />
employees and their entitlement to annual leave is<br />
not affected by their absence.<br />
An employee will continue to accrue annual leave<br />
while they are away on <strong>ACC</strong>. They will acquire the<br />
full 4 weeks’ entitlement when their anniversary<br />
date arises, whether or not they are on <strong>ACC</strong> leave<br />
at the time of the anniversary. See the A-Z Guide to<br />
Annual Holidays for further information.<br />
REHABILITATION<br />
Anyone (including an injured employee) suffering<br />
a personal injury for which he or she has cover is<br />
entitled to rehabilitation provided by the Corporation<br />
to assist in restoring health, independence, and<br />
participation, to the maximum extent practicable. At<br />
the same time, individuals, to the extent practicable<br />
having regard to the consequences of their particular<br />
injury, are responsible for their own rehabilitation.<br />
Employer’s obligation<br />
If the Corporation decides it is reasonably practicable<br />
to return an injured employee to the same job he<br />
or she had prior to incapacity, and with the same<br />
employer, it must give the employer written notice<br />
of its decision. The employer must then take all<br />
practicable steps to assist the injured employee<br />
with vocational rehabilitation under his or her<br />
individual rehabilitation plan.<br />
When determining what is meant by all ‘practicable<br />
steps’ (although, ultimately, this will be a matter for<br />
the courts to decide) employers will need to consider<br />
the following factors:<br />
• the nature and consequence of the injury;<br />
• the achievement of rehabilitation outcomes;<br />
•cost; <br />
•cost effectiveness;<br />
• the availability of other forms<br />
of rehabilitation; and<br />
• any other relevant factors.<br />
Individual rehabilitation plan<br />
Within 13 weeks of accepting an injured employee’s<br />
claim for cover, the Corporation must determine<br />
whether a social or vocational rehabilitation plan<br />
will be necessary after the 13 weeks are up. If so, the<br />
Corporation must prepare an individual rehabilitation<br />
plan in consultation with the injured employee (or any<br />
other claimant).<br />
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The Corporation must provide an injured employee<br />
with information about:<br />
• rehabilitation to which there may be entitlement;<br />
• the plan development process; and<br />
• the employee’s right to have a representative<br />
involved in preparing the plan; and<br />
• the Corporation’s right to require an<br />
assessment of vocational independence<br />
when vocational rehabilitation is completed,<br />
and the potential consequences of such<br />
an assessment (that is, where the plan<br />
includes vocational rehabilitation); and<br />
• the potential consequences of agreeing<br />
to the rehabilitation plan.<br />
In preparing an individual rehabilitation plan the<br />
Corporation must assess the need for rehabilitation<br />
to assist in restoring independence, maintaining or<br />
obtaining employment, or regaining or acquiring<br />
vocational independence. The plan itself must:<br />
• identify rehabilitation needs;<br />
• identify the assessments to be done;<br />
• identify the service or services appropriate<br />
to needs, and whether the Corporation is<br />
liable to provide any or all of these; and<br />
• specify which services the Corporation<br />
will provide, pay for, or contribute to.<br />
The Corporation must assess whether there is a<br />
need for social and vocational rehabilitation, but<br />
does not have to assess a need solely related to<br />
maintaining employment.<br />
Even though an injured employee does not agree<br />
to a plan, the Corporation can advise that the plan<br />
has been finalised and is to be regarded as if the<br />
employee had agreed to it. When finalised, the<br />
Corporation must implement the plan, although the<br />
injured employee can seek a review of its decision.<br />
The Corporation and the employee may also agree<br />
to modify the plan.<br />
To the extent that they are willing and able to<br />
do so, the following persons must be given the<br />
opportunity to participate in the preparation and<br />
costing of a plan (although costs of preparation<br />
are met by the Corporation):<br />
• the injured employee;<br />
• any registered medical practitioner<br />
who is providing treatment;<br />
• any employer or potential employer.<br />
The Corporation must provide rehabilitation<br />
in accordance with any agreed individual<br />
rehabilitation plan, but only to the extent that<br />
it has specified which services it will provide.<br />
Individual rehabilitation plans must be updated<br />
from time to time to reflect the outcome of an<br />
employee’s progress, based on assessments that<br />
have been carried out.<br />
Social and vocational rehabilitation (see below) may<br />
be provided before any assessment of entitlement<br />
has been undertaken or completed, or before the<br />
Corporation starts or concludes its consideration<br />
of the matters it must otherwise take into account<br />
in considering whether to provide vocational<br />
rehabilitation. In other words, social and vocational<br />
rehabilitation may be begun before the Corporation<br />
has complied with official requirements.<br />
Social rehabilitation<br />
Before an individual rehabilitation plan is agreed on,<br />
the Corporation must provide any social rehabilitation<br />
considered suitable and necessary to help restore<br />
independence to the maximum extent practicable.<br />
Social rehabilitation covers matters such as aids and<br />
appliances, attendant care, child care, home help and<br />
modifications to the home, training and transport for<br />
independence and so on. The Corporation must also<br />
provide any necessary vocational rehabilitation.<br />
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Vocational rehabilitation<br />
The purpose of vocational rehabilitation is<br />
to help an incapacitated employee maintain<br />
employment, obtain employment, or regain<br />
or acquire vocational independence. The<br />
employment must be suitable for the particular<br />
employee and appropriate to the employee’s levels<br />
of training and experience (an injured pianist cannot<br />
be expected to work in a factory).<br />
The Corporation must provide vocational<br />
rehabilitation to an employee who has suffered<br />
a workplace injury and is entitled to weekly<br />
compensation, or who, without vocational<br />
rehabilitation, is likely to be entitled to weekly<br />
compensation, or who is on parental leave.<br />
Vocational rehabilitation must be provided for the<br />
minimum period to achieve its purpose, generally this<br />
cannot be for longer than three years (not necessarily<br />
consecutive). However the Corporation does have the<br />
discretion to extend the vocational rehabilitation for<br />
longer than three years if they consider that:<br />
• the vocational rehabilitation would be likely<br />
to achieve its purpose under the claimants<br />
individual rehabilitation plan; and<br />
• the rehabilitation would be cost-effective when<br />
balanced against the cost of entitlements<br />
under the Act which may be reduced by the<br />
provision of the vocational rehabilitation; and<br />
• the vocational rehabilitation would be<br />
appropriate in the circumstances.<br />
An assessment of an injured employee’s vocational<br />
rehabilitation needs must consist of:<br />
• an initial occupational assessment to<br />
identify appropriate types of work; and<br />
• an initial medical assessment to determine<br />
whether the types of work identified are,<br />
or are likely to be, suitable for the injured<br />
employee from a medical point of view.<br />
Assessors who carry out assessments must be<br />
people the Corporation considers have the necessary<br />
qualifications and experience to do so.<br />
Matters considered in providing<br />
vocational rehabilitation<br />
In deciding whether vocational rehabilitation is<br />
appropriate to achieve its purpose, the Corporation<br />
must consider whether it is reasonably practicable to:<br />
• return the injured employee to his<br />
or her previous employment with<br />
the same employer; or (if not)<br />
• return the employee to employment of a<br />
different kind with the same employer; or<br />
• return the employee to the same kind of<br />
employment with a different employer; or<br />
• return the employee to different<br />
employment with a different employer<br />
where the employee can use his or her<br />
experience, education or training; or<br />
• help the employee use as many pre-injury<br />
skills as possible to obtain employment.<br />
In deciding whether to provide vocational<br />
rehabilitation the Corporation must consider<br />
whether rehabilitation is likely to:<br />
• achieve its purpose under the injured<br />
employee’s rehabilitation plan;<br />
• be cost effective (in the sense of reducing<br />
the costs of entitlements under the Act);<br />
• be appropriate in the circumstances; and<br />
An injured employee must be told that once<br />
vocational rehabilitation has been completed he or<br />
she may be assessed for vocational independence.<br />
The Corporation may engage someone suitably<br />
qualified to assist in the assessment, preparation,<br />
and costing of a vocational rehabilitation plan<br />
and to provide a link between the employee and<br />
the services the plan identifies. It must give the<br />
following persons the opportunity to participate<br />
in the preparation and costing process:<br />
• the injured employee;<br />
• any registered medical practitioner<br />
who is providing treatment;<br />
• the employee’s employer, or any potential<br />
employer, to the extent that he or she<br />
is willing and able to participate.<br />
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The Corporation meets the cost of preparation of<br />
such a plan, including the costs of any assessment<br />
approved as necessary so that the plan can be<br />
prepared.<br />
As with the rehabilitation plan, the Corporation must<br />
