Transitional claims Policy v4.0
Summary
3.0 Transitional claims: Single employment at Date
of First Incapacity / Date of Subsequent Injury
Objective
(DOFI/DOSI)
Clients with ongoing entitlement to weekly compensation under
a For claims receiving unabated weekly compensation up
Accident Insurance Act 1998 (AI Act), Schedule 1, Section 428
to 31 March 2002:
to 431, continue to be entitled to compensation under Accident
• there will be no change to the rate of weekly compen-
Compensation Act 2001 (AC Act), Section 365.
sation from 1 April 2002, except where the rate is affected
by changes to the minimum
1. Rules
• when a further medical certificate is entered onto Path-
2. Transition of existing weekly compensation claims
way for a period on or after 1 April 2002, the ongoing
3. Transitional claims: Single employment at Date of First Inca-
assessment will automatically be made under the AC Act
pacity / Date of Subsequent Incapacity (DOFI/DOSI)
2001.
4. Continuing entitlement
5. Transitional claims: Multiple employment at DOFI/DOSI
For example, an employee in non-permanent work has
6. Incapacity for all employment
an accident on 10 January 2002, and remains incapa-
7. No incapacity for at least one employment
citated from that date. In the 52 weeks prior to 10 Jan-
8. Transition of existing claims
uary 2002 they earn $30,000.
9. Incapacity starts or recommences for the 'no-incapacity'
employment
NOTE Example
10. Subsequent incapacity
Pre-incapacity earnings
11. Payments for permanent incapacity made under former Acts
$30,000 ÷ 52
12. Ceasing payments
13. Deterioration or new personal injury
Weekly earnings
14. Compare rates weekly
$576.92
15. Deterioration between 1 July 1992 and 30 June 1999
16. Ongoing proof of incapacity
Weekly compensation @ 80%
17. Abatement
$461.54
18. Total earnings excess for transitional claims
19. Minimum weekly earnings increase
b This rate, calculated under the AI Act 1998, continues to
20. Entitlements for injuries prior to 1 April 2002, where claim
be paid after 1 April 2002 while the client remains incapa-
lodged post 1 April 2002
citated.
Owner
9(2)(a)
Expert
9(2)(a)
4.0 Continuing entitlement
a The client continues to be eligible for weekly compen-
Policy
sation until either:
• ACC determines that they are no longer incapacitated,
1.0 Rules
including vocational independence assessment
a For all transitional claims:
• any other normal cessation provisions apply, eg upper
• payments will continue to be made under the AI Act
age limits.
1998 up to and including 31 March 2002
• from 1 April 2002, payments will be made under the AC
Act 2001
5.0 Transitional claims: Multiple employment at
DOFI/DOSI
the AC Act rules for incapacity and abatement will apply,
with some modifications.
a The attached table shows a summary of the incapacity
regime relating to multiple employment claims under prior
and current legislation.
2.0 Transition of existing weekly compensation
claims
a Where a person is entitled immediately before 1 April
2002 to weekly compensation based on a calculation
under a former Act, then:
• the base rate of weekly compensation payable is saved
• abatement adjustments are made under the AC Act
2001 rules, from 1 April 2002
• the client is eligible for indexation under the AC Act
2001 rules
Transitional claims - Multiple employment at DOFI -
• if the person has weekly earnings below the minimum
DOSI.PNG
full-time earner rate, they are eligible to have weekly
earnings increased to this rate, if they were in full-time
employment prior to incapacity.
Excluding cases where compensation is based on rele-
vant earnings or prescribed amounts under the 1972 and
1982 Acts.
ACC > Claims Management > Manage Client Payments > Operational Policies > Weekly Compensation > Transitionals > Transitional claims Policy
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6.0 Incapacity for all employment
AI Act 1998, Transitional Claims
a If a client held more than one employment at DOFI/DOSI,
https://www.westlaw.co.nz/maf/wlnz/app/document?
is incapacitated for all those employments, and is re-
doc-
ceiving weekly compensation on this basis at 31 March
guid=Ibad19b9ce02e11e08eefa443f89988a0&isToc
2002. There will be no change to their rate of weekly
Nav=true&tocDs=AUNZ_NZ_LEGCOMM_TOC&start
compensation from 1 April 2002 if they continue to have
Chunk=1&endChunk=1
an incapacity for all employment. However, from 1 April
Accident Compensation Act 2001, section 367 - mul-
2002, ACC will generally consider the client to be incapa-
tiple employment
citated if they are unable to engage in one of their
http://www.legislation.govt.nz/act/public/2001/0049/
employments.
latest/DLM104176.html
For example, a person was employed in two casual em-
ployee jobs when they had an accident on 20 March
1999.
9.0 Incapacity starts or recommences for the ‘no-
incapacity’ employment
In the 52 weeks prior to their incapacity, they earned the
a If the client, after 1 April 2002, continues to have ‘no inca-
following:
pacity’ for at least one employment held at DOFI/DOSI
and becomes incapacitated for one of those ‘no inca-
Job A $15,000.00
pacity’ employments held at DOFI/DOSI then:
Job B $10,000.00
• Section 367 provides that a recalculation of weekly
Total earnings $25,000.00
earnings is required, so that the client can begin to re-
Long term rate (divide total by 52) $480.77
ceive compensation based on weekly earnings from all
Weekly compensation @ 80% $384.62
employment held at DOFI/DOSI
• the recalculated rate of weekly compensation only ap-
The client continues to receive the same rate following 1
plies from the date the client becomes incapacitated for
April 2002, subject to abatement. From this date, if the
the ‘no incapacity’ employment.
client has an incapacity for just one of those jobs, they
are still eligible to have compensation based on earnings
NOTE Once transitioned, incapacity is no longer
from all the jobs held at DOFI/DOSI.
considered on a per employment basis, ie the
‘no-incapacity’ employment cannot revert
back to being a ‘no-incapacity’ employment.
7.0 No incapacity for at least one employment
a The following only applies to a transitional client who:
10.0 Subsequent incapacity
• had more than one employment at DOFI/DOSI
• immediately prior to 1 April 2002, was not eligible for
a If the client ceases to be incapacitated for the employ-
weekly compensation in respect of all employment be-
ments that they receive weekly compensation for after 1
cause for at least one of those employments they had no
April 2002, then eligibility for weekly compensation ends.
incapacity.
If there is a subsequent incapacity relating to the same
injury, then weekly earnings may be recalculated under
8.0 Transition of existing claims
the AC rules, if the client is still an earner.
a Section 367 of the AC Act 2001 provides for transitional
If the incapacity recommences within 28 days of the ces-
clients who had more than one employment, and ‘no
sation, the client can continue to receive weekly compen-
incapacity’ for one of them, to continue to receive weekly
sation at the rate previously calculated unless a recal-
compensation based on the existing calculation of weekly
culation would produce a better result.
earnings from 1 April 2002:
• weekly compensation is recalculated to include all
employment if the client later becomes incapacitated for
the other employment, for which they had ‘no incapacity’.
11.0 Payments for permanent incapacity made under
See Incapacity starts or recommences for the ‘no-
incapacity’ employment
former Acts
• alternatively, if the client regains full capacity for all
a Payments for permanent incapacity calculated under
employments, entitlement simply ends, as per normal
Section 60 of the 1982 Act or Section 114 of the 1972 Act
rules.
are continued beyond 1 April 2002 by AC Act 2001, Sec-
tion 365.
During the period that they continue to have ‘no inca-
pacity’ for at least one employment, the ‘No-incapacity
Special rules apply to permanent incapacity payments
excess calculation’ continues to apply, to establish wheth-
continued after 1 April 2002. ACC cannot:
er any of the client’s earnings from that employment are
• apply abatement to permanent incapacity payments
liable for abatement.
• require a vocational independence assessment of
clients in respect of permanent incapacity payments con-
See AI Act 1998, Transitional Claims
tinued under Section 365.
Examples – incapacity starts or recommences for
Accident Compensation Act 2001, section 365
the no-incapacity employment - Reference
http://www.legislation.govt.nz/act/public/2001/0049/
http://thesauce/team-spaces/chips/compensation/
latest/DLM104174.html
weekly-compensation/reference/transitionals-187/
examples--incapacity-starts-or-recommences-for-
the-no-incapacity-employment/index.htm
ACC > Claims Management > Manage Client Payments > Operational Policies > Weekly Compensation > Transitionals > Transitional claims Policy
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Page 2 of 4
12.0 Ceasing payments
AC Act 2001, Schedule 1 Part 2
a ACC can only cease permanent incapacity payments if
http://www.legislation.govt.nz/act/public/2001/0049/
either of the following apply:
latest/DLM104546.html
• the client reaches the upper age limit
• the client dies.
