Privacy check before disclosing information Policy v22.0
Summary
3.0 Printing client information
a Only print documents for one client at a time, unless 
Objective
you’re batch printing and processing a bulk mailing of a 
When providing personal information to a client, client advocate, 
standard letter. Make sure the number of letters matches 
client lawyer, provider, supplier or employer, you must take care 
the number of envelopes.
to protect individual privacy at all times. See also Responding to 
a request for official or personal information.
When you print client information you must:
Owner
[Out of Scope]
• always use secure print or user box functionality to print
enclosures
Expert
• always fasten documents using staples, not paper clips.
Policy
When printing a multiple page letter use the Multi-
functional Device (MFD) staple functionality, if available
1.0 Rules
a You must check all incoming client documentation to 
• avoid using mail merge
ensure the information relates to the client and does not 
contain inappropriate or non-injury related information.
• not put post-it notes on letters.
You must complete a content and privacy check before 
disclosing any personal information, even if we initiated 
the disclosure. A content check ensures we only give the 
4.0 Enclosure types
information that was requested and is relevant. A privacy 
a There are two types of enclosure, substantial and minor.
check ensures we only give information about the client 
who is requesting it.
A substantial enclosure generally contains varied and 
potentially sensitive health information or multiple docu-
You must also include an appropriate covering letter 
ments.
when providing requested information.
If sending information via email to an external email ad-
NOTE Examples
dress make sure the email address has been verified in 
• independence allowance report
Eos first.
• vocational independence report
• home and community support assessment
report
• medical case review report
2.0 Privacy checking client information
• complex social rehabilitation assessment
• lump sum independence allowance (LSIA)
a Before you provide a copy of a client’s personal infor-
assessment
mation or file you must complete a privacy check to 
ensure that no other person’s information is included.
b A minor enclosure is routine correspondence or one or 
The case owner or Client Information Requests team 
two short documents.
(CIR) is responsible for privacy checking full client copy 
NOTE Examples
files that they prepare.
• a 1 or 2 page letter, eg a letter approving home
help
For anything other than a minor enclosure you must add 
• a letter with a form or information sheet in-
a 'Contact' in Eos noting that documents have been pri-
cluded
vacy checked prior to disclosure.
• a short report with limited medical information
in it, eg a report about a simple injury such as a
In particular, you must ensure:
broken ankle that does not refer to pain issues or
other medical conditions
• the recipient's name and address is correct and, if
• reimbursement claim forms
appropriate, check the 'Verification and 'Valid Address'
statuses
• information about people other than the client is re-
moved
• any information that may negatively affect the client's
5.0 When to use the ACC6173 Information disclo-
physical or mental health is discussed with their
sure checklist
medical practitioner (e.g. GP or Psychiatrist) prior to re-
a Full or partial copy file
lease. If the medical practitioner agrees it may be
harmful, we can withhold that information
If you’re providing a full copy file or partial copy file you 
• any information you send to a supplier is fit for purpose.
must complete an ACC6173 information disclosure 
Only provide what is required, particularly in respect
checklist when you do the privacy check.
to non-injury conditions.
Before you do the privacy check, clear your work area. If 
possible, use the dedicated privacy desk in your unit or 
an available empty desk.
ACC > Claims Management > Manage Client Information > Operational Policies > Client privacy > Privacy check before disclosing information Policy
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b Substantial enclosure
ACC5937 Authority to act - Client
 
If you're providing a substantial enclosure completing an 
ACC6173 information disclosure checklist is optional. You 
may still find it useful to follow the checklist to make sure 
you don't miss anything.
c Minor enclosure
Changes to a client’s residential or postal 
address.PNG
If you're providing a minor enclosure completing an 
ACC6173 information disclosure checklist is optional. But 
ACC210 Change of bank account or address
you must make sure that:
Communication using email (Clients)
• the recipient's name and address is correct and, if 
https://au.promapp.com/accnz/Process/45278637-26cd-4f32-8f4e-aebf9f60b05b
appropriate, check the 'Verification and 'Valid Address'
b Any time the client provides information that we can 
statuses
verify in Eos, make sure that you check the 'Verification' 
• information about people other than the client is re-
status and verify or re-verify as appropriate.
moved
• any information that may negatively affect the client's 
physical or mental health is discussed with their
c A current Home address in Eos should always be a resi-
medical practitioner (e.g. GP or Psychiatrist) prior to re-
dential address.
lease. If the medical practitioner agrees it may be
harmful, we can withhold that information
• any information you send to a supplier is fit for purpose. 