ask an injured employee to agree to a vocational<br />
rehabilitation plan, and if, after a reasonable time the<br />
employee has not agreed, can advise that the plan<br />
has been finalised and that the employee is regarded<br />
as having agreed. However, the injured employee can<br />
apply to have the plan reviewed (see under ‘Review’).<br />
Initial occupational assessment<br />
Initial occupational assessment (to assess vocational<br />
rehabilitation needs):<br />
An occupational assessor carrying out an initial<br />
assessment must:<br />
• take into account information provided by<br />
the injured employee and the Corporation<br />
(which must provide all the information it has<br />
relevant to an occupational assessment);<br />
• discuss with the injured employee all suitable<br />
types of work available in New Zealand;<br />
• consider any comments made by the injured<br />
employee about those types of work.<br />
The assessor must then prepare a report for the<br />
Corporation identifying appropriate types of work<br />
and taking into account information provided by the<br />
injured employee as well as any discussions held with<br />
the injured employee. A copy of the report goes to<br />
the employee and the medical assessor but not to the<br />
employer. Employers should therefore ensure every<br />
employment agreement, collective or individual,<br />
requires an injured employee to give the employer a<br />
copy of any such report.<br />
Medical assessor<br />
Medical assessors must be registered medical<br />
practitioners who hold vocational registration in<br />
general practice under the Medical Practitioners Act<br />
and have an interest and proven work experience,<br />
either in disability management in the workplace, or<br />
in occupational rehabilitation. They must also have at<br />
least five years’ experience in general practice and be<br />
Fellows of the Royal New Zealand College of General<br />
Practitioners. Otherwise they must be undertaking<br />
training for that purpose or towards an equivalent<br />
qualification, or have undertaken relevant advanced<br />
training (in which case they must also be members<br />
of recognised colleges and have work experience in<br />
disability management or occupational rehabilitation).<br />
However, if a qualified practitioner is not available<br />
without unreasonable delay or inconvenience, and if<br />
the delay would adversely affect the provision of an<br />
injured employee’s vocational rehabilitation, it will be<br />
possible for a practitioner with broadly comparable<br />
qualifications and experience to assess the employee.<br />
With an initial assessment a medical assessor must<br />
take into account information provided by the<br />
Corporation, reports, information, or comments from<br />
the assessor (including medical reports provided by<br />
the Corporation before the individual rehabilitation<br />
plan was prepared), the occupational assessor’s report,<br />
and the medical assessor’s clinical examination.<br />
Account may also be taken of any condition suffered<br />
by the claimant not related to the personal injury.<br />
A copy of the report goes to the injured<br />
employee and the Corporation, but need not<br />
go to the employer. So as with occupational<br />
assessors’ reports, employers should ensure every<br />
employment agreement, collective or individual,<br />
requires an injured employee to provide the<br />
employer with a copy of any medical assessment.<br />
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Changing circumstances<br />
Vocational rehabilitation may start or resume if<br />
circumstances change.<br />
The Corporation may decide at any time that there<br />
has been a change of circumstances affecting<br />
the need for vocational rehabilitation. If so, the<br />
Corporation and the injured employee may agree<br />
to modify the current plan to reflect changed<br />
circumstances.<br />
The Corporation may restart vocational rehabilitation<br />
under the injured employee’s plan (with any agreed<br />
modifications) if, having obtained employment as<br />
a result of vocational rehabilitation, the employee’s<br />
incapacity means he or she is not able to maintain it.<br />
VOCATIONAL INDEPENDENCE<br />
Assessment<br />
Assessment of vocational independence (once<br />
vocational rehabilitation has been completed):<br />
The Corporation has the right to determine the<br />
vocational independence of an employee who<br />
is receiving weekly compensation or who may<br />
have an entitlement to weekly compensation. It<br />
will do this by assessing that the comprehensive<br />
vocational rehabilitation identified in the individual<br />
rehabilitation plan has been completed and has<br />
focused on the employee’s needs, and that any injuryrelated<br />
barriers have been addressed so that the<br />
employee is able to maintain or obtain employment,<br />
or to regain or acquire vocational independence.<br />
Vocational independence will be assessed from<br />
time to time, at such reasonable intervals as the<br />
Corporation thinks appropriate.<br />
A vocational independence assessment, like<br />
assessments for vocational rehabilitation<br />
purposes, comprises both an occupational and<br />
a medical assessment.<br />
An occupational assessment considers the progress<br />
and outcomes of vocational rehabilitation carried out<br />
under the employee’s individual rehabilitation plan.<br />
The assessment also considers whether the types of<br />
work identified in that plan (available or not) are still<br />
suitable because they match skills gained through<br />
education, training and experience.<br />
The purpose of the medical assessment is to<br />
provide the Corporation with an opinion whether,<br />
given the particular injury, the employee has the<br />
capacity to undertake any type of work identified<br />
in the occupational assessment and reflected in<br />
the rehabilitation plan.<br />
The Corporation must give notice of a requirement<br />
to participate in an assessment of vocational<br />
independence stating:<br />
• the purpose, nature and effect of the assessment;<br />
• that the injured employee has to participate;<br />
• the consequences of not participating;<br />
• the right to be accompanied by someone<br />
else during the assessment.<br />
The Corporation cannot require an injured employee<br />
to participate in an assessment unless the employee<br />
is likely to achieve vocational independence and has<br />
completed any rehabilitation the Corporation had to<br />
provide under an individual rehabilitation plan.<br />
IF VOCATIONAL INDEPENDENCE IS<br />
ESTABLISHED<br />
If the Corporation decides an injured employee has<br />
achieved vocational independence, that employee<br />
is no longer regarded as being incapacitated<br />
for employment. Instead, the employee will be<br />
considered able to engage in work for which he<br />
or she is suited by reason of experience, education,<br />
or training, or any combination of the three, for a<br />
period of 35 hours a week or more. From 1 July 2010,<br />
this threshold will be lowered, so that vocational<br />
independence will be found when the employee is fit<br />
to work for 30 hours a week or more. The entitlement<br />
to weekly compensation will then be lost three<br />
months after the employee has been notified of the<br />
Corporation’s decision.<br />
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A person whose vocational independence is<br />
established will be eligible for the unemployment<br />
benefit if he or she fails to find employment during<br />
the three-month period.<br />
IF VOCATIONAL INDEPENDENCE IS LOST<br />
The Corporation must reconsider vocational<br />
independence if, having previously decided an<br />
injured employee was vocationally independent (or<br />
if this was determined under the Accident Insurance<br />
Act 1998 or under the Accident Rehabilitation and<br />
Compensation Insurance Act 1992), later there<br />
are reasonable grounds for believing vocational<br />
independence or capacity for work may have<br />
deteriorated. A claimant would need to provide<br />
information to this effect.<br />
If the Corporation does subsequently decide<br />
that vocational independence has been lost, the<br />
employee will regain his or her weekly compensation<br />
entitlement.<br />
DISENTITLEMENTS<br />
The Corporation is not liable to provide statutory<br />
entitlements for personal injury caused by a workrelated<br />
gradual process, disease, or infection:<br />
• if the injury was suffered before 1 <strong>April</strong> 1974<br />
and the claimant had, prior to 1 <strong>April</strong> 1993,<br />
commenced any proceedings relating to the<br />
personal injury other than under the current Act<br />
and had received or is entitled to receive, any<br />
sum of money as a result of the proceedings; or<br />
• if the gradual process injury was suffered<br />
before 1 <strong>April</strong> 1974 and the claimant received<br />
a sum of money, whatever the amount, by way<br />
of damages, compensation, or settlement of<br />
any claim other than under the current Act.<br />
Wilfully inflicted injuries<br />
For personal injuries or death which occurred<br />
between 1 August 2008 and 30 June 2010, the<br />
fact that the personal injury was wilfully inflicted<br />
or resulted in death by suicide will not disentitle<br />
the claimant from cover.<br />
For personal injuries or death which occurred before<br />
1 August 2008, or after 30 June 2010, the Corporation<br />
does not have to provide any entitlement (except<br />
treatment) for a personal injury wilfully self-inflicted<br />
or which the claimant has caused to be inflicted on<br />
him or herself, or for death due to suicide (unless this<br />
was the consequence of mental injury for which the<br />
claimant had cover).<br />
CLAIMS PROCESS<br />
An injured employee, or anyone wishing to<br />
claim under the Act, must lodge a claim with the<br />
Corporation for injury cover, or for injury cover and<br />
a specified entitlement or, once the Corporation has<br />
accepted that there is cover for the personal injury, for<br />
a specified entitlement. This can be done personally<br />