17.0 Abatement
a Any payment beyond 1 April 2002 is subject to the IRPC
13.0 Deterioration or new personal injury:
Act abatement rules.
For more information on Apply abatement, see:
• earnings liable for abatement
• applying the abatement formula
For more information on specific policies on transitional
Deterioration or new personal injury.PNG
claims, see:
a In this situation, entitlement is the higher of:
• no incapacity excess for an individual employment
• the permanent incapacity payment, under Section 60 of
• total earnings excess.
the 1972 Act or 114 of the 1982 Act
Determine employee earnings liable for abatement -
• weekly compensation calculated under AC Act 2001,
Reference
Schedule 1 Part 2 . This calculation includes both earn-
ings from employment and earnings from permanent
http://thesauce/team-spaces/chips/compensation/
incapacity payments.
weekly-compensation/reference/abatement-187/
determine-employee-earnings-liable-for-abatement/
Note:
index.htm
The Part 2, Schedule 1 provisions for calculating weekly
Transitional claims 1-7-99 to 31-3-02 (AI Act 98)
earnings for an employee exclude from the calculation
https://go.promapp.com/accnz/
periods during which the client received weekly compen-
Process/9c7b43e1-3d64-4750-82c7-08d101e230a1?
sation.
force=False
However, where a reassessment applies for a client re-
ceiving permanent incapacity payments, the permanent
incapacity payments are included as earnings in the Part
2 calculation, as ACC does not consider these payments
to be ‘weekly compensation’.
Accident Compensation Act 2001, Schedule 1,
Clause 2
http://www.legislation.govt.nz/act/public/2001/0049/
latest/DLM104546.html
14.0 Compare rates weekly
a If the client later receives earnings liable for abatement, it
is applied to the reassessed weekly compensation in the
normal manner. If, as a result, the weekly compensation
payable is less than the payment for permanent inca-
pacity, then the permanent incapacity payment is pay-
able.
In effect, the ‘higher of’ assessment of the Schedule 1
weekly compensation amount and the permanent inca-
pacity amount is performed on a week by week basis.
15.0 Deterioration between 1 July 1992 and 30 June
1999
a Different rules applied between 1 July 1992 and 30 June
1999 where a client’s condition, for which they were re-
ceiving permanent incapacity payments, deteriorated.
16.0 Ongoing proof of incapacity
a Medical certificates are only required for periods where
the client is entitled to receive weekly compensation pay-
ments calculated under AC Act 2001, Schedule 1 Part 2 .
Failure to produce medical certificates will mean the
client is only entitled to their permanent incapacity pay-
ment.
ACC > Claims Management > Manage Client Payments > Operational Policies > Weekly Compensation > Transitionals > Transitional claims Policy
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18.0 Total earnings excess for transitional claims
b Transitional clients who have weekly earnings assess-
a
ment under the 1992 and 1998 Act, and who are eligible
If a client receives earnings during a period of incapacity,
for ‘long term’ weekly compensation based on weekly
the abatement rules of Clause 51 of Schedule 1 of the
earnings that are less than the new full time minimum
AC Act 2001 apply to proportionally reduce weekly
rates immediately prior to 1 April 2002, are eligible for an
compensation payments dependent on the level of those
increase in weekly earnings to the new minimum from 1
earnings.
April 2002, if:
• they were in full time employment immediately prior to
The only change in the abatement calculation is how the
the commencement of incapacity
excess reduction is applied under Clause 51(2). This
• they are liable to pay the minimum annual earner pre-
calculation provides that weekly compensation when
mium
combined with earnings cannot exceed the client’s
• ACC is satisfied they would have continued in full-time
weekly earnings applicable for that abatement week.
employment.
The comparison rate for the excess check in Clause 24
If self-employed, they are also eligible for an increase if
(2) of Schedule 1 of the AI Act 1998 was described as the
the transition date falls within the short-term period, if
client’s ‘earnings immediately before the incapacity com-
they are liable to pay the minimum annual earner pre-
menced’. This was interpreted to mean the client’s short-
mium. This includes:
term weekly earnings rate and was applied irrespective of
• clients receiving compensation based on minimum
whether the abatement week applied for the short or
weekly earnings at the transition date
long-term period.
• clients with actual weekly earnings above the AI Act
1998 minimum, but less than the new minimum amounts.
The AI Act rule applied for:
• all new weekly compensation calculations after 1 July
1999
• 1992 Act weekly compensation calculation where the
20.0 Entitlements for injuries prior to 1 April 2002,
client was in the short-term period at 1 July 1999.
where claim lodged post 1 April 2002
a AC Act 2001, Section 360 directs that any claim for cover
For all remaining existing 1972, 1982, 1992 Act long term
lodged on or after 1 April 2002 for an injury suffered prior
weekly compensation calculations continuing after 1 July
to 1 April 2002 will have entitlements assessed under the
1999, the excess check comparison rate remained as the
AC Act 2001 rules.
long-term weekly earnings.
The effect of this is that the weekly earning calculations
The AC Act 2001 reinstates the ARCI Act approach to the
of the AC Act 2001 can be applied to a period prior to 1
application of the excess check and provides that in the
April 2002.
excess comparison rate is the:
• short-term weekly earning rate for abatement assess-
This includes entitlement for any period prior to 1 April
ment in the short-term period
2002.
• long-term weekly earnings rate for abatement assess-
ments in the long-term period.
Accident Compensation Act 2001, section 360
This new rule applies to all new and existing claims from
http://www.legislation.govt.nz/act/public/2001/0049/
1 April 2002 and will be applied automatically by Path-
latest/DLM104164.html
way. Where the new rule is applied, notify the client of the
new assessment by sending an ACC641 Weekly
compensation advice (140K) and ACC651 Abatement
assessment form, (83K) generated by Pathway.
ACC651 Abatement assessment
ACC641 Weekly compensation advice
Accident Compensation Act 2001, Schedule 1,
Clause 51
http://www.legislation.govt.nz/act/public/2001/0049/
latest/DLM105402.html
19.0 Minimum weekly earnings increase
a As at 1 April 2002, a new minimum weekly earnings rule
came into force. The minimum rates from 1 April 2002 are
as follows:
Minimum weekly earnings increase.PNG
ACC > Claims Management > Manage Client Payments > Operational Policies > Weekly Compensation > Transitionals > Transitional claims Policy
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Transitional claims 1972 and 1982 Acts Policy v5.0
Summary
AC Act 1972
http://www.westlaw.co.nz/maf/wlnz/app/document?
&src=search&doc-
Objective
guid=I7979db04e02711e08eefa443f89988a0&epos=
This information applies to claims where cover exists under
1&snip-
either the AC Act 1972 or the AC Act 1982, because the de-
pets=true&fcwh=true&start-
ceased died prior to 1 July 1992 and a claim cover was lodged
Chunk=1&end-
with ACC before 30 September 1992.
Chunk=1&isToc-
Nav=true&tocDs=AUNZ_NZ_LEGCOMM_TOC&con-
text=89&extLink=false
It sets out the provisions for:
•eligibility to the ‘one-off’ entitlements, ie assistance with:•fu-
neral expenses
•lump sum payments to survivors, if they have not been paid
2.0 Lump sum payment
prior to 1 April 2002
a About lump sum payments for accidental death
•eligibility and cessation rules after 1 April 2002 for ongoing
entitlements that the client was entitled to prior to this date
If the person died before 1 July 1992, Section 382 of the
under the Accident Insurance Act transitional provisions. These
AC Act provides for payment of a lump sum to spouses,
may be:•grandparented childcare
children, and other dependants of the deceased under
•earnings-related compensation for a spouse, child, or other
AC Act 1982, Section 82.
dependant originally determined under the 1972 or 1982 Acts.
b Eligibility criteria
Owner
9(2)(a)
Consider making such a payment if all of the following
apply:
Expert
9(2)(a)
•the date of death and the date of accident were before 1
July 1992
Policy
•the claim was accepted for cover as personal injury
caused by accident (PICBA)
1.0 Funeral expenses
•the claim for cover was lodged before 1 October 1992
a Section 381 of the AC Act 2001 allows us to consider
•where there were more than 12 months between the
paying a grant under Schedule 1 Clause 64 to cover the
date of accident and the date the claim was lodged, a
cost of funeral expenses for a fatal injury claim, when the
decision on the late lodgement was made under AC Act
death was covered by the 1972 or 1982 Act.
1982, Section 98.