8.0 Temporary client addresses
Only provide what is required, particularly in respect
a If the client has a temporary physical address, the client 
to non-injury conditions.
must specifically confirm that the temporary address is 
appropriate for ACC to send documents to. If they do, in 
any information you send to a supplier is fit for purpose. 
Eos add the temporary address as the home address. 
Only provide what is required.
Task to remember to update Eos once the client returns 
ACC6173 Information Disclosure Checklist
to their normal mailing address.
If the client does not request for mail to be sent to their 
6.0 Client addresses
temporary address, then do not change their home ad-
dress to the temporary address. The client must collect 
a You must check the 'Verification' and 'Valid Address' sta-
the information from an ACC office.
tuses of the client or authorised representative’s physical 
address, and either verify or reverify by telephone or in 
You may send blank forms to a temporary address. They 
person as needed.
must not contain any client details.
Verify their address on first contact, and then either:
9.0 Alternative address
• at regular intervals
• before you provide any information by email, post or 
a An alternative address should only be used as a mailing 
courier.
address IF the current home address does not receive 
mail.
Only use a window envelope or labelope to display the 
address and make sure only the name and address are 
For example,
visible.
- where the client uses a PO box instead of receiving mail 
to their home address
- where the client is deceased, we should keep the ad-
Always print the address from Eos using the CLI05 Ad-
dress as their last physical address and load the details 
dress label and make sure Eos is set to default to the 
of their representative as the alternative address.
postal address.
Add or edit alternative address
7.0 Changes to a client’s residential or mailing ad-
10.0 Client email addresses
dress
a Ensure you:
a Changes to a client’s residential or mailing address must 
be requested by either:
• only use a verified client email address in Eos
• create emails and attach documents from within Eos
• the client
• complete a privacy check
• someone with authority to act on behalf of the client. 
• have disabled auto population of email addressess in 
There must be a signed ACC5937 Authority to act form 
Outlook
on the client's file.
The “ACC Privacy Check” tool will also support a tar-
We’ll accept written notification of a change of address by 
geted second check for emails sent externally which in-
letter, on a signed ACC form such as an ACC250, or on 
clude any attachments, or client or customer identifiers.
an ACC210 Change of bank account or address form. 
We will also accept a scanned copy by email. See 
Communication using email.
We’ll accept verbal notification of a change of address 
from the client, after they confirm their identity by pro-
viding the attached information.
ACC > Claims Management > Manage Client Information > Operational Policies > Client privacy > Privacy check before disclosing information Policy
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11.0 Provider and supplier addresses
13.0 Exception – Clients in prison
a If you’re an Eos user you must use Eos when checking 
a If a client is in prison and they don’t have an advocate, 
 
provider and vendor addresses. See Searching for pro-
we can only provide them with a printed copy of their file. 
vider or vendor addresses in Eos. Make sure you com-
Clients in prison generally don’t have access to com-
pare the provider or vendor's contact details with those in 
puters. You must send them an INP12 Personal info re-
Eos. If they need updating you must:
quest - provide info - clients in prison letter, which in-
cludes suitable wording for clients in prison about the 
• ask them to email you their new contact details
risks of using a courier. Do not use the ACC6181 infor-
• email the new details to the Provider/Vendor Regis-
mation sheet.
trations (PVR) team at [email address] and put 
'Change contact details' in the subject line.