or a treatment provider can lodge the claim on the<br />
injured person’s behalf (and must do so promptly).<br />
A claim can be lodged whether an injury is workrelated<br />
or non-work-related. The employee does<br />
not have to inform the employer that an injury<br />
accident has occurred. While there is an accidentreporting<br />
obligation on employers under the<br />
Health and Safety at Work Act 2015, the real<br />
likelihood of apparently quite minor accidents<br />
having more serious outcomes means all employers<br />
should require their employees, as a term of the<br />
relevant employment agreement, to report every<br />
workplace accident to their employer or manager.<br />
Once the Corporation has received a claim it<br />
must decide whether or not there is cover under<br />
the Act. If it accepts the claim, the Corporation<br />
must provide the injured person with information<br />
about the entitlements it considers apply, and<br />
facilitate access to them.<br />
18
BACK<br />
Claims must be lodged within 12 months of the<br />
date on which a claimant (injured employee) suffers<br />
a personal injury, or in the case of a claim for an<br />
entitlement, within 12 months of the date on which<br />
the need for the entitlement arose. However, the<br />
Corporation must not decline a claim lodged after<br />
these time limits unless lateness prejudices its ability<br />
to make decisions. Every claim decision must be made<br />
on reasonable grounds and in a timely manner.<br />
Once a claim is lodged, the Corporation can<br />
require a claimant to provide a certificate from a<br />
registered health professional and any other relevant<br />
information, including health information, which may<br />
be needed. This can include undergoing a medical<br />
assessment at the Corporation’s expense.<br />
No later than 21 days after a claim is lodged, the<br />
Corporation must investigate it at its own expense<br />
and either make its decision and notify the claimant,<br />
or decide that further information is required and<br />
extend the time for making a decision. If this happens<br />
a decision must be made within four months of the<br />
claim being lodged.<br />
If the Act’s time limits are not met the claimant is<br />
regarded as having a decision in his or her favour. The<br />
Corporation must tell the claimant that the time limit<br />
has expired and that because of this the claimant<br />
has personal injury cover. In other words, the claim is<br />
taken as accepted once the time limit has expired.<br />
Special provisions apply in respect to complicated<br />
claims, defined as those relating to mental injuries<br />
caused by certain criminal acts, gradual process<br />
injuries, treatment injury and claims lodged later<br />
than the specified 12-month period. If faced with<br />
such a claim you should seek advice from your local<br />
Employers’ Organisation.<br />
DISPUTE RESOLUTION<br />
An injured employee (or any claimant) may apply to<br />
the Corporation for a review of any:<br />
• decision on a claim; or<br />
• delay in processing a claim<br />
considered unreasonable.<br />
An employer may apply to the Corporation for:<br />
• delay in processing a claim<br />
considered unreasonable.<br />
• a review of its decision that an injury is<br />
a work-related personal injury suffered<br />
during employment with that employer.<br />
An employer may not apply to the Corporation for a<br />
review of its decision about entitlements provided<br />
or to be provided to an employee who has suffered a<br />
work-related personal injury.<br />
A levy payer (including an employer) may apply,<br />
within three months of notification, for a review of a<br />
Corporation determination regarding the levy paid or<br />
payable. A levy payer is not entitled, for Income Tax<br />
Act purposes, to seek a review of the calculation of<br />
someone’s taxable income.<br />
A registered health professional or organisation<br />
may apply for a review of a Corporation decision<br />
that it contributed to a personal injury caused by<br />
medical error.<br />
How to apply for a review<br />
Review applications must be:<br />
• made in writing, wherever practicable on<br />
a form provided by the Corporation;<br />
• identify the decision or decisions<br />
to which they relate;<br />
• state the grounds for the application;<br />
• state the relief sought (if the<br />
applicant knows this);<br />
• made within three months of the date<br />
of a decision reached because the<br />
19
BACK<br />
Corporation has failed to meet statutory<br />
time limits (when an injured employee is<br />
automatically considered to have cover); or<br />
• made within three months of the injured<br />
employee receiving the Corporation’s<br />
notice regarding a claim; or<br />
• made within three months of the injured<br />
employee being notified of a decision<br />
under the Code of Claimants’ Rights.<br />
A review application relating to a claim for<br />
entitlement cannot be made until at least 21 days<br />
have passed since the entitlement claim was made.<br />
In all cases, late review applications will be<br />
accepted if the applicant:<br />
• was so affected or traumatised by the personal<br />
injury giving rise to the review as to be unable<br />
to consider his or her review rights; or<br />
• made reasonable arrangements for the<br />
application to be made by an agent<br />
but the agent unreasonably failed to<br />
ensure it was made on time; or<br />
• was not notified by the Corporation of the<br />
obligations of someone making an application.<br />
The Corporation must acknowledge review<br />
applications and explain that the reviewer will<br />
be deemed to have made a decision in the<br />
applicant’s favour if a hearing date has not been<br />
set within three months of its receiving the<br />
application. The Corporation must also explain<br />
that a review decision binds both the applicant<br />
and the Corporation, any person who the decision<br />
states has a responsibility under the Act (such as<br />
an employer, where the applicant is an employee),<br />
and any other party to the review.<br />
A reviewer is deemed to have made a decision in<br />
favour of an applicant if a hearing date has not been<br />
set within three months of the Corporation receiving<br />
the review application and the applicant did not<br />
cause or contribute to the delay. The deemed decision<br />
will apply as from the date the review application<br />
was received by the Corporation. However, a claimant<br />
who is not an applicant cannot lose cover because of<br />
a deemed review decision unless he or she caused or<br />
contributed to the delay. So even though an employer<br />
applicant receives a favourable ‘deemed’ review<br />
decision, a claimant employee will still retain cover<br />
provided there was no delay on the employee’s part.<br />
The Corporation is not liable to provide entitlements<br />
as the consequence of a deemed review decision<br />
other than those that can be provided under the Act.<br />
Once a review application is received<br />
On receiving a review application the Corporation<br />
must send the applicant an acknowledgement<br />
indicating when the application was received and<br />
explaining ‘deemed’ review decisions and the<br />
effect of a review decision. The Corporation must<br />
allocate a reviewer as soon as possible after receiving<br />
an application, even if it considers that in the<br />
circumstances there is no right to a review. If, for some<br />
reason, a new reviewer is required, the Corporation<br />
must allocate the new reviewer as soon as practicable.<br />
Reviewers are required to act independently<br />
and when allocated a review must disclose any<br />
involvement with a claim other than as a reviewer.<br />
Reviews may be conducted in any manner the<br />
reviewer thinks fit, but must comply with relevant<br />
provisions of the Act and with the principles of natural<br />
justice. Reviewers must exercise due diligence in<br />
decision-making, adopting an investigative approach<br />
with a view to conducting the review in an informal,<br />
timely, and practical manner. They can admit any<br />
relevant evidence from anyone entitled to be present<br />
and heard, whether or not the evidence would be<br />
admissible in a court of law.<br />
20
BACK<br />
A review hearing must be conducted unless an<br />
application is withdrawn or all those entitled to be<br />
heard agree not to have a hearing.<br />
The hearing must be held at a time and place<br />
agreed to by all parties to the application (if the<br />
application is made by an injured employee this<br />
does not include the employer) and by the reviewer.<br />
If the parties to the application cannot agree, then<br />
the reviewer must decide when and where the<br />
review hearing will be held.<br />
A reviewer must take all practicable steps to ensure<br />
notice is given to everyone entitled to be present and<br />
heard at least seven days prior to a hearing. Where<br />
the applicant is an injured employee, this will include<br />
the employer, see below.<br />
Those entitled to be present at a review hearing with<br />
a representative, if they want to be are:<br />
• the applicant and the Corporation;<br />
• a registered heath professional or<br />
organisation whose inaction or action is<br />
the basis for a claim of medical error;<br />
• a registered health professional or<br />
organisation (as above) where the<br />
applicant is a treatment provider; or:<br />
if the review relates to a decision to accept or decline<br />
cover for a work-related personal injury:<br />
•the claimant;<br />
• the claimant’s employer; and<br />
• in the case of a gradual process claim, any<br />
employer whose name the reviewer receives<br />
from the claimant, from the claimant’s employer,<br />
or from the Corporation. (Any other employer<br />
or former employer of the claimant is to be<br />
given seven days’ notice of the hearing.)<br />
Persons present at a hearing can either speak for<br />
themselves or through their representative.<br />
A reviewer must make a review decision within<br />
28 days after:<br />
• the day on which the hearing finishes;<br />