Provided the application meets these eligibility criteria,
We can pay these expenses if all the following apply:
there’s no time limit on when the surviving client can
•neither we, nor any previous incarnations of ACC, have
apply for this entitlement.
previously paid such a grant for this claim
c How to process application
•the date of accident and the date of death were both
before 1 July 1992
•the claim was accepted for cover as a personal injury
If the date of death was before 1 July 1992, process the
caused by accident (PICBA), under the 1972 or 1982 Act.
application for this entitlement according to:
•Section 82 of the 1982 Act
If these criteria apply, consider and pay the claim using
•1982 Claims Manual (Volume 2, Part 15, Procedure 10
the same procedures and account codes as for the cur-
‘Lump Sums’).
rent Act.
Section 382
The amount payable is the lesser of:
http://www.westlaw.co.nz/maf/wlnz/app/document?
•the cost of the funeral
doc-
•$4,500.
guid=I67901ff1e03211e08eefa443f89988a0&tocDs=
AUNZ_NZ_LEGCOMM_TOC&isToc-
AC Act 1982
Nav=true&startChunk=1&endChunk=1
http://www.westlaw.co.nz/maf/wlnz/app/document?
&src=search&doc-
AC Act 1982, Section 82
guid=I88b2cb47e02711e08eefa443f89988a0&epos=
http://www.westlaw.co.nz/maf/wlnz/app/document?
1&snip-
&src=search&doc-
pets=true&fcwh=true&start-
guid=I88b2cb47e02711e08eefa443f89988a0&epos=
Chunk=1&end-
1&snip-
Chunk=1&isToc-
pets=true&fcwh=true&start-
Nav=true&tocDs=AUNZ_NZ_LEGCOMM_TOC&con-
Chunk=1&end-
text=107&extLink=false
Chunk=1&isToc-
Nav=true&tocDs=AUNZ_NZ_LEGCOMM_TOC&con-
text=107&extLink=false
ACC > Claims Management > Manage Client Payments > Operational Policies > Accidental Death Entitlements > Transitional provisions > Transitional claims 1972 and 1982
Acts Policy
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Page 1 of 6
AC Act 1982, Section 98
d Which Act to use for reassessments
http://www.westlaw.co.nz/maf/wlnz/app/document?
&src=search&doc-
guid=I88b2cb47e02711e08eefa443f89988a0&epos=
By default, determine reassessments under the 1972 or
1&snip-
1982 Act provisions as applicable for the particular claim.
pets=true&fcwh=true&start-
Chunk=1&end-
However, where the client has previously decided to re-
Chunk=1&isToc-
ceive their entitlement under a later Act instead, assess
Nav=true&tocDs=AUNZ_NZ_LEGCOMM_TOC&con-
them under AC Act 2001, Schedule 1, Clauses 76-78.
text=107&extLink=false
e Frequency of reassessments
3.0 Childcare
We can’t reassess a client’s entitlement more than once
a The AC Act 2001, Section 387 allows us to continue
in any 12 month period.
paying for childcare for a child of the deceased, if all of
f Advise surviving client of options
the following apply:
•the date of death was before 1 July 1992
When you reassess the entitlement, you need to write to
•immediately before 1 July 1992, they were receiving or
the surviving client or their representative, explaining:
were entitled to receive childcare payments under AC Act
•the entitlement under Schedule 1, Clauses 76-78
1972, Section 121 or AC Act 1982, section 80
•they can elect to be assessed either under the Act
•they were entitled to receive this entitlement under Sec-
they’re currently receiving their entitlement under (either
tion 149 of the 1992 Act and Section 449 of the 1998 Act,
the 1972 or 1982 Act) or under the 2001 Act
which continued an entitlement from the 1972 or 1982
•once they’ve been notified of the results of the assess-
Act.
ment, if they do elect to receive the entitlement under the
2001 Act they can’t revoke that decision
We call this a grandparented entitlement. The rate they
•when they do elect to receive the entitlement under
receive is calculated according to the provisions of the
Schedule 1, Clauses 76-78, the entitlement applies from
1972 or 1982 Act, as applicable. When you continue pay-
the date of their election.
ments, use the account codes the previous payments
used.
4.0 Earnings-related compensation (ERC) to
The review and appeal rights of the 1982 Act apply to a
spouse
client with a grandparented childcare entitlement.
a Use the information in this document if:
b Client elects preference
•date of death was before 1 July 1992 and the claim for
cover was accepted under the 1972 or 1982 Act
Where the client is receiving an entitlement for a grand-
•the surviving spouse is receiving weekly compensation
parented claim, they can request that we switch to reas-
as a dependant spouse under the 1972 or 1982 Act.
sessing their entitlement under Schedule 1, Clauses
b About ERC to spouse of deceased
76-78 of the AC Act 2001.
If the client elects to receive the entitlement under the AC
The AC Act 2001, Section 384 allows us to continue
Act 2001:
paying compensation to a surviving spouse of the de-
•they can’t revoke that decision later. From that point,
ceased for a fatal injury claim.
they will always be reassessed under the 2001 Act, and
receive their entitlement under that Act. This rule applies
Under the 1972 and 1982 Acts, this entitlement was
regardless of the Act that was in place at the date of elec-
called earnings-related compensation (ERC), which is
tion
very similar to weekly compensation.
•the entitlement, in accordance with Schedule 1, Clauses
76-78, applies from the date of the election.
5.0 Payment rate
If a client is currently receiving a grandparented entitle-
ment:
a The entitlement the spouse receives is the rate that was:
•when we notify them that we will be carrying out a reas-
sessment, they can elect which Act they want us to reas-
•calculated under the 1972 or 1982 Act
sess them under
•transitioned under Section 145 of the 1972 Act or Sec-
•when we notify them of the results of the reassessment,
tion 446 of the 1998 Act
they can accept receiving that entitlement, or they can re-
quest that we reassess their entitlement under the other
From 1 July 1992, the rate is subject to annual index-
relevant Act.
ation.
c Reassessing child care entitlements
From time to time, we reassess the ongoing entitlement
for childcare payments on a fatal injury claim.
ACC > Claims Management > Manage Client Payments > Operational Policies > Accidental Death Entitlements > Transitional provisions > Transitional claims 1972 and 1982
Acts Policy
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6.0 Cessation
8.0 If relationship subsequently ends
a There are three reasons we may stop paying ERC to a
a It’s not relevant to our decision whether that relationship
spouse:
subsequently ends, once the spouse has remarried or
entered a relationship in the nature of marriage. They
•the spouse remarries or enters a relationship in the
don’t regain any entitlement if they become single again
nature of marriage
after cessation.
•a financial dependency check determines that they are
financially able to support themselves
•they reach the upper age limits.
Entering the relationship determines the cessation date
as two years after either:
See the relevant sections for more details.
•the date they remarried
b
•the date they entered a relationship in the nature of mar-
Remarriage or de facto relationship
riage, after 1 July 1999.
However, if the relationship ends before we’ve made our
If a spouse with entitlement under the 1972 or 1982 Act
decision on whether it qualifies, we may not be able to
remarries or enters a de facto relationship, ERC entitle-
cease their entitlement on the basis of that relationship.
ment generally ends two years after the date of remar-
riage. However, if the de facto relationship began before
1 July 1999, AC Act 2001, Section 384(3) specifies:
•if a spouse entered a de facto relationship before 1 July
9.0 Confirming legal marriage
1999, it is to be treated as though it commenced on 1
a If the spouse advises they’ve legally married, you must
July 1999, and entitlement ceases two years after this
obtain a marriage certificate as proof.
date. However, because the AC Act 2001 only comes into
force on 1 April 2002, ACC policy is that entitlement will
cease 2 years after 1 April 2002
10.0 Confirming relationships in the nature of mar-
•if a spouse entered a de facto relationship after 1 July
1999, entitlement ceases two years after the date the
riage
relationship began.
a If there’s evidence the spouse has entered a relationship
c If two dates apply
that could be in the nature of marriage, you need to
determine whether it qualifies as a relationship in the
nature of marriage and, if it does, determine the date we
It’s possible that, if the spouse has entered a relationship
can consider the spouse entered that relationship.
in the nature of marriage, one of the other cessation cri-
teria could come to apply before the end of the two-year
period. In this case, the cessation date is the earlier of
Use the same criteria for determining the nature of a new
the two.
relationship, as you use for determining whether the
spouse qualifies as a spouse of the deceased under the
2001 Act.
Example:
See the following policies to determine if the spouse
qualifies as a spouse of the deceased:
A spouse of the deceased moves in with her new de
•Who is a spouse or partner of the deceased?
facto partner on 15 July 2002. We determine the ces-
•What is a de facto relationship?
sation date is two years from that time. However, in an
•Definition of living together and apart.
annual dependency check completed on 20 November
Who is a spouse or partner of the deceased? Policy
2002, we determine she is self-supporting.