Please note that in most cases we'll need to write to a 
client in prison as we'll be unable to contact them by tele-
Or, the provider or vendor may email the PVR team with 
phone. However, if you're able to phone a client who's in 
a copy to you. Physical and email addresses, phone and 
prison, you can record their preferred delivery method as 
fax numbers are automatically updated in Eos from the 
a Contact in Eos. Do not release the information until you 
Medical Fees Processing (MFP) system.
receive the client’s instructions.
See also Communication using email.
If the client has not nominated a lawyer or advocate for 
us to send the information to, you must contact the client 
when their information is ready to advise that we will pre-
Communication using email (clients)
pare a paper copy to be couriered to the prison. The 
https://au.promapp.com/accnz/Process/45278637-26cd-4f32-8f4e-aebf9f60b05b
client will need to be made aware that prison staff check 
NOTE What if a vendor/provider is no longer in-
all incoming packages, which may include their package.
volved in a claim?
Preparing client information in a CIT
Once a vendor or provider is no longer actively 
involved in the claim, remove them from the 
participants list. This reduces the chance of 
14.0 Information for reviews and appeals
incorrectly selecting them and appropriately dis-
closing information later on
a If a full or partial copy file is required for a review or 
appeal, or a transcript of a review hearing, you may:
Manage Participants
• ask the recipient to collect it from an ACC office
• send it to them by post on a password protected CD or 
12.0 Delivery options for clients, client advocates, 
USB
client lawyers
• send it to them by email within a password protected 
a If a client, their advocate, or their lawyer requests a copy 
PDF if the file is small. This is not recommended for large 
of the client’s file, we prefer to provide an electronic copy 
files that need more than one email
on a password protected CD or USB. You may send the 
• deliver it in person to the client if appropriate, after com-
CD or USB by post with an appropriate covering letter. 
pleting an identity check (eg. as part of a scheduled out-
See Responding to a request for official or personal infor-
reach visit).
mation.
Only send the information by courier if this is specifically 
If they want a printed copy we prefer that they collect it 
requested. See 18.0 'When to send client information by 
from us. We do this to ensure their information is secure 
courier' below.
and only accessed by authorised people.
Do not use post (if printed) to provide full or partial copy 
Only consider sending personal information by courier if 
files, review transcripts or relevant documents that relate 
specifically requested. See 18.0 'When to send client 
to a review or appeal.
information by courier' below.
Complete Client Information request
15.0 Collecting from an ACC office
a A requestor may collect their information or file from an 
ACC office:
• If the information is prepared at a different office, you 
must courier it to the appropriate ACC branch or unit to 
be collected. Double envelope the information before you 
place it in the courier bag
• You must check the person’s authorisation and identi-
fication before handing over the information. Complete 
the ACC6179 form and upload to the claim)
For more information see Responding to a request for 
official or personal information.
Complete Client Information request
ACC > Claims Management > Manage Client Information > Operational Policies > Client privacy > Privacy check before disclosing information Policy
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16.0 Sending information by email
18.0 When to send client information by courier
a If using email to send or receive client information ensure 
a You may only use a courier to provide information to a 
 
you:
client, client advocate or client lawyer if you have the 
client's consent to use courier.
• remember the "one email, one client" rule. Each email 
you send, with or without attachments, must only refer to 
• You must reconfirm consent separately for each infor-
a single client or recipient
mation request
• send your email and attachments to a verified email ad-
• The client must specifically request delivery by courier
dress
• You must let them know the risks of sending their infor-
• complete a privacy check
mation by courier. See the ACC6181 Receiving personal 
• check all email threads and delete any information that 
information by courier information sheet
is not relevant to the client
• ask another staff member to double check attachments 
Before providing any information by courier you must:
if you have any doubts about sending the information
• never use a Multi-Functional Device (MFD) to send 
• check the recipient’s address including, if appropriate, 
documents outside of ACC
the 'Verification' and 'Valid Address' statuses and the reci-
• use the "ACC Privacy Check" email notification to check 
pient's authority to receive the information
all attachments before sending your email.