• if there is no hearing, on the day the<br />
applicant, the Corporation and all persons<br />
who would have been entitled to be present<br />
and heard agree not to have a hearing;<br />
• if no such date has been specified, the day on<br />
which it was agreed not to have a hearing.<br />
A review decision must:<br />
• be in writing;<br />
• give reasons; and<br />
• contain information about the right of appeal.<br />
The reviewer must, as soon as practicable, give<br />
a copy of the decision to the applicant and the<br />
Corporation and to any other person entitled to be<br />
present and heard at the hearing who was present.<br />
If someone entitled to be present at the hearing was<br />
not present, the reviewer need only provide a copy of<br />
the decision on request.<br />
The Corporation must supply a copy of a review<br />
decision to anyone who asks for it, but must<br />
ensure the decision contains no information<br />
identifying any individual. It may charge a fee for<br />
doing so but no greater than the cost of preparing<br />
and supplying the decision.<br />
In making a decision a reviewer must disregard the<br />
Corporation’s decision and look at the matter afresh<br />
on the basis of the information provided at the review.<br />
The reviewer must also put aside the Corporation’s<br />
policy and procedure and make a decision solely on<br />
the basis of the substantive merits of the case under<br />
the Act. If the review concerns a decision revised by<br />
the Corporation, the Corporation must establish that<br />
the original decision was made in error.<br />
The reviewer must keep an accurate record of<br />
evidence for at least two years.<br />
21
BACK<br />
The reviewer must either:<br />
• dismiss the application; or<br />
• modify the Corporation’s decision; or<br />
• quash the Corporation’s decision; or<br />
• direct that a decision be made within<br />
a time frame specified by the reviewer,<br />
if the Corporation has not made a<br />
decision in a timely manner; or<br />
• make a decision for the Corporation if it has<br />
not made a decision in a timely manner.<br />
If the decision is quashed, the reviewer must<br />
either provide a substitute decision or direct<br />
the Corporation to make the decision again as<br />
directed by the reviewer.<br />
The reviewer may make a decision even though<br />
someone entitled to be present and heard did<br />
not attend, unless a reasonable excuse for nonattendance<br />
is supplied, or the reviewer considers<br />
the decision should not be made until the person<br />
has been heard.<br />
A reviewer is deemed to have made a decision in an<br />
applicant’s favour if the Corporation has received<br />
a review application but has not set a hearing date<br />
within three months of receiving the application.<br />
Costs on review<br />
The Corporation must meet all the costs a reviewer<br />
incurs in conducting a review.<br />
Applicants who have a decision fully or partly in their<br />
favour must be awarded costs and expenses, whether<br />
or not there is a hearing. Costs and expenses may also<br />
be awarded to unsuccessful applicants if the reviewer<br />
considers an applicant acted reasonably in applying<br />
for a review. A reviewer may, but need not, award<br />
costs and expenses to any person other than the<br />
applicant in whose favour a decision is made.<br />
If following a review application, the Corporation<br />
revises its decision fully or partly in favour of the<br />
applicant before the review is heard (whether a<br />
reviewer has been appointed or not and whether<br />
or not a review hearing has been scheduled), the<br />
Corporation must award the applicant costs and<br />
expenses.<br />
The Corporation must pay any costs and expenses<br />
awarded within 28 days.<br />
APPEALS<br />
Employers may appeal to the District Court against<br />
a review decision that an injury was a work-related<br />
personal injury. As well, in the case of a gradual<br />
process injury, any employer entitled to be present<br />
and heard at a review hearing may appeal any<br />
decision that the injury was work-related. The Act<br />
does not specifically state that employers can appeal<br />
awards of costs and expenses, as it does in the case<br />
of employees (and claimants generally) and the<br />
Corporation (see below), but as costs and expenses<br />
awards can be appealed by ‘any affected person’,<br />
employers too, have the right to appeal against them.<br />
Employees—and the Corporation—may appeal<br />
review decisions, including awards of costs and<br />
expenses, except where these relate to a decision by<br />
the Corporation under the Code of Claimants’ Rights<br />
on a complaint by the claimant.<br />
Registered health professionals and organisations<br />
may appeal decisions relating to medical error.<br />
Bringing an appeal<br />
A notice of appeal must be filed in the prescribed<br />
form within 28 days of a reviewer giving an appellant<br />
a copy of the review decision, or within 28 days of<br />
a ‘deemed’ review decision. In the latter case this<br />
means 28 days after the expiry of the three-month<br />
period during which the Corporation, having received<br />
a review application, has failed to set a hearing date.<br />
The District Court has a discretion to allow a longer<br />
time for filing.<br />
22
BACK<br />
Once an appeal notice is received, the District<br />
Court Registrar must notify the Corporation,<br />
requesting the names and contact details of<br />
anyone who had a right to be present and heard<br />
at the review hearing. The Corporation must<br />
supply this information within seven days.<br />
The time and place for a review is to be fixed by the<br />
Registrar and notified to the appellant and to persons<br />
who were entitled to be present and heard at the<br />
review hearing. Anyone with a right to be heard<br />
may ask the Corporation for any of the items the Act<br />
requires it to provide to the Registrar—a copy of the<br />
decision appealed against, the record of the review<br />
hearing, documents and exhibits relating to the<br />
review, and any notes or directions of the reviewer.<br />
The District Court may hear any evidence it thinks<br />
fit whether admissible in a court of law or not. If a<br />
question of fact is involved, evidence taken before or<br />
received by the reviewer may be produced, subject<br />
to any order of the Court. Oral evidence may involve<br />
producing a copy of the reviewer’s notes and/or a<br />
record of the hearing, or having a witness read a<br />
written statement, or producing any other material<br />
the Court considers appropriate. Affidavit evidence<br />
about a question of fact may be given by means of<br />
affidavits provided to the Court Registrar. Exhibits<br />
relating to questions of fact may be brought by<br />
producing any exhibits forwarded to the Registrar<br />
or in the custody of the parties to the appeal.<br />
A Judge may appoint an assessor, consulting the<br />
parties about the appointment. If the parties cannot<br />
agree, the Judge has the right to decide the matter.<br />
Assessors are paid by the Department for Courts.<br />
Anyone entitled to appear and be heard may ask<br />
the Court to limit the persons who can be present<br />
at a hearing. The Court will grant the application if it<br />
considers it necessary to do so to protect personal<br />
privacy. It may not do so to protect the Corporation.<br />
Further appeals<br />
With the leave of the District Court, a party dissatisfied<br />
with its decision may appeal to the High Court, or<br />
if the District Court refuses leave, may ask the High<br />
Court for special leave to appeal. Appeals must be<br />
made within 21 days of the District Court’s decision.<br />
Subsequent appeals to the Court of Appeal are<br />
possible but are confined to questions of law.<br />
LEVIES<br />
The Act requires employers to pay a levy to fund the<br />
cost of entitlements for work-related personal injuries.<br />
Payment must be made by the date specified by<br />
the Corporation in an invoice or ‘other appropriate<br />
document’. The date must be not less than 30 days<br />
after the date of the invoice. A levy rate is prescribed<br />
in regulations made under the Act and the levy<br />
itself paid into a Work Account. The levy rate must<br />
be wholly or partially related to the amount of<br />
earnings paid, estimated to be paid, or deemed by<br />
regulation to have been paid by the employer to his<br />
or her employees for the relevant period. Levies are<br />
calculated so that the cost of Work Account claims is<br />
fully funded. ‘Fully funded’ means that the premium<br />
collected each year must be sufficient to cover the<br />
total on-going costs of all claims occurring in the<br />
premium year.<br />
An employer is not required to pay any levy on an<br />
employee’s earnings above a specified maximum.<br />
Consequently, if an employee’s earnings are paid by<br />
two or more employers, an employer (who must pay<br />
the levy up to the specified maximum) may, if total<br />
earnings exceed the specified maximum, apply to the<br />
Corporation for a pro rata refund of the excess levy<br />
paid. The refund will be calculated in proportion to<br />
the earnings paid by each employer to the employee.<br />
Appeals may be dismissed, or the Court may modify<br />
or quash the review decision. If the decision is<br />
quashed, the Court must indicate what the effect<br />
of this will be.<br />
23
BACK<br />
Levies are paid for a prescribed period and the<br />
Corporation may require an employer to pay a levy<br />
based on its reasonable estimate of the levy payable.<br />
When the prescribed period ends, the Corporation<br />
must, as soon as practicable, calculate the levy<br />
actually payable, and refund any amount greater than<br />
$20 with interest on any amount in excess of $1,000<br />
(the interest rate being prescribed by regulation).<br />
Similarly, the employer must pay the Corporation any<br />
outstanding amount greater than $20. No invoice will<br />
be issued for amounts less than $20.<br />
If, in any income year, an employer believes relevant<br />