What is a de facto relationship? Policy
Definition of living together or apart Policy
The cessation date that applies is the earlier of the two –
the date of the decision on the dependency check, ie
November 2002.
11.0 Ongoing dependency
a Use the following rules to determine whether a spouse
7.0 Monitoring nature of new relationships
ceases to be entitled to ERC.
a You need to ensure the spouse knows that ACC annually
monitors whether they’ve remarried or entered a rela-
After 1 April 2002 entitlement ends on whichever is the
tionship in the nature of marriage and that, if they do
earlier of:
either, this will affect their entitlement.
•the date the youngest child of the deceased turns 18, if
the spouse still continues to provide care to that child
•the date the spouse ceases to provide care to all child-
ren of the deceased who are under the age of 18.
Entitlement can continue beyond these dates if, at that
date:
•the spouse is age 45 or over. In this case, entitlement
continues until the spouse reaches age 65, New Zealand
superannuation qualifying age (NZSQA)
•the spouse is age 45 or under, but continues to be finan-
cially dependent. In this case, entitlement continues until
they are assessed as no longer financially dependent, or
they reach age 65, whichever first applies.
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12.0 Ongoing eligibility checks
14.0 Checking dependency
a ACC is required to periodically check the eligibility of
a Use the information the spouse provides on the ACC537
spouses, using the ACC137 Continuing dependency
Dependency check (transitional only) (81KB) form to
(transitional only) (121KB) form.
determine if the spouse qualifies as a dependant. They
are dependent if both the following apply:
Eligibility is ongoing for the period they continue to pro-
•they do not qualify as self-supporting
vide care for a child of the deceased who is under the
•their degree of dependency has either changed less
age of 18 years. If this does not apply, or circumstances
than 5% since it was first assessed or is still more than
change over time, then the following Notes sets out eligi-
25%.
bility.
NOTE What if the spouse was •over age 45 when
they ceased to care for the youngest child of
15.0 Determining self-support
the deceased, or the child turned 18 •over
a If the ACC537 Dependency check (transitional only)
age 45 on 30 June 1997
(81KB) shows the spouse’s income for the last 12 months
they are eligible to receive compensation until
was less than $13,500, they do not qualify as self-
the earliest of:
supporting.
•upper age limits apply
•two years after they remarry or enter into a rela-
However, if they earned more than $13,500, obtain a de-
tionship in the nature of marriage
tailed financial statement using the ACC254 Statement of
NOTE What if the spouse •ceased to provide care
financial position (89KB) form to determine whether they
for a child of the deceased, aged 18 and
can financially support themselves.
under; or the youngest child turns 18; and
•the spouse is under age 45 at this date
Based on the information they provide on this form, the
spouse qualifies as self-supporting if their income, in-
a dependency check is required. If ACC accepts
cluding assets, but excluding any payments from ACC, is
dependency then they are eligible until the ear-
significantly higher than their monthly expenditure.
liest of:
•upper age limits apply
•two years after they remarry or enter into a rela-
16.0 Calculating degree of dependency
tionship in the nature of marriage
a Use the following method to determine the spouse’s
NOTE What if the spouse •did not have any children
degree of dependency as a percentage value.
•was under age 45 as at 30 June 1997, but
was assessed as financially dependent at
•Find the deceased’s relevant 12-months’ earnings at the
that date
time of death. Adjust this for the relevant indexation since
that date. Call this ‘A’
they are eligible until the earliest of:
•Calculate the spouse’s 12-months’ earnings for the rele-
vant period. Call this ‘B’
•upper age limits apply
•Use the following formula to calculate the dependency
•two years after they remarry or enter into a rela-
percentage ‘C’
tionship in the nature of marriage
b However, if at the cessation date above, the spouse is
A
still caring for an other dependant, contact the Customer
A + B x 100 = C
Services Technical Support for advice on the action to
take.
17.0 Examples of self-supporting financial situations
a A married couple were in their early twenties. Both were
13.0 When to check dependency
earners. They had bought a section of land, and were
a ACC may have to carry out a dependency check to deter-
saving to build a house on it. The husband died in an
mine whether the spouse is either:
accident.
•financially able to support themselves
•still as financially dependent as they were at the time of
Because of their financial commitments, at the time of the
death.
accident, we assessed that the wife was totally depen-
dent on the husband’s income.
You must only perform this full dependency check once,
on the date when they stop caring for the children or
In an annual entitlement check, we find that the spouse is
other dependants, or the youngest child turns 18. The
no longer caring for any of their children. We carry out a
spouse is supposed to advise ACC if this happens. If they
dependency check and find evidence that the wife was
do not, this will probably be discovered when the annual
able to pay off the loan for the section, all their hire-
entitlement check is carried out.
purchase contracts and their other commitments. She
has continued her employment and is flatting with her
Provided ACC has confirmed dependency at this date,
sister.
there is no requirement to check financial dependency on
an ongoing basis after this. The regular eligibility check
We also discover that the wife has been able to save all
after this is solely done to confirm contact details and
of her weekly compensation payments and is using this
whether the person has remarried or begun a relationship
money to fund frequent trips overseas.
in the nature of marriage.
In this situation, the wife qualifies as fully self-supporting
and her entitlement ceases.
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Page 4 of 6
b A couple owned a motor camp as a partnership. The hus-
20.0 Procedure: Continue or cease ERC to spouse
band died in an accident. We assessed the wife as totally
a
dependent. She took over the care of the deceased’s el-
Complete this procedure each year, when Eos brings up
derly uncle, who was an ‘other dependant’ of the de-
the relevant task.
ceased.
Remember never contact the spouse on the exact anni-
The spouse contacts us to advise that the uncle has died
versary of the date of death.
and she is no longer caring for him. We carry out a
1.Send the client an ACC137 Continuing dependency
dependency check and it becomes clear that, before the
(transitional only) (121KB) form. Enter a task on Eos to
death, the wife did virtually all the day-to-day running of
follow up its return.
the business, while the husband pursued leisure activ-
2.Check the completed ACC137 form, to make sure the
ities.
information is complete and correct.
3.Check the information on the ACC137 form and in the
After the death of her husband the wife continued to op-
case file, to find out if the spouse:•is still caring for any
erate the business. Her income has increased substan-
children of the deceased under age 18, or any other
tially as she’s now the sole owner of the business.
dependants of the deceased
•has reached the upper age limit. If this is not already on
Although her commitments are the same, because of the
file, work out the date now, and record it on the file
increase in income, there’s no continued dependency.
•has remarried or entered a relationship that is, or could
Her entitlement ceases.
be, in the nature of marriage.
If any of the above apply, establish the date it became so.
18.0 Determining upper age limit
4.If applicable, determine whether the spouse’s rela-
a The date that the spouse of the deceased loses their
tionship is in the nature of marriage, and obtain proof of
entitlement, because of reaching the upper age limit, is
this.
the later of the following:
5.If applicable, determine whether a dependency check is
required. If so, send the spouse:•a covering letter.
•the date the spouse reaches age 65
•an ACC537 Dependency check (transitional only)
•the date the deceased would have reached age 65, if
(81KB) form.
they hadn’t died.
6.If the completed ACC537 form shows the spouse’s
earnings are more than $13,500 for the last 12 months,
19.0 NZ Superannuation not relevant
send them:•a covering letter.
•an ACC254 Statement of financial position (89KB) form
a For this type of entitlement, the spouse can be entitled to
receive both ERC from us and NZ Superannuation from
7.If performing a dependency check, establish whether
Work and Income NZ concurrently, without ever needing
the spouse qualifies as self-supporting.
to elect to receive only one or the other.
8.Decide whether to continue or cease entitlement. See
When to continue or cease weekly compensation to a
spouse or partner. The only difference is in the letter used
Work and Income NZ is responsible for determining eligi-
to advise the client of the decision, and the need to give
bility and calculating and paying NZ Superannuation to
one month’s notice of cessation.
the spouse, irrespective of any entitlement the spouse
9.If the entitlement continues, but the spouse is within
has from us.
two years of the upper age limit, send a letter advising of
this.
10.File all documents relevant to the decision-making.
21.0 Earnings-related compensation to a child
a An other dependant who is eligible immediately before 1
April 2002 for ERC under the 1972 or 1982 Act continues
to be eligible after that date.