• place the information in a clearly addressed envelope or 
package before you put it in the courier bag.
When sending a verification email from Eos, remove the 
party name from the 'Subject' field and replace it with 
For more details see Responding to a request for official 
"Please confirm your email address"
or personal information.
The easy guide to email and messaging (ACC 
ACC6181 Receiving personal information by courier
Sharepoint)
Complete Client Information request
Communication using email (clients)
NOTE Exception
https://au.promapp.com/accnz/Process/45278637-26cd-4f32-8f4e-aebf9f60b05b
If the client is in prison, you must send them an 
Risks associated with email communication (client)
INP12 Personal info request - provide info -
https://au.promapp.com/accnz/Process/Minimode/Permalink/EO1xLRwZ3TZnOXjSpT0Ubf
clients in prison letter, which includes suitable 
wording for clients in prison about the risks of 
What to include in emails to clients, providers and 
using a courier. Do not use the ACC6181 infor-
employers
mation sheet.
https://au.promapp.com/accnz/Process/Minimode/Permalink/GLhB1JBrdpLc4GQrgfPdMi
INP12 Personal info request - provide info - clients in 
17.0 When to send client information by post
prison
a You can use post to send client information if it's a minor 
enclosure or it's on a password protected CD.
19.0 Clients that live overseas
You can send substantial enclosures by post, however, 
a You may send personal information to a client if they live 
you must:
overseas.
• obtain the client’s agreement for it to be posted, espe-
You may only send client information to their advocate, 
cially if it contains sensitive personal information
insurer, representative or employer if you have the 
• record this agreement in Eos and make the client aware 
client's consent and the requestor has authority to act on 
of the nature of the material in the enclosure
behalf of the client. See the Privacy Act 2020, Principle 6, 
• check with the client before sending each enclosure.
Subclause (1)(b).
If the client has any concerns about the material being 
The staff member preparing the password protected CD, 
posted then you must use an alternative delivery method, 
eg case owner, is responsible for sending the disk over-
such as a courier.
seas.
You must carefully check the items that you place in the 
envelope to make sure:
20.0 Delivery options for suppliers, providers, GPs 
and employers
• they relate to the right client, the right claim(s) and the 
right request
a You may send documents by courier if requested by a 
• multi-page items are stapled and there are no missing 
supplier, provider, General Practitioner (GP) or employer. 
pages or extra pages attached.
You must request a signature on delivery.
Ensure the envelope is securely sealed before sending.
Only include information about one client in a package or 
envelope and make sure the package is clearly ad-
NOTE Envelope peer checks
dressed before you place it in the courier bag.
If you're sending more than one page, the Pri-
vacy Team highly recommend getting a col-
If you need to send information about multiple clients, 
league to check your letter before the envelope 
use a separate courier bag for each client. This applies to 
is sealed. This involves taking the documents out 
both printed information and password protected CDs.
of the envelope and checking that they relate to 
the right client and are supposed to be included. 
Many privacy breaches have been prevented by 
a peer check!
ACC > Claims Management > Manage Client Information > Operational Policies > Client privacy > Privacy check before disclosing information Policy
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21.0 What to do when client information is returned 
to us
  a When someone returns client information to us, eg per-
sonal information that has been included with a referral to 
a provider or a copy file returned from a Review Hearing 
or Appeal, you must create a 'Contact' in Eos to record 
what's been received before you place the documents in 
the document destruction bin.
Create the 'Contact' at Claim level. If multiple claims are 
involved, create it at Party level.
Make sure you include:
• as much detail as possible about what was received, eg 
"Medical Case Review copy medical notes", "Appeal 
copy file" etc, and how it was received, eg sealed 
envelope, attached to provider report etc
• what you did with the documents, eg placed in secure 
document destruction bin, uploaded to claim file record 
etc, and any other relevant information.