employee earnings are likely to vary by 20 per cent or<br />
more from those of the previous year (that is, are likely<br />
to decrease or increase to that extent), the employer<br />
must notify the Corporation of the estimated increase<br />
or decrease. Employers may notify the Corporation of<br />
any lesser variation estimated.<br />
The Corporation must recalculate the levy in line<br />
with any estimate received and notify the employer<br />
accordingly. It may also require the employer to<br />
provide further information.<br />
Experience rating<br />
<strong>ACC</strong> introduced experience rating from 1 <strong>April</strong><br />
2011. Experience rating is a system of modifying a<br />
business’s <strong>ACC</strong> work levy based on its claims history.<br />
Historically, the work levy has been based on injury<br />
rates across industry categories. A business has paid<br />
the same work levy as others operating in the same<br />
industry, despite differences in their safety record.<br />
Experience rating will reward those business owners<br />
with safer workplaces, and encourages a focus on<br />
improving workplace safety and making New Zealand<br />
businesses better places to work.<br />
Experience rating takes into account a business’s<br />
<strong>ACC</strong> claims history over an ‘experience period’ when<br />
setting its levies. The experience period is the three<br />
tax years immediately before the applicable levy year.<br />
Under the experience rating framework, employers<br />
who have lower-than-average injury rates, with<br />
better-than-average rehabilitation or return to work<br />
rates, may receive a discount on their <strong>ACC</strong> work levy.<br />
Those with worse-than-average claims experience<br />
may receive a loading on their levy. Experience rating<br />
will be applied in two different methods based on the<br />
employer’s levies.<br />
NO-CLAIMS DISCOUNT PROGRAMME<br />
Businesses (including self-employed people) who<br />
have paid an annual levy of less than $10,000 for all, or<br />
part, of the experience period will receive a no claims<br />
discount or a high claims loading of up to 10 per cent<br />
on the current portion of their levy.<br />
The levy adjustments for these businesses are:<br />
• a 10 per cent discount if no weekly<br />
compensation days paid have been<br />
made over the experience period<br />
• a 10 per cent loading (increase) if the<br />
business has generated more than 70 weekly<br />
compensation days paid, or any fatal claim<br />
• no change for a business generating between<br />
one and 70 weekly compensation days paid.<br />
Weekly compensation days are days beyond first<br />
week compensation paid by the employer.<br />
EXPERIENCE RATING PROGRAMME<br />
Based on their claims history, businesses who paid<br />
$10,000 or more in levies for each of the three years<br />
in the experience period could receive a discount or<br />
loading of up to 50 per cent on the current portion<br />
of their work account levy. <strong>ACC</strong> will compare the<br />
number of weekly compensation days that injuries in<br />
the workplace have generated, all claims with medical<br />
costs of $500 or more or any fatal claim.<br />
This information will be compared to other businesses<br />
in their Industry Levy Risk Group (LRG)—a group of<br />
businesses operating in the same or similar industries,<br />
with similar injury risk profiles. If a business’s<br />
performance compares favourably with others in its<br />
LRG its levy may be discounted. A loading may be<br />
applied to the work levy for employer’s who do not<br />
compare favourably.<br />
Businesses that fall below minimum liable earnings<br />
(currently $26,520 in the 2010/11 levy year) or have<br />
not been invoiced for an <strong>ACC</strong> levy for each of year<br />
of the experience period are exempt. Their levies<br />
will continue to be calculated as usual. Even if you<br />
are currently exempt, improving the safety and<br />
well-being of the people in your workplace will be<br />
reflected in your levy when you become eligible<br />
for experience rating.<br />
24
BACK<br />
Because the experience rating system is based on <strong>ACC</strong><br />
data, employers should ensure that data is accurate<br />
by keeping comprehensive records of work place<br />
accidents and the number of <strong>ACC</strong> paid compensation<br />
days. Employers should also check experience rating<br />
notices from <strong>ACC</strong> against their own records to ensure<br />
they are accurate, and seek a review for all contested<br />
claims within three months of receiving the notice.<br />
Classification for levy purposes<br />
For levy purposes, the Corporation must classify<br />
employers in industry or risk classes that most<br />
accurately describe the particular employer’s<br />
activity. Industry or risk classes are set out in<br />
regulations made under the Act.<br />
For an employer engaged in two or more activities,<br />
classification will be under the industry or risk<br />
class attracting highest levy. However, in certain<br />
circumstances, where the employer requests this,<br />
the Corporation may classify such an employer<br />
separately for different activities, provided thresholds<br />
specified in regulations are met. For this to happen<br />
the activities in question must be distinct and<br />
independent and provide services or products to<br />
customers in such a way that each could, without<br />
adaptation, continue on its own without the other<br />
activities. As well, the employer’s accounting records<br />
must demonstrate the separate management and<br />
operation of each activity and allocate to each the<br />
earnings of employees engaged solely in that activity.<br />
Where an employer is engaged in two or more<br />
activities (as above) any employee engaged in two<br />
or more of those activities must be classified in the<br />
industry or risk class attracting the higher or highest<br />
levy rate. However, if the particular activity accounts<br />
for 5 per cent or less of an employee’s earnings for the<br />
year, then that activity need not be considered when<br />
determining the appropriate classification. But the<br />
employer must maintain records sufficiently accurate<br />
to satisfy the Corporation that the apportionment of<br />
total earning is correct.<br />
If none of the classifications of industry or risk defined<br />
in regulations apply to the activity of a particular<br />
employer, or self-employed person, the Corporation<br />
may define a classification that it considers<br />
appropriate. The new classification will then apply<br />
to all persons involved in the activity not covered by<br />
a classification defined by regulations, and may be<br />
incorporated in the relevant regulations when these<br />
are next amended.<br />
In some cases it will be possible for the Corporation<br />
to make arrangements that enable employers to<br />
carry out self-assessments, but in any event, levies<br />
may not be prescribed by the Minister responsible<br />
for the administration of the Act unless he or she first<br />
considers a recommendation from the Corporation,<br />
based on its consultations with levy payers (although<br />
the Minister is entitled to reject the recommendation).<br />
Corporation intentions in regard to levy and certain<br />
other regulations must be advertised in national<br />
newspapers and submissions called for.<br />
Risk adjustment of employer levies<br />
An employer levy may be adjusted up or down following<br />
an audit of an employer’s safety management practices.<br />
The Minister must approve audit tools, measuring such<br />
practices against independent New Zealand or foreign<br />
standards. The Corporation is required to make a copy of<br />
every audit tool approved by the Minister available free<br />
of charge for public inspection.<br />
Criteria for upward adjustment<br />
of levies<br />
The Corporation may start on a process to increase<br />
levies if it considers the number of injuries occurring<br />
to the employer’s employees is significantly greater<br />
than might reasonably be expected for a comparable<br />
employer of that type and size in that industry or<br />
risk class. (Criteria on which to base its decision<br />
are set out in the Act.) In initiating the process the<br />
Corporation must notify the employer of its reasons<br />
for doing so and explain that the purpose of the<br />
process is to decide whether or not the employer’s<br />
safety management practices should be audited. The<br />
notice must also state that the Corporation and the<br />
employer are required to ‘enter into a dialogue’ about<br />
the standard of the employer’s safety management<br />
practices, and that failure to reach the standard<br />
required by an audit, or failure to allow an audit to<br />
take place, may result in an increase in the employer’s<br />
levies (an ‘upward adjustment of’).<br />
25
BACK<br />
After the notice is given, the Corporation and the<br />
employer must discuss the standard of the employer’s<br />
safety management practices. The Corporation<br />
should consider:<br />
• whether the employer should initiate a self-audit;<br />
• whether the Corporation should assist; and<br />
• whether the Corporation should help the<br />
employer to understand the need to improve<br />
safety management practices and how to do this.<br />
The employer must be given a reasonable<br />
opportunity to explain and comment on the health<br />
and safety situation in the workplace.<br />
When the Corporation/employer dialogue has<br />
concluded, the Corporation must, on the basis of<br />
the information gathered, decide whether to carry<br />
out an audit of the employer’s health and safety<br />
management practices and notify the employer of<br />
its decision.<br />
If the employer refuses to allow an audit to take<br />
place, or the audit cannot be completed in a<br />
reasonable time because the employer fails to<br />
participate, or because of the way in which the<br />
employer participates, the Corporation may increase<br />
the employer’s levies without completing the audit.<br />
If the employer fails to reach the required standard,<br />