This compensation is eligible for annual indexation. The
other dependant ceases to be entitled to compensation at
the earlier of:
•when they receive, over a 12-month period, average
earnings per week greater than the minimum weekly
earnings rate that applies for a full-time worker who is
incapacitated
•the date NZSQA upper age limits apply.
These rules are the same as those for an other depen-
dant who has cover under the AC Act 2001. See When to
continue or cease weekly compensation to an other
dependant.
ACC > Claims Management > Manage Client Payments > Operational Policies > Accidental Death Entitlements > Transitional provisions > Transitional claims 1972 and 1982
Acts Policy
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Page 5 of 6
22.0 Relevant legislation
a AC Act 2001, Section 385 sets out these rules, but does
this by directing that Section 447 of the Accident Insur-
ance Act 1998 continues to apply. Section 447 directs
that the cessation rules set out in Schedule 1 Clause 71
of the Accident Insurance Act 1998 apply.
ACC > Claims Management > Manage Client Payments > Operational Policies > Accidental Death Entitlements > Transitional provisions > Transitional claims 1972 and 1982
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Page 6 of 6
Transitional claims 1992 and 1998 Acts v6.0
Summary
3.0 Funeral grant: Death prior to 1 April 2002
a Section 381 of the AC Act 2001 directs that a funeral
Objective
grant is payable if the following criteria are met:
This information applies to claims where cover exists under
either:
•the client died as a result of personal injury before 1 April
2002 and a claim for this has been accepted under one
•the Accident Rehabilitation and Compensation Insurance Act
of the former Acts
1992 (ARCI Act)
•the Corporation has not already paid a grant for funeral
•the Accident Insurance Act 1998 (AI Act).
expenses before 1 April 2002.
It applies when both the following apply:
In addition, ACC requires an application that clearly re-
•the date of death was between 1 July 1992 and 31 March 2002
quests payment of a funeral grant.
•a claim has been lodged, cover accepted and ongoing entitle-
Section 381 of the AC Act 2001
ments (weekly compensation and childcare) are already calcu-
http://www.westlaw.co.nz/maf/wlnz/app/document?
lated by 31 March 2002.
&src=rl&doc-
guid=I67902062e03211e08eefa443f89988a0&hitgui
Owner
9(2)(a)
d=I225e6bf6e03011e08eefa443f89988a0&snip-
pets=true&start-
Expert
9(2)(a)
Chunk=1&end-
Chunk=1&isToc-
Policy
Nav=true&tocDs=AUNZ_NZ_LEGCOMM_TOC&ex-
tLink=false#anchor_I225e6bf6e03011e08eefa443f89
1.0 Late lodgement of claims
988a0
a Under the AC Act, 2001, Section 360, if a fatal injury is
suffered before 1 April 2002 and the claim for cover is not
lodged before 1 April 2002, then:
4.0 Maximum payable
a When the above criteria applies, the funeral grant is pay-
•the injury is only covered if the claim meets the criteria
able under AC Act 2001, Schedule 1, Clause 64. This
for cover under the AC Act 2001, as well as the criteria
means ACC pays the lesser of:
for cover under the Act that was in force when the injury
occurred.
•the actual costs of the funeral
AC Act, 2001, Section 360
•$4,500.
http://www.westlaw.co.nz/maf/wlnz/app/document?
When the date of death is prior to 1 April 2002, this is the
&src=rl&doc-
maximum amount payable, ie even where the funeral
guid=I67904a14e03211e08eefa443f89988a0&hitgui
grant amount has otherwise been increased by index-
d=I225e6b1fe03011e08eefa443f89988a0&snip-
ation. This increased amount does not apply if the date of
pets=true&start-
death was before 1 April 2002.
Chunk=1&end-
Chunk=1&isToc-
The funeral grant is payable to the deceased client’s
Nav=true&tocDs=AUNZ_NZ_LEGCOMM_TOC&ex-
estate. See Funeral grants for more information, in-
tLink=false#anchor_I225e6b1fe03011e08eefa443f89
cluding how to establish actual costs of a funeral and
988a0
make the payment. $4,500 is always the maximum
amount payable.
2.0 Entitlements
AC Act 2001, Schedule 1, Clause 64
http://www.westlaw.co.nz/maf/wlnz/app/document?
a This information sets out the provisions for:
doc-
guid=I679d8e68e03211e08eefa443f89988a0&tocDs
•eligibility for ‘one-off’ entitlements, ie the funeral grant
=AUNZ_NZ_LEGCOMM_TOC&isToc-
and survivor’s grant, if they have not been paid prior to 1
Nav=true&startChunk=1&endChunk=1
April 2002
•eligibility and cessation rules after 1 April 2002 for on-
going entitlements the person was entitled to, prior to this
5.0 Overseas factors
date under the AI Act transitional provisions. These
a As long as the above criteria are met, the funeral grant is
are:•childcare payable to children of the deceased
also payable in the following situations:
•weekly compensation payable to survivors.
•the deceased was an overseas visitor to New Zealand
and the injury occurred in New Zealand
•the death occurred overseas, after 1 July 1992, and the
deceased qualified as a person who is ordinarily resident
in New Zealand.
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Page 1 of 5
6.0 Defining spouse, child and other dependant
7.0 Survivor’s grant
a Who is a spouse of the deceased?
a The AC Act 2001, Section 382 directs that a survivor’s
grant is payable at the rate set out in clause 65 of Sche-
•Under the ARCI Act 1992, the definition of spouse ex-
dule 1, where the following criteria are met:
cluded same-sex relationships.
•the client died on or after 1 July 1992 but before 1 April
•Under the AI Act 1998, a spouse can include the sur-
2002 and the personal injury has cover under the ARCI
viving partner of a same-sex relationship.
Act 1992 or the AI Act 1998
b
•a spouse, child or other dependant was entitled to be
Who is a child of the deceased?
paid a survivor’s grant before 1 April 2002
•ACC did not paid a survivor’s grant before 1 April 2002.
Under the ARCI Act 1992, a child of the deceased did not
include children of same-sex relationships.
This means the survivor must be eligible as a spouse,
child or other dependant under whichever prior legislation
Under the AI Act 1998, a child of the deceased could in-
is relevant.
clude children of same-sex relationships, for the purpose
of determining eligibility to a survivor’s grant, if:
When this applies, the rates to pay are:
•death occurred between 1 July 1992 and 30 June 1999
•$4,702.79 for a spouse
•no survivor’s grant was paid before 1 July 1999.
•$2,351.40 for a child under the age of 18 or other depen-
c Who is an other dependant?
dant.
A person qualified as an other dependant if all the fol-
For these transitional claims, these rates are not in-
lowing applied:
creased by indexation.
•their annual income was less than the specified amount
at the date of death. For the applicable amount at the
See Survivor’s grant for the more information.
date of death, see Accidental death claim indexation
AC Act 2001, Section 382
(1992 Act) and Accidental death claim indexation (1998
Act).
http://www.westlaw.co.nz/maf/wlnz/app/document?
•they were financially dependent on the deceased at the
doc-
date of death
guid=I679d8e68e03211e08eefa443f89988a0&tocDs
•their financial dependency was due to a proven physical
=AUNZ_NZ_LEGCOMM_TOC&isToc-
or mental disability
Nav=true&startChunk=1&endChunk=1
•they didn’t qualify as a child of the deceased who was
clause 65 of Schedule 1
under 18 years
http://www.westlaw.co.nz/maf/wlnz/app/document?
•they weren’t a spouse of the deceased.
doc-
guid=I679d8e68e03211e08eefa443f89988a0&tocDs
Under the ARCI Act 1992 an other dependant could in-
=AUNZ_NZ_LEGCOMM_TOC&isToc-
clude a child of the deceased as long the child is over 18
Nav=true&startChunk=1&endChunk=1
years at the date of death.
Under the AI Act 1998, a child of the deceased was ex-
cluded from the definition of an other dependant, regard-
8.0 Eligibility for childcare
less of the child’s age.
a ACC can make payments towards the cost of supervising
or caring for children on a fatal claim if the following
Accidental death claims indexation (1992 Act)
apply:
http://thesauce/team-spaces/chips/compensation/
accidental-death-entitlements/reference/indexation-/
•the claim has been accepted for cover under the Acci-
ad-claims-index-1992/index.htm
dent Rehabilitation and Compensation Insurance Act
Accidental death claims indexation (1998 Act)
(ARCI Act) 1992 or the Accident Insurance Act 1998
http://thesauce/team-spaces/chips/compensation/
•you have confirmed that the child qualifies as a child of
accidental-death-entitlements/reference/indexation-/
the deceased
ad-claims-index-1998/index.htm
•the child (or their representative) has applied for child-
care entitlement
•the child is either:•under 14
•under 21 and needs childcare because of their physical
or mental condition
•the child lives in NZ.