ACC > Claims Management > Manage Client Information > Operational Policies > Client privacy > Privacy check before disclosing information Policy
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Disclosure of care indicator information to third parties 
Policy v18.0
 
Summary
3.0 Considering what information to disclose
a You can disclose information when it is necessary for 
Objective
health and safety purposes, and in proportion to the situ-
For more information about care indicator clients go to Care 
ation. This means in some situations, limited disclosure of 
indicated clients.
the risks will be adequate. However, in other circums-
tances the risk identified may warrant detailed disclosure.
[Out of Scope]
Owner
To assess this you must consider:
Expert
1. Whether the care indicator information is relevant for 
the third party, eg.
Policy
- if the information concerns a known reaction to a partic-
1.0 Reasons for disclosure
ular clinical intervention, this information may only be 
a The Health and Safety at Work Act 2015 recognises that 
relevant for a provider who will undertake that clinical 
an organisation can influence the health and safety of 
intervention.
people working for another agency, such as contracted 
providers. Therefore, you must consider whether infor-
2. Whether alternative options will mitigate risk without 
mation contained in a care indicator should be disclosed 
disclosure, eg.
to third parties.
You can disclose care indicator information to assist third 
- if a client has a history of repeated sexist language and 
parties, such as suppliers/providers, FairWay Resolution 
behaviour, a referral to a provider of a particular gender 
Ltd, and other government agencies to allow them to:
may mitigate this risk without the need for disclosure.
• perform their role as part of managing the claim eg. 
3. The nature of the care indicator information, ie. the 
undertake an assessment, and/ or
client’s particular behaviours and when they occurred: eg.
• enable them to mitigate any health and safety risk.
- previous violent behaviour would likely present a great-
er health and safety risk than abusive language
2.0 When to disclose
- recent behaviour may be more relevant than behaviour 
a You must disclose care indicator information when you:
that occurred over a year ago.
• refer a care indicated client to a provider
4. The type of third party affected, including the type of 
• become aware that a client has self-referred to a pro-
service they provide and their relationship with ACC, eg:
vider, eg. they visit a new GP or physiotherapist
• receive new information about client risk and there are 
- a client’s behaviour may present a lower health and 
third parties already providing services to a client.
safety risk than abusive language, or
NOTE What reason can I give that allows me to dis-
- a provider conducting an assessment that could affect 
close
ongoing entitlements may have a higher health and 
Principle 11 of the Privacy Act allows for disclo-
safety risk than a provider the client has referred them-
sure when there is reasonable grounds to be-
selves to for treatment.
lieve that disclosure is necessary to prevent or 
lessen a serious threat to public safety or the life 
5. The requirement for ACC to provide a security guard 
or health of another individual
when requested the provider.
NOTE What if the care indicator is not active and 
appears greyed out?
Inactive care indicator Information can NOT be 
4.0 Deciding on disclosure
disclosed to third parties.
a For disclosure to service providers, determine that disclo-
sure is necessary for health and safety purposes and 
proportionate to the situation (see Considering the level 
of information to disclose). Where you have concerns 
around a decision, these should be escalated to your 
Team Leader.
For disclosure to non-claim related third parties, the team 
leader/site lead can determine whether to disclose infor-
mation. For urgent disclosures ie. when ACC is informed 
that a client is about to visit a third party’s office, the 
leader should disclose to the third party, then inform 
ACC’s Health, Safety and Wellbeing, and Privacy teams.
When disclosure does not need to occur immediately, the 
leader should first consult with these teams.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Operational Policies > Issues > Care indicated clients > Disclosure of care indicator
information to third parties Policy
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5.0 How to send Care Indicator information to third 
7.0 What should you do if a third party provider ad-
parties
vises you of an incident involving an ACC 
  a The staff member dealing with a care Indicated client 
client?
referral must advise Service Providers in writing using the 
a If a third party provider advises you of a health and safety 
template provided, either:
risk or incident involving an ACC client, please ask the 
provider to fill out a third party incident report available on 
• prior to the provider’s initial contact with the client, or
our external website.
• as soon as possible when ACC receives new infor-
mation about client risk, and the third party is already pro-
Please also notify your manager of the incident and 
viding services to the client.
follow the procedures set out in Assessing a client's risk 
level.