the Corporation must increase the employer’s levies.<br />
It must not do so if the standard required by the<br />
audit tool is reached.<br />
If, later on, an employer whose levies have<br />
increased reaches the audit tool standard and a levy<br />
readjustment is required, the levies must return to the<br />
standard rate for an employer in that industry or risk<br />
class.<br />
Workplace safety management<br />
practices (WSMP)<br />
<strong>ACC</strong> operates a workplace safety management<br />
practices programme (WSMP). Under this<br />
programme audits are conducted to assess<br />
safety management practices of the employer to<br />
determine whether a discount should be placed<br />
on the employer levies. Employers can make an<br />
application to <strong>ACC</strong> to enter the WSMP programme.<br />
<strong>ACC</strong>—approved auditors assess the safety<br />
management practices of the employer based on a<br />
list of standardised criteria. This standard criteria is<br />
available to employers making an application to <strong>ACC</strong>.<br />
There are three levels of safety management that the<br />
employer can achieve under the WSMP system; the<br />
primary level, secondary level and tertiary level. If all<br />
of the audit requirements at each level are achieved<br />
then the employer can receive a corresponding<br />
discount in their Workplace Cover Levy; 10 per cent<br />
for primary level, 15 per cent for secondary level,<br />
and 20 per cent for tertiary level. Business Central<br />
member only consultants can be engaged for an<br />
additional fee to help employers achieve the WSMP<br />
standards.<br />
<strong>ACC</strong> Workplace Safety Discount<br />
Programme<br />
This programme, which was previously open to<br />
employers in certain industries, is open to small to<br />
medium employers in all industries from 1 <strong>April</strong><br />
2013. If approved, employers will receive a 10<br />
percent discount to their work levy. Some details:<br />
The <strong>ACC</strong> Workplace Safety Discount programme<br />
is a great way for small to medium businesses and<br />
self-employed clients to save 10 per cent on the<br />
work component of their <strong>ACC</strong> levy.<br />
The discount is valid for three years from the date the<br />
application is accepted, including the year in which<br />
the application is accepted.<br />
To be eligible, you must either be:<br />
• self-employed; or<br />
• running a small to medium business with a<br />
total annual payroll of $537,000 (or less) or<br />
have 10 (or fewer) full-time employees.<br />
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Employers are required to:<br />
• Provide evidence of other training or experience<br />
• Correctly complete and return<br />
a simple application form<br />
• Attach the appropriate documentation for the<br />
self-assessment section of the application form.<br />
For more information on how to apply, go to the<br />
Workplace Safety Discount Programme page on<br />
the <strong>ACC</strong> website.<br />
WORK <strong>ACC</strong>OUNT<br />
The purpose of the Work Account is to finance<br />
entitlements for individuals whose entitlements<br />
would have been provided from the Work Account<br />
under the Accident Rehabilitation and Compensation<br />
Insurance Act 1992. The Work Account covers:<br />
• work injuries suffered before 1 July 1999;<br />
• non-work injuries suffered by earners<br />
before 1 July 1992 (when employers funded<br />
both work and non-work accidents);<br />
• costs incurred by the Corporation as a<br />
contributing insurer where an injury was<br />
caused or contributed to before 1 July 1999<br />
(that is, during the time the Corporation was<br />
the sole provider of accident compensation.<br />
(From 1 July 1999 to 31 March 2000 there was<br />
a short period when employers were able to<br />
choose their own private accident insurer.)<br />
Funds for the Work account are derived from levies<br />
payable by employers, private domestic workers,<br />
and self—employed persons. The funds in the Work<br />
account must be applied to meet the costs of:<br />
• Entitlements in respect of employee, private<br />
domestic workers and self—employed persons<br />
for work—related personal injuries; and<br />
• Entitlements that would have been<br />
funded from the Residual Claims Account<br />
immediately before the commencement<br />
of the Injury Prevention, Rehabilitation and<br />
Compensation Amendment Act 2009; and<br />
• Entitlements in respect of certain persons<br />
whose entitlements would have been provided<br />
from the Self- Employed Work Account under<br />
the Accident Insurance Act 1998; and<br />
• obligations under accident insurance contracts<br />
of employers and private domestic workers, and<br />
for self—employed persons taken on by the<br />
Corporation under section 7 of the Accident<br />
Insurance (Transitional Provisions) Act 2000; and<br />
• entitlements in respect of employers, private<br />
domestic workers, and self- employed persons<br />
that, immediately before 1 <strong>April</strong> 2007, would<br />
have been funded from the Self- Employed<br />
Work Account or the Employers account;<br />
The levy is intended to fully fund outstanding<br />
claims’ liability by 31 March 2019.<br />
Promotion of employer involvement<br />
In carrying out its duties in relation to the Work<br />
Account, the Corporation must take all practicable<br />
steps to ensure that to the extent practicable,<br />
employers are involved in the rehabilitation of<br />
individuals covered by the Work Account. The<br />
‘employers’ referred to are the employer who was<br />
employing the injured employee at the time the<br />
injury was suffered, and employers in the same<br />
industry class as that employer.<br />
<strong>ACC</strong>REDITED EMPLOYERS<br />
The Act allows employers—in particular<br />
larger employers—to enter into accreditation<br />
agreements with the Corporation to provide, at<br />
their own cost, entitlements in respect of workrelated<br />
personal injuries suffered by their employees.<br />
Before entering into an accredited employer<br />
agreement the employer must consult his or her<br />
employees, or their representatives, including any<br />
registered union, about the employer’s ability to<br />
comply with the relevant statutory requirements.<br />
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Accreditation, reducing the cost of levies payable to<br />
the Corporation (some payment will be required to<br />
fund the cost of residual, unfunded claims), will be<br />
granted if the Corporation considers the employer:<br />
• has appropriate experience in managing<br />
occupational health and safety issues ‘positively’;<br />
• has demonstrated a commitment to injury<br />
prevention and an understanding and<br />
awareness of the importance of rehabilitation<br />
and the employer’s involvement in rehabilitation;<br />
• has appropriate injury prevention policies and<br />
procedures in place and adequate resources<br />
to manage work-related personal injury claims,<br />
to promote and manage rehabilitation, and to<br />
fulfil reporting requirements (see below); and<br />
• is financially solvent and therefore able,<br />
and able to continue, to meet expected<br />
financial and other obligations relating<br />
to work-related personal injury claims.<br />
The Corporation may revoke an accreditation<br />
agreement at any time if, having discussed the matter<br />
with the employer, it decides that the employer no<br />
longer fulfils the above requirements or complies<br />
with the framework to be established by the Minister<br />
for accreditation purposes.<br />
Under an accreditation agreement an employer is<br />
liable for some or all of the entitlements accruing in<br />
respect of a work-related personal injury suffered<br />
by his or her employees. In return, reduced levies<br />
are charged on the basis set out in the framework.<br />
An accreditation agreement may provide for the<br />
employer to recover contributions from insurers (in<br />
respect to the period when private accident insurance<br />
applied), other accredited employers, and/or the<br />
Corporation, as, for example, in the case of gradual<br />
process and subsequent injuries. An accreditation<br />
agreement may also provide for an accredited<br />
employer to make contributions to insurers, other<br />
accredited employers, and the Corporation.<br />
During the claim management period, an accredited<br />
employer must manage every work-related personal<br />
injury claim suffered by an employee, provide any<br />
entitlements, and pay the costs specified in relation<br />
to such claims. However, the Corporation may, in<br />
some cases, agree to assume some or all of the<br />
employer’s liability on such terms and conditions as<br />
it thinks fit. The Act provides for what will happen if<br />
an accredited employer ceases to exist or fails, or is<br />
unable to perform obligations under an accreditation<br />
agreement. (In the event of insolvency, receivership,<br />
or liquidation, any debt constituting payment of<br />
weekly compensation will rank in priority next after<br />
wages or salary.) In dealing with any injured employee<br />
an accredited employer must comply with the Code<br />
of <strong>ACC</strong> Claimants’ Rights.<br />
A Corporation monitoring programme may audit<br />
the activities of accredited employers to ensure<br />
statutory requirements are being met and that<br />
accurate and complete reports have been provided<br />
to the Corporation. Where an audit is carried out, the<br />
employer, and employee representatives (including<br />
any registered union) must be given the opportunity<br />
to be heard.<br />
Reporting and information<br />
Accredited employers must report to the Corporation<br />
in accordance with their accreditation agreement.<br />
Information supplied will be available for use by the<br />
Corporation’s information manager in facilitating the<br />
Government’s overall injury management strategy.<br />
An accredited employer must also, without charge,<br />
provide each employee with a written statement<br />