The deceased does not have to have been the primary
caregiver of the child.
There was no childcare for Accidental Death Unit (ADU)
cases originally included in the ARCI Act 1992. The 1993
Amendment added the ability for ACC to develop regu-
lations for childcare on fatal claims as follows:
NOTE What if the date of death is after 1 July 1992?
Then childcare commenced on the latest of 1
January 1994 or the deceased's date of death
ACC > Claims Management > Manage Client Payments > Operational Policies > Accidental Death Entitlements > Transitional provisions > Transitional claims 1992 and 1998
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Page 2 of 5
NOTE What if the date of death is before 1 July
11.0 Weekly compensation
1992?
a Transitional provisions for ARCI/AI Act dependants
Then payment of childcare under the regulations
could only be accessed if ACC had previously
This information sets out the rules for ongoing eligibility
been providing childcare entitlements under the
and cessation for weekly compensation for a spouse,
1972/1982 Acts
child or other dependant who:
•had their entitlement determined after 1 July 1992 but
before 1 April 2002
9.0 Paying childcare
•is eligible immediately before 1 April 2002.
a Make payments from the later of the following dates:
b Relevant legislation
•the date of death of the deceased
The AC Act 2001, Section 383 applies when a spouse,
•1 January 1994
child or other dependant is entitled to weekly compen-
•where the child is born after the date of death, the child’s
sation immediately prior to 1 April 2002, which is:
date of birth.
•payable under the AI Act 1998, that is, usually because
the deceased died and entitlement was established be-
Make the payments:
tween 1 July 1999 and 30 June 2001
•on the dependent child’s child care subcase
•payable initially under the ARCI Act 1992, and transi-
•weekly, on behalf of the child, to the child care arranger.
tioned under Section 445 of the AI Act 1998, that is,
usually because the deceased died between 1 July 1992
and 30 June 1999. This can also arise if the claim relates
10.0 Continue or cease childcare
to a accidental death before 1 July 1992, but was not
a
lodged before 1 October 1992.
Children eligible for childcare on 31 March 2002
Compensation continues to be payable as if calculated
under Schedule 1 of the AC Act 2001. This means that,
The AC Act 2001, Section 386 specifies that people eli-
from 1 April 2002, the rules around cessation and upper
gible for childcare under Section 448 of the AI Act 1998
age limits set out in the AC Act 2001 apply to these exist-
continue to be eligible after 31 March 2002. The ces-
ing claims.
sation rules set out in Schedule 1 of the AC Act apply.
AC Act 2001, Section 383
That is, entitlement ends at the earlier of:
http://www.brookersonline.co.nz/databases/modus/
•five years from the date entitlement started
lawpart/statutes/ACT-NZL-PUB-
•the date on which the child turns 14.
Y.2001-49~BDY~PT.11~SG.!248~S.383?
si=1878974479
If the child is older, but has needed child care due to a
disability, then the date they cease to need care applies.
Section 445 of the AI Act 1998
http://www.westlaw.co.nz/maf/wlnz/app/document?
This is a change to the AI Act 1998 cessation rules, which
doc-
specified that in no circumstances could payments to a
guid=Ibad19b9ce02e11e08eefa443f89988a0&tocDs
child with a disability go beyond the date they turned 21.
=AUNZ_NZ_LEGCOMM_TOC&isToc-
This rule has been deleted, so that a child who continues
Nav=true&startChunk=1&endChunk=1
to need care because of an ongoing disability is eligible
for five years.
12.0 NZSQA
See When to continue or cease childcare for information
a There is no difference between a claim transitioned from
about ongoing child care payments and cessation.
either the ARCI Act 1992 and AI Act 1998 and the AC Act
2001 in respect of the rules around the upper age limits
There was no indexation of accidental death childcare
based on the date a spouse or other dependant reaches
before 1 July 2002. The following rates applied from 1
NZSQA.
January 1994 until 30 June 2002:
•1 child - $100
b Compensation based on minimum weekly earnings
•2 children - $60 each
•3 or more children - $140 divided equally.
The AC Act 2001 introduced a new basis for assessing
AC Act 2001, Section 386
minimum weekly earnings that apply when a client is a
http://www.westlaw.co.nz/maf/wlnz/app/document?
full-time earner immediately prior to the commencement
doc-
of incapacity.
guid=I679d8e68e03211e08eefa443f89988a0&tocDs
=AUNZ_NZ_LEGCOMM_TOC&isToc-
See the Weekly compensation indexation tables for the
Nav=true&startChunk=1&endChunk=1
minimum weekly earnings rates.
Section 448 of the AI Act 1998
http://www.westlaw.co.nz/maf/wlnz/app/document?
Where the deceased’s weekly earnings were less than
doc-
the amounts set out in the minimum weekly earnings
guid=Ibad19b9ce02e11e08eefa443f89988a0&tocDs
column, weekly compensation payable to any depen-
=AUNZ_NZ_LEGCOMM_TOC&isToc-
dants can be increased accordingly from 1 April 2002.
Nav=true&startChunk=1&endChunk=1
When to continue or cease childcare Policy
ACC > Claims Management > Manage Client Payments > Operational Policies > Accidental Death Entitlements > Transitional provisions > Transitional claims 1992 and 1998
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Page 3 of 5
d Spouse’s age and the NZ Superannuation qualification
age limits
Spouses, near or over the NZ Superannuation quali-
fication age (NZSQA), can be eligible for either weekly
compensation or NZ Superannuation, or both.
The ‘date of death’ is the date the deceased died.
NOTE What if the spouse had reached NZSQA at
date of death or will reach NZSQA within 12
months after death?
they remain entitled to both weekly compen-
sation and NZ Superannuation, up to 12 months
from the later of:
•the date of attaining NZSQA
•the date of first entitlement.
Then the spouse elects which entitlement they
want to receive from that date
NOTE What if the spouse reaches NZSQA more
than 12 months after the date of death
they elect which entitlement they receive
Weekly compensation indexation (2001 Act)
Policy.PNG
14.0 Electing entitlement after reaching NZSQA
13.0 Continue or cease weekly compensation
a The spouse must at some stage elect which entitlement
they wish to receive, when they can’t receive both.
a Eligibility criteria for continued payments to a spouse
The standard weekly compensation procedures and rules
Payments to the spouse can continue until the latest of
apply for:
the following dates:
•how to notify the spouse that they must elect one entitle-
•at the end of five consecutive years from the date the
ment
entitlement first became payable
•how the spouse notifies their election
•when the surviving spouse no longer has the care of any
•the time limits for notifying us detailed in clause 69 of
other dependants of the deceased
Schedule 1
•the youngest child of the deceased that the spouse has
•the circumstances under which they can later change
care of, turns age 18 or the spouse no longer has the
their election.
care of any children who qualify as children of the de-
ceased.
In all cases, where the standard procedures and rules
refer to ‘the client’, read this as referring to ‘the spouse of
This date is referred to as the ‘surviving spouse’s weekly
the deceased’.
compensation cessation date’.
b Exceptions
See When to continue or cease weekly compensation to
spouse for more information.
clause 69
Even if the spouse is eligible under the above criteria,
http://www.brookersonline.co.nz/databases/modus/
you need to cease the payments if either:
lawpart/statutes/ACT-NZL-PUB-
•one or more of the standard weekly compensation cri-
Y.1998-114~END~SCHG~SCH.1~PT.5~CL.69?
teria apply for ceasing payments, eg imprisonment of the
si=1878974479
spouse, or discovering the spouse should not originally
have been eligible
When to continue or cease weekly compensation to
•the spouse elects to receive NZ Superannuation. See
a spouse or partner Policy
‘Spouse’s age and the NZ Superannuation qualification
age limits’.
c Factors not relevant
15.0 Other dependant
a For an ‘other dependant’, after 1 April 2002, eligibility for
weekly compensation continues if:
The following factors aren’t relevant to continuing eligi-
bility for weekly compensation:
•they earn less on average than the minimum weekly
•if the surviving spouse remarries
earnings amount payable to a full-time earner
•the age the deceased would have reached had they not
•the upper age limits do not apply.
died, ie the upper age limit.
There is no requirement to check periodically on the disa-
bility of the other dependant.
See When to continue or cease weekly compensation to
other dependant for more information.