Complete and send the following template to the third 
party, in writing on referral, or by email.
Third party report
NOTE Email template
https://forms.acc.co.nz/INCIDENT_REPORTING/index.htm
Dear [insert name],
As a partner of ACC, we will disclose information 
to enable you to assess your safety when car-
rying out work on our behalf. This includes client 
care indicated information which is necessary for 
your health and safety purposes.
We will supply a security guard on request for 
any appointment where you believe the client is 
a threat to yourself or others at you site.
This client had a Care Indicator placed on their 
file [insert year].The Care Indicator relates to an 
incident involving [insert incident or behaviour 
details].
If you need any more information or support in 
dealing with this client please contact me on the 
details below.
Thank you,
[Insert name and contact details]
b Note: If not documented in the referral, a record of this 
advice is to be added as a contact at party level in Eos 
using the ‘Claimant care notes’ option.
Add a contact - EOS
6.0 Security guards for care indicated client 
appointments
a If the Service Provider requests a security guard because 
of concern about their own personal safety, or that of their 
staff, the request should be tasked to client adminis-
tration.
See Ordering security for staff and provider safety.
For non-claim related third parties, the Client service 
leader should inform the relevant third party as soon as 
practicable with all the necessary information so that the 
third party can make a fully informed decision to ensure 
their safety.
Order a security guard
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Operational Policies > Issues > Care indicated clients > Disclosure of care indicator
information to third parties Policy
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Medical Case Review and Medical Single Discipline 
Assessment Service Page v19.0
 
Summary
NOTE Telehealth
MCR's and Medical SDA's have been enabled 
for telehealth where these are clinically appro-
Objective
priate. and follow the Medical Council of NZ 
Medical Case Reviews (MCRs) and Medical Single Discipline 
guidelines . The client must consent and the pro-
Assessments (Medical SDAs) are initiated by ACC and are used 
viders report must include the following decla-
to determine diagnosis, causation, and/or treatment and rehabil-
ration:
itation recommendations.
I have undertaken this assessment via telehealth 
with the consent of <insert client’s/patient’s 
Owner
[Out of Scope]
name>. The telehealth assessment has allowed 
me to produce the findings in this report. In my 
Expert
view an in-person assessment is not required, 
and I was able to make my findings without one.
Procedure
Medical Council of NZ guidelines on providing tele-
health
1.0 Overview
https://www.mcnz.org.nz/assets/standards/c1a69ec6b5/Statement-on-telehealth.pdf
Arrange Medical Case Review Assessment Process 
Page
https://go.promapp.com/accnz/Process/7a6beb10-efad-42a6-a72c-19dcf6278604#
4.0 Medical Case Reviews
a Medical Case Reviews (MCR's) and Medical Single 
a An MCR is used to help determine cover and ongoing 
Discipline Assessments (Medical SDA's) are medical 
entitlements. MCR's are initiated by ACC and are used to 
assessments initiated by ACC and are used to seek an 
obtain clarity about diagnosis/es and assessment of cau-
opinion from a non-treating medical specialist.
sation together with recommendations for further investi-
• An MCR can be used to help determine cover and on-
gations, treatment or rehabilitation. MCR's can be pur-
going eligibility and support
chased as either Standard or Complex, taking into ac-
• A Medical SDA is used to obtain recommendations for 
count the complexity of the Client's presentation. MCRs 
the best onward treatment or rehabilitation
must only be sought from a non-treating medical spe-
cialist.
b The provider completing an MCR or Medical SDA is able 
to order tests or investigations if this is necessary for 
b ACC Staff must seek internal clinical advice before refer-
them to be able to come to an opinion. They can also 
ring for an MCR.
make recommendations for tests or investigations.
c Standard Medical Case Reviews (CSM1)
Medical Assessment Quick Ref Guide_updated.pdf
• Expected to take up to 3.5 hours
d Complex Medical Case Reviews (CSM2)
• Expected to