setting out the procedures and requirements under<br />
the accreditation agreement relating to the lodging<br />
of claims, claims’ handling, provision of rehabilitation,<br />
assessment of incapacity, and dispute resolution.<br />
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COVER FOR NON-WORK<br />
RELATED PERSONAL INJURY<br />
As well as accidents in the workplace resulting<br />
in injury and incapacity, the Corporation covers<br />
injuries suffered by non-earners and by earners<br />
who are injured other than at work. It also covers<br />
motor vehicle accidents and accidents caused<br />
by one or other of the forms of treatment injury<br />
identified by the Act—medical error and medical<br />
mishap. Such accidents are funded from a number<br />
of accounts apart from the Work Account, allowing<br />
the Corporation to cover them without crosssubsidisation<br />
between the various injury categories.<br />
Earners’ account<br />
The account finances statutory entitlements for<br />
employees who suffer non-work injuries. It is funded<br />
through levies payable by employees set at a rate<br />
prescribed in regulations made under the Act. The<br />
levy is paid in instalments as if it were income tax,<br />
that is, it is deducted at source as PAYE and the rules<br />
governing PAYE apply to it. However, an earners’<br />
levy deduction is not to be treated as part of a tax<br />
deduction payment.<br />
If an employee’s earnings include a benefit such as<br />
board and lodging, or any other benefit in kind which<br />
is included in the employee’s wages, or any payment<br />
by way of pension, superannuation, retiring allowance,<br />
other allowance, or annuity, that amount must be<br />
taken into account when determining the deduction<br />
to be made for levy purposes. If an employer makes a<br />
deduction but fails to deal with it in the way the Act<br />
requires, the deduction, for Tax Administration Act<br />
purposes, will rank equally with the amount of any tax<br />
deduction the employer has not paid.<br />
Non-earners’ account<br />
As its name indicates, the account funds accidents to<br />
non-earners. Funds come from general taxation and<br />
provide for treatment costs, rehabilitation and the<br />
like. Non-earners are people who are neither in paid<br />
employment nor self-employed, including retired<br />
people and children.<br />
Motor vehicle account<br />
The account funds injuries involving the use of<br />
motor vehicles, including some arising in a work<br />
context, which are also categorised as work-related<br />
injuries for the purposes of employer-paid first week<br />
compensation (see under ‘Work-Related Personal<br />
Injury’). Funds for motor vehicle injuries come from a<br />
levy paid by every registered motor vehicle owner, by<br />
everyone who holds a trade licence, and from a petrol<br />
tax on every litre of motor spirits in respect of which<br />
duty is payable under the Customs and Excise Act<br />
1996.<br />
Treatment injury account<br />
Funds for this account come from any levies payable<br />
by registered health professionals or any organisation<br />
that provides treatment under the Act. If there is no<br />
such levy, or the levy relates only to funding part of<br />
the Account, funds will come from either the Earners’<br />
or Non-Earners’ Account, as appropriate.<br />
CODE OF <strong>ACC</strong> CLAIMANT’S<br />
RIGHTS<br />
The Act provides for a Code of <strong>ACC</strong> Claimants’ Rights<br />
to be developed so that claimants can know what<br />
they can reasonably expect when dealing with the<br />
Accident Compensation Corporation. Among other<br />
things, the Code will:<br />
• provide remedies where the Corporation<br />
has breached the Code;<br />
• explain a claimant’s right to a review<br />
of any decision the Corporation makes<br />
about a claimant’s complaint.<br />
A claimant who wants a review will be able to use<br />
the dispute resolution procedures set out in the Act.<br />
The Code’s rights and obligations are additional to<br />
any other claimant rights or Corporation obligations.<br />
They do not affect claimants’ entitlements or<br />
responsibilities under the Act itself, under any<br />
other enactment, or under the general law. The<br />
Code applies both to the Corporation itself and<br />
to accredited employers under <strong>ACC</strong>’s Partnership<br />
Programme in their dealings with accident<br />
compensation claimants.<br />
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TERMINATION OF<br />
EMPLOYMENT<br />
While an employee is on <strong>ACC</strong> they remain employed<br />
despite their absence. An employer should maintain<br />
regular contact with the employee to keep updated<br />
on their progress and their expected date of return to<br />
work. When an employee has been incapacitated and<br />
unable to attend work for an extended period of time<br />
due to an injury an employer may have to assess the<br />
employee’s on-going employment with the Company.<br />
An employee should first be given a reasonable<br />
opportunity to recover and any decision to<br />
terminate their employment should be based on the<br />
business need to replace that employee. For further<br />
information, please refer to the section on Incapacity/<br />
Long Term Illness in the Employer Guide on discipline<br />
and termination and contact the AdviceLine Team<br />
or your Business Central Employment Relations<br />
Consultant for further advice.<br />
DEFINITIONS<br />
Accident<br />
‘Accident’ means:<br />
• a specific event or series of events involving<br />
the application of a force (including gravity)<br />
or resistance external to the human body,<br />
or the sudden movement of the body to<br />
avoid such an external force or resistance,<br />
or involves a twisting movement of the<br />
body, other than a gradual process;<br />
• the inhalation or oral ingestion of any solid,<br />
liquid, gas or foreign object on a specific<br />
occasion, other than the inhalation or<br />
ingestion of a virus, bacterium, protozoa<br />
or fungus, unless that inhalation or<br />
ingestion is the result of a criminal act of a<br />
person other than the injured person;<br />
• a burn or exposure to radiation rays of any<br />
kind, on a specific occasion, not including<br />
a burn or exposure caused by exposure to<br />
the elements (sunburn, for example);<br />
• the absorption of any chemical through<br />
the skin within a defined period of<br />
time not exceeding one month;<br />
• any exposure to the elements or to extremes of<br />
temperature or environment, within a defined<br />
period of time not exceeding one month that:<br />
for a continuous period of more than one month<br />
results in any restriction or lack of ability preventing<br />
the performance of an activity in the manner or<br />
within the range considered normal for that person;<br />
or causes death.<br />
‘Accident’ does not include:<br />
• any of the above occurrences if<br />
they are treatment given:<br />
• in New Zealand by, or at the direction<br />
of, a registered health professional; or<br />
• outside New Zealand by, or at the direction<br />
of, a person who has qualifications<br />
the same or equivalent to those of a<br />
registered health professional; or<br />
• any ecto-parasitic infestation (such as<br />
scabies), unless it is work-related; or<br />
• the contraction of any disease carried by<br />
an arthropod as an active vector (such<br />
as malaria resulting from a mosquito<br />
bite), unless it is work-related.<br />
The fact that someone has suffered a personal injury<br />
is not of itself to be construed as an indication or<br />
presumption that it was caused by an accident.<br />
Employee<br />
‘Employee’ means:<br />
A natural person who receives or<br />
is entitled to receive—<br />
• any amount that is treated as income from<br />
employment as defined in paragraph (a) of<br />
the definition of income from employment in<br />
section OB 1 of the Income Tax Act 1994; or<br />
• any salary, wages or other gross<br />
income to which section OB 2(2) of<br />
the Income Tax Act 1994 applies.<br />
(Income from employment is essentially salary or<br />
wages and any extra emoluments. It also includes<br />
accident compensation payments.)<br />
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Employer<br />
‘Employer’ means:<br />
a person who pays, or is liable to pay—<br />
• any amount that, in relation to any other<br />
person, is treated as income from employment,<br />
as defined in paragraph (a) of the definition<br />
of income from employment in section<br />
OB 1 of the Income Tax Act 1994; and<br />
• any salary, wages or other gross<br />
income to which section OB 2(2) of the<br />
Income Tax Act 1994 applies; but<br />
• does not include, for the purpose of Part 6 of the<br />
Accident Compensation Act, (‘Management of<br />
the Scheme’), a person who is an employer solely<br />
by reason of any of paragraphs (f), (g), (h), (i), (ia),<br />
(ib), or (iba) of the definition of salary or wages<br />
in section OB 1 of the Income Tax Act 1994.<br />
(In other words, the employer is not required to pay<br />
the employee’s tax on earnings-related compensation<br />
payments (other than first week compensation) or<br />
any other compensation payment made to an injured<br />
employee. The exception is where an employer has<br />
entered into an agreement with the Corporation to<br />
provide injured employees with their entitlements.<br />
This can be done either by becoming an accredited<br />
employer or by entering into a reimbursement<br />
agreement which means that the employer pays<br />
compensation entitlements to the injured employee<br />
and is reimbursed by the Corporation.)<br />
Incapacity<br />
For the purposes of determining incapacity,<br />
incapacity means:<br />
• in the case of an earner or someone on<br />
unpaid parental leave, determining whether<br />
that person is unable, because of injury, to<br />
engage in employment in which he or she<br />
was employed when the injury was suffered.<br />
The Corporation must also determine the incapacity<br />
for employment of someone deemed still to be<br />
an employee, because he or she was an employee<br />