When to continue or cease weekly compensation to
an other dependant Policy
ACC > Claims Management > Manage Client Payments > Operational Policies > Accidental Death Entitlements > Transitional provisions > Transitional claims 1992 and 1998
Acts
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Page 4 of 5
When to continue or cease weekly compensation to
16.0 Child
a child Policy
a There is no effective difference between the ARCI Act
1992, AI Act 1998 and the AC Act 2001 in respect of the
rules around general cessation criteria. That is, after 1
April 2002, eligibility continues until the later of:
•the end of the calendar year in which the child turns 18
years of age
•if the child is in full-time study, the earliest of ceasing the
study or turning age 21.
Under the AI Act 1998 a child with a disability, to the
extent that they qualify as an other dependant, is eligible
to continue to receive compensation beyond the age of
18. Continuing eligibility rules for an other dependant
apply.
17.0 Eligibility criteria for continued payments
a A child of the deceased, who receives weekly compen-
sation payments for a fatal injury, continues to be entitled
until the end of the calendar year in which they turn 18.
Where the child can prove they are currently engaged in
fulltime study at a place of education, as defined under
section 13 of the AI Act 1998, the entitlement continues
until the earliest of the following dates:
•they cease study
•they complete the study
•they turn 21.
b Exception
Even when the child is eligible under the above criteria,
you need to cease payments if one or more of the stan-
dard criteria apply for ceasing weekly compensation pay-
ments, for example, imprisonment, or discovering the
child shouldn’t originally have been eligible.
c Factors not relevant
It’s not relevant to the decision, to consider the age that
the deceased would have reached if they hadn’t died, ie
the upper age limit.
d Child recommencing study
When a child loses their entitlement because they’re over
18, and aren’t studying fulltime, they can apply to regain
their entitlement if they take up or recommence fulltime
study before age 21. The study doesn’t have to be conti-
nuous. They are entitled for any period in which they’re
engaged in fulltime study.
A child of the deceased can regain their entitlement as
long as:
•they remain under 21 years
•they can provide satisfactory proof that they’re engaged
in fulltime study.
This applies, whether they:
•take up fulltime study for the first time
•recommence fulltime study after having stopped.
See When to continue or cease weekly compensation to
child for more information.
ACC > Claims Management > Manage Client Payments > Operational Policies > Accidental Death Entitlements > Transitional provisions > Transitional claims 1992 and 1998
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Transitional claims 1-7-99 to 31-3-02 (AI Act 98) Policy v3.0
Summary
4.0 Continuing entitlement
a The client continues to be eligible for weekly compen-
Objective
sation until:
This information relates to ACC's application of the Accident
Insurance Act 1998 (AI Act 1998), which applied from 1 July
• ACC determines that they’re no longer incapacitated, in-
1999 to 31 March 2002.
cluding work capacity assessment
• any other normal cessation provisions apply, eg upper
For more information about the application of the AI Act 1998
age limits.
after 31 March 2002, refer to the transitional provisions for the
Accident Compensation Act 2001 (AC Act 2001).
5.0 Abatement
Owner
9(2)(a)
a If the person derives earnings during incapacity for any
Expert
9(2)(a)
period on or after 1 July 1999, apply the AI Act 1998
abatement provisions.
Policy
NOTE Example
1.0 Rules
An employee in non permanent work has an
accident on 10 Jan 1999, and remains incapa-
a Clients with ongoing entitlement under Sections 39 to 46
citated from that date.
and Sections 138 to 141 of the Accident Rehabilitation
and Compensation Insurance Act 1992 (ARCI Act 1992)
In the 52 weeks prior to 10 January 1999 he
continue to be entitled to compensation under Sections
earns $30,000.
428 to 431 of the AI Act 1998.
Pre-incapacity earnings
For all transitional claims:
$30,000 ÷ 52
• payments will continue to be made under the ARCI Act
Weekly earnings
1992 up to and including 30 June 1999
$576.92
• from 1 July 1999 onwards, payments will be made
under the AI Act 1998
Weekly compensation at 80%
• the AI rules for incapacity and abatement will apply, with
$461.54
some modifications.
b This rate, calculated under the ARCI Act 1992, continues
to be paid after 1 July 1999, while the client remains
incapacitated.
2.0 What’s in this document
a The following scenarios are covered in this document:
6.0 Transitional claims: Multiple employment at
DOFI
• transitional claims with single employment
• transitional claims with multiple employment
a From 1 July 1999, ACC needs to confirm:
• abatement for transitional claims
• entitlements for injuries prior to 1 July 1999, where the
• any period a client is claiming weekly compensation
claim is lodged after 1 July 1999
relating to employment held at DOFI
• minimum rate for transitional claims
• if they’re incapacitated for that employment.
• maximum rate for transitional claims
• indexation
This determines the calculations of weekly earnings and
• subsequent incapacity
abatement at any given period.
• NZSQA.
Several scenarios will arise for transitional claims:
b Scenario 1
3.0 Transitional claims: Single employment at date
Incapacity for all employment
of first injury (DOFI)
a For claims receiving unabated weekly compensation up
c Scenario 2
to 30 June 1999:
Initial incapacity for all employment, then full capacity re-
gained for one employment
• there will be no change to the rate of weekly compen-
sation from 1 July 1999
d Scenario 3
• when a further medical certificate is entered onto Path-
Full capacity for one employment regained, without re-
way for a period on or after 1 July 1999, the ongoing
turning to that work
assessment will automatically be made under the AI Act
1998.
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7.0 Scenario 1: Incapacity for all employment
b Possible scenarios
a If a client is receiving weekly compensation on 30 June
For transitional claims, two scenarios will arise:
1999 and they continue to have an incapacity for all
employment from 1 July 1999 onwards, there’ll be no
• client returns to that employment before 1 July 1999
change to the rate of weekly compensation.
• client returns to that employment after 1 July 1999.
It is not feasible to prepare for a reassessment of claims
in the first category by 1 July 1999. As there will be few
NOTE Example
claims in this category, consider this reassessment as
A client was employed in two casual employee
part of the normal claim review process, and:
jobs when he had an accident on 20 March
1999.
• if there is medical or other information indicating there is
no incapacity for one employment, a complete inves-
In the 52 weeks prior to his incapacity, he earned
tigation should be undertaken
the following:
• if it is determined the client no longer has an incapacity,
Job A
the reassessed entitlement is effective from the date ACC
$15,000
determines there is no incapacity.
Job B
After completing investigations and determining that the
$10,000
client no longer has an incapacity, calculate the ongoing
weekly compensation rate using the formula for recal-
Total earnings $25,000
culating earnings, shown later in this document.
Long term rate (divide total by 52)
$480.77
Once the investigation and calculation have been com-
pleted, the TCM should contact Entitlements & Legis-
Weekly compensation at 80%
lation in Corporate Office, to confirm the reassessment.
$384.62
9.0 Scenario 3: Full capacity for one employment
b The client continues to receive the same rate following 1
regained, without returning to that work
July 1999, provided he has an ongoing incapacity for
a The following rules apply if a client:
both jobs.
• has had multiple employment, for which they have been
incapacitated
8.0 Scenario 2: Initial incapacity for all employment,
• is assessed as no longer being incapacitated for one of
then full capacity regained for one employment
those employments
• doesn’t actually return to that employment.
a The following rules apply if a client:
This is most likely to happen if that employment has been
• had multiple employment for which they’ve been
terminated during incapacity.
incapacitated
• then has ceased to be incapacitated for one of those
In this situation:
jobs, and has returned to that work.
• the client is not eligible to receive weekly compensation
From the date after 1 July 1999 the client ceased to be
for that employment, even though they receive no earn-
incapacitated for that employment:
ings from that employment
• there are no continuing earnings to be considered under
• they are only eligible for weekly compensation based on
the no incapacity excess abatement provision.
weekly earnings for the employment(s) where they con-
tinue to be incapacitated
• any continuing earnings are considered in the no inca-
pacity excess abatement calculation.
10.0 Medical confirmation of work capacity
Note:
a As this reassessment results in a lower weekly compen-
Ensure the client has regained a full capacity for the
sation entitlement, without the client actually deriving
employment concerned before recalculating.
earnings from employment, ACC needs clear medical
confirmation that the person would be fully capable of
If the client is unable to engage in any part of the employ-
performing all the duties of the terminated or ceased
ment because of the injury, they are considered to have
employment.
an ongoing incapacity in relation to that employment.
Resumption of full hours or normal pay alone doesn’t
indicate that there would be no incapacity for that
11.0 Consult Entitlements & Legislation section
employment.
a Any decisions on the ongoing weekly compensation rate
for transitional claims in this category should be con-
firmed by the TCM, in consultation with Customer Service
Technical Support (CSTS) in Corporate Office.