within 14 days before incapacity commenced<br />
and would have been an employee within three<br />
months (or 12 months if a seasonal employee—<br />
confirmation required from the employer), is a<br />
potential employee, or has purchased the right to<br />
receive weekly compensation.<br />
Personal injury<br />
Personal injury means:<br />
•death; <br />
• physical injuries, including a strain or sprain;<br />
• mental injury suffered by someone as a<br />
consequence of his or her physical injuries;<br />
• mental injury caused by a criminal<br />
act (set out in the Act’s Schedule 3<br />
and generally of a sexual nature);<br />
• work-related mental injury that is suffered<br />
by a person in certain circumstances (see<br />
under ‘Work—related mental injury’ above);<br />
• damage, (other than wear and tear) to<br />
dentures or prostheses (such as artificial limbs)<br />
that replace a part of the human body.<br />
• from 1 July 2010, any degree of hearing loss<br />
that is 6 per cent or more of binaural hearing<br />
loss caused by a personal injury as a result of:<br />
an accident to the person; a treatment injury; a<br />
consequence of treatment given to the person<br />
for another personal injury for which the person<br />
has cover; a personal injury caused by a workrelated<br />
gradual process disease or infection; a<br />
consequence of treatment given for a personal<br />
injury caused by a work- related gradual process<br />
disease or infection for which the person has<br />
cover; a cardio-vascular or cerebro- vascular<br />
episode that is a treatment injury suffered<br />
by the person; or a personal injury that is a<br />
cardio-vascular or cerebro- vascular episode.<br />
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Personal injury does not include:<br />
• injury caused wholly or substantially by a<br />
gradual process, disease, or infection (except in<br />
the circumstances set out under the heading<br />
‘Gradual process, disease, or infection’);<br />
• a cardio-vascular or cerebro-vascular episode<br />
(except in the circumstances described<br />
under ‘Cardio-vascular, cerebro-vascular’);<br />
• personal injury caused wholly or<br />
substantially by the ageing process;<br />
• personal injury to teeth or dentures<br />
caused by their natural use.<br />
• from 1 July 2010, any degree of hearing<br />
loss that is 6 per cent or more of binaural<br />
hearing loss caused by a personal injury:<br />
that is not caused by the circumstances<br />
described above; or is caused by the ageing<br />
process; or is caused by any other factors.<br />
Place of employment<br />
‘Place of employment’ means any premises or place:<br />
• occupied for the purposes of employment; or<br />
• to which a person has access because<br />
of his or her employment; or<br />
• attended for a course of education or training<br />
for the purposes of current employment, if<br />
the employee receives earnings from that<br />
employment for his or her attendance.<br />
<strong>ACC</strong> AS A NO FAULT SCHEME<br />
Recent changes to the Sentencing Act 2002 bring<br />
into question whether <strong>ACC</strong> is a completely no fault<br />
scheme. The Supreme Court in 2009 ruled that<br />
reparation could not be ordered for earnings lost due<br />
to an injury, even if <strong>ACC</strong> compensation did not meet<br />
the full extent of the loss. However the Sentencing<br />
Amendment Act 2014 has overturned that decision.<br />
Under the amendment Courts will now be able to<br />
order reparation to top-up any shortfall in a victim’s<br />
<strong>ACC</strong> compensation. Shortfalls include the 20 percent<br />
of wages not recoverable under <strong>ACC</strong> compensation,<br />
any shortfall in earnings if the <strong>ACC</strong> compensation has<br />
been calculated on artificially low earnings, and the<br />
shortfall if a claimant’s weekly earnings exceed the<br />
maximum weekly compensation under <strong>ACC</strong>.<br />
This is relevant for employers who are found liable<br />
under the Health and Safety at Work Act 2015 for<br />
workplace injuries resulting in an employee needing<br />
time off work. The employer could be made to top<br />
up the weekly compensation to address any of the<br />
above shortfalls. The amendment came into effect<br />
on 6 December 2014.<br />
‘Practicable’<br />
In relation to rehabilitation, practicable means<br />
practicable after considering and balancing:<br />
• the nature and consequences of the injury;<br />
• the achievement of rehabilitation outcomes;<br />
•costs; <br />
•cost effectiveness;<br />
• the availability of other forms of rehabilitation;<br />
• other relevant factors<br />
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APPENDIX<br />
Occupational diseases<br />
1. Pneumoconioses caused by sclerogenetic<br />
mineral dust (silicosis, anthraco-silicosis,<br />
asbestosis) and silico-tuberculosis, provided<br />
that silicosis is an essential factor in causing<br />
the resultant incapacity or death.<br />
2. Lung cancer or mesothelioma<br />
diagnosed as caused by asbestos.<br />
3. Diseases of a type generally accepted<br />
by the medical profession as caused by<br />
beryllium or its toxic compounds.<br />
4. Diseases of a type generally accepted<br />
by the medical profession as caused by<br />
phosphorus or its toxic compounds.<br />
5. Diseases of a type generally accepted<br />
by the medical profession as caused<br />
by chrome or its toxic compounds.<br />
6. Diseases of a type generally accepted<br />
by the medical profession as caused by<br />
manganese or its toxic compounds.<br />
7. Diseases of a type generally accepted<br />
by the medical profession as caused<br />
by arsenic or its toxic compounds.<br />
8. Diseases of a type generally accepted<br />
by the medical profession as caused<br />
by mercury or its toxic compounds.<br />
9. Diseases of a type generally accepted<br />
by the medical profession as caused<br />
by lead or its toxic compounds.<br />
10. Diseases of a type generally accepted<br />
by the medical profession as<br />
caused by carbon bisulphide.<br />
11. Diseases of a type generally accepted<br />
by the medical profession as caused<br />
by the toxic halogen derivatives of<br />
hydrocarbons of the aliphatic series.<br />
12. Diseases of a type generally accepted<br />
by the medical profession as caused by<br />
benzene or its toxic homologues.<br />
13. Diseases of a type generally accepted<br />
by the medical profession as caused<br />
by nitro- and amido-toxic derivatives<br />
of benzene or its homologues.<br />
14. Diseases of a type generally accepted<br />
by the medical profession as<br />
caused by ionising radiations.<br />
15. Primary epitheliomatous cancer of the skin<br />
diagnosed as caused by tar, pitch, bitumen,<br />
mineral oil, anthracene, or the compounds,<br />
products, or residues of these substances.<br />
16. Anthrax infection.<br />
17. Leptospirosis diagnosed as caused by<br />
working with animals or their carcasses.<br />
18. Brucellosis diagnosed as caused by<br />
working with animals or their carcasses.<br />
19. Orf diagnosed as caused by working<br />
with animals or their carcasses.<br />
20. Streptococcus suis diagnosed as caused by<br />
working with animals or their carcasses.<br />
21. Angiosarcoma of the liver diagnosed as<br />
caused by vinyl chloride monomer.<br />
22. Byssinosis diagnosed as caused by working<br />
with cotton, flax, hemp, or sisal dust.<br />
23. Pneumoconiosis diagnosed as caused<br />
by tin, iron oxide, barium, or cobalt.<br />
24. Diseases of a type generally accepted by the<br />
medical profession as caused by tungsten.<br />
25. Hand-arm vibration syndrome diagnosed<br />
as caused by hand and/or arm vibration.<br />
26. Sino-nasal carcinoma diagnosed as<br />
caused by working with wood dust.<br />
27. Diseases of a type generally accepted by the<br />
medical profession as caused by ethylene oxide.<br />
28. Extrinsic allergic alveolitis diagnosed as caused<br />
by work involving the inhalation of organic dusts.<br />
29. Naso-pharyngeal carcinoma diagnosed<br />
as caused by formaldehyde.<br />
30. Laryngeal carcinoma diagnosed as caused<br />
by sulphuric acid mists or organic solvents.<br />
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31. Lung cancer diagnosed as caused by bis<br />
(chloromethyl) ether (and chloromethyl<br />
methyl ether), cadmium, coke oven<br />
emissions, nickel, radon, silica, or soot.<br />
32. Primary epitheliomatous cancer of the<br />
skin diagnosed as caused by shale oil.<br />
33. Bladder carcinoma diagnosed as<br />
caused by 2-naphthylamine, benzidine,<br />
4-aminobiphenyl, N, N-Bis (2-chloroethyl)-<br />
2-naphthylamine, other aromatic amines,<br />
or poly-cyclic aromatic hydrocarbons.<br />
34. Hodgkin’s lymphoma diagnosed<br />
as caused by wood dust.<br />
35. Chronic solvent-induced encephalopathy<br />
diagnosed as caused by organic<br />
solvents, particularly styrene, toluene,<br />
xylene, trichloroethylene, methylene<br />
chloride, or white spirit.<br />
36. Peripheral neuropathy diagnosed as caused<br />
by organic solvents such as n-hexane, carbon<br />
disulphide, or trichloroethylene; pesticides<br />
such as organophosphates; acrylamide.<br />
37. Occupational asthma diagnosed as caused<br />
by recognised sensitising agents inherent<br />
in the work process such as, but not limited<br />
to, isocyanates, certain wood dusts, flour<br />
dusts, animal proteins, enzymes, and latex.<br />
38. Chronic obstructive pulmonary<br />
disease diagnosed as caused by coal,<br />
silica, cotton dust, or grain dust.<br />
39. Chronic renal failure diagnosed as<br />
caused by metals such as cadmium or<br />
copper, including via welding fumes.<br />
40. Occupational allergic contact dermatitis<br />
diagnosed as caused by recognised sensitising<br />
agents inherent in the work process such as,<br />
but not limited to, nickel and other metals,<br />
rubber additives, resins, petroleum distillates,<br />
solvents, soaps, detergents, and plant allergens.<br />
41. Vitiligo diagnosed as caused by para-tertiarybutylphenol,<br />
para-tertiary-butylcatechol, paraamylphenol,<br />
hydroquinone, or the monobenzyl<br />
or monobutyl ether of hydroquinone.<br />
34