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12.0 Formula for recalculating earnings
a Recalculate entitlement according to the following for-
14.0 No incapacity excess calculation for transitional
mula. Relevant earnings (RE)/Weekly earnings (WE)
claims
consist of:
a A new excess calculation applies to establish the amount
of earnings liable for abatement when the client:
• held more than one job at DOFI (or DOSI)
• is not incapacitated for one of those jobs
• is deriving earnings from that no incapacity job.
The ‘no incapacity excess’ abatement calculation:
Formula for recalculating earnings.PNG
• applies for transitional claims where claimants held
more than one employment at DOFI
b The continuing earnings from the no incapacity job (B)
• is calculated by using the formula detailed in the abate-
are considered for the no incapacity excess abatement
ment document.
calculation.
If there are any continuing earnings from Job 2, the for-
NOTE Example
mula for calculating the weekly earnings rate used in the
A client had an injury on 14 April 1993 and was
no incapacity excess would be Total B ÷ C × D.
incapacitated from that date. They had two jobs
prior to incapacity.
NOTE Example
Job A
A client is incapacitated from 30 October 1994,
$200.00 (A)
following an accident. Prior to her incapacity, she
was employed in two jobs.
Job B
$100.00 (B)
On 10 October 1999, ACC determines that she
no longer has incapacity for Job B but doesn’t
Total long term weekly earnings
return to this position.
$300.00 (C)
Her weekly compensation must be reassessed
After indexation
from 10 October 1999, to only include earnings
$331.32 (D)
from Job A.
Job A weekly earnings
$300 (A)
b From 1 October 1999, the client becomes no longer
incapacitated for Job B, returns to it, and earnings from
Job B weekly earnings
that job are being abated.
$200 (B)
From the date ACC confirms the person has no inca-
Total weekly earnings
pacity for Job B, the revised weekly earnings figure (A
$500 (C)
C D) applies: $200 ÷ $300 × $331.32 = $220.88
Total weekly earnings updated by indexation
$539.88 (D)
c The no incapacity excess calculation is performed for Job
B, as follows:
Revised weekly earnings
• calculate the long term weekly earnings relating to that
$300(A) ÷ $500(C) × 539.88(D)
employment only
• update that figure by any indexation (B ÷ C × D): $100 ÷
Rate payable from 10 October 1999
$300 × $331.32 = $110.44
$323.93
13.0 Abatement (overview)
d This figure is applied as the long term calculation of pre
incapacity earnings, in the no incapacity excess abate-
a Any payment beyond 1 July 1999 is subject to the new
ment calculation, as follows:
abatement rules.
Earnings each week from Job B
You should refer to the abatement documents for infor-
$200.00
mation on:
Deduct long term weekly earnings for Job B
• earnings liable for abatement
$110.44
• applying the abatement formula
• applying abatement to weekly compensation.
Earnings liable for abatement
$89.56
For transitional claims, there are specific policies in rela-
tion to:
• the no incapacity excess, for an individual employment
• the total earnings excess.
These are outlined in the next topics.
ACC > Claims Management > Manage Client Payments > Operational Policies > Weekly Compensation > Transitionals > Transitional claims 1-7-99 to 31-3-02 (AI Act 98)
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15.0 Total earnings excess for transitional claims
17.0 Applying the abatement calculation
a As per the ARCI Act 1992:
a Abatement applied to earnings of $89.56, using abate-
ment amounts as at October 1999
• total income from weekly compensation and from earn-
= $8.62
ings during incapacity
• may not exceed earnings immediately prior to inca-
Deduct $8.62 from $176.70 weekly compensation
pacity.
= $168.08
The calculation that applies, as shown below, is the same
as that under the ARCI Act 1992, and any excess amount
established as Total D is further deducted from the
18.0 Total earnings excess calculation
abated weekly compensation figure.
Total earnings excess calculation.PNG
Total earnings excess for transitional claims.PNG
19.0 Abatement for the week including 1 July 1999
b Is based on earnings details prior to DOFI. For transi-
tional clients receiving abated earnings in the:
a For any claim receiving earnings over the week including
1 July 1999, Pathway automatically assesses, under the
• short term period, the short term weekly earnings rate is
correct rules, the periods:
used
• long term period, the long term relevant earnings or
• prior to 1 July 1999
weekly earnings (rate as assessed under the 1972, 1982
• on or after 1July1999.
or 1992 Act) is used with relevant Orders in Council
(OICs) or Indexation already applied.
The new AI Act 1998 rules apply from the next ACC pay
day for that claim after 1 July 1999.
Note:
If the client is receiving earnings from employment that
the no incapacity excess provision applies to, Total C
should apply the full amount of earnings from that
20.0 Entitlements for injuries prior to 1 July 1999,
employment, not just the no incapacity excess amount.
where claim lodged post 1 July 1999
a Section 423 of the AI Act 1998 directs that any claim
lodged on or after 1 July 1999 will have entitlements as-
sessed under the AI Act 1998 rules.
16.0 Total earnings excess for transitional claims
(example)
This includes entitlement for any period prior to 1 July
a This continues the scenario set out in the no incapacity
1999.
excess calculation example, which established:
NOTE Example
• weekly earnings of $220.88 in respect of Job A
A client has an accident on 1 March 1999, but
• a figure of $89.56 as the earnings liable for abatement,
doesn’t lodge a claim until 20 August 1999.
after applying the no incapacity excess calculation.
Revised weekly compensation at 80% of $220.88 =
$176.70.
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b We accept the claim and agree that there’s been an on-
22.0 Minimum rate following subsequent incapacity
going incapacity since 1 March 1999 until 21 October
a
1999 when they receive a full clearance.
If a client:
The client started permanent work on 10 May 1998 in
• receives the minimum rate under the ARCI Act 1992
Job A and earnings are:
• returns to work
• $18,500 from 10 May 1998 to 28 Feb 1999
• has a subsequent incapacity after 1 July 1999
• $1600 in the 4 weeks prior to incapacity.
Weekly compensation entitlement for that subsequent
Prior to 10 May 1998, the client was employed in Job B.
incapacity is calculated under the AI Act 1998 rules.
The AI Act 1998 weekly earnings calculations apply. That
If they are entitled to the minimum for this subsequent
is, although the client worked for the full 52 week period,
incapacity, it would be paid at the AI Act 1998 rate of
we only assess their weekly compensation on earnings
$289.09 subject to indexation. These amounts are valid
from employment they held at DOFI, as shown:
from 1 July 2001 or $225.96 if the client is under age 20.
From 8 March 1999 to 4 April 1999:
Short term earnings
23.0 Subsequent incapacity – 28 day rule
$1600 ÷ 4 =$400
a The 28 day rule that applies under the ARCI Act 1992
does not apply under the AI Act 1998.
Weekly compensation
at 80% = $320
Entitlement is recalculated under the AI Act 1998 rules, if
an ARCI Act client has:
• a period of full capacity for employment
From 5 April 1999 to 20 October 1999:
• a further incapacity after 1 July 1999.
Long term earnings
Refer to the subsequent incapacity document elsewhere
$18,500 ÷ 42 (weeks worked) = $440.48
in Informe for more detail. The same rules also apply for
transitional claims.
Weekly compensation
at 80% = $352.38
NZSQA
Section 434 of the AI Act 1998 outlines that Clause 25,
Note:
Relationship between weekly compensation and New
The full explanation for determining weekly compensation
Zealand superannuation, of Schedule 1 applies to transi-
for these clients is found elsewhere in CHIPS.
tional clients receiving weekly compensation.
There is one important difference between the two Acts,
regarding the trigger date for cessation of weekly
21.0 Minimum full time earner rate
compensation due to age.
a The minimum full time earner rate we pay depends on:
From 1 July 1999 this alters:
• the Act the entitlement was first calculated under
• from being based on the date of first entitlement to
• the client’s age
‘compensation for loss of earnings’, this wording includes
first week compensation paid by an employer
the period of entitlement.
• to being based on the date of first entitlement to ‘weekly
compensation’, which does not include a first week pay-
ment.
The ARCI Act 1992 rules base cessation dates on the fol-
lowing:
• work injuries the date is taken as date of first incapacity
• non work injuries the date is taken from date of first
weekly compensation entitlement, plus seven days.
For any claim receiving weekly compensation after 1 July
1999, the second rule applies and no distinction is made
between work and non work injury claims.
Minimum full time earner rate.PNG
b Note:
The client age under 20 rate is the same under both Acts.
If a client was entitled to the under 20 rate calculated
under the ARCI Act 1992 and they reached age 20 before
1 November 1999, the rate of entitlement only increases
to the ARCI Act 1992 over 20 rate for the period until 1
November 1999.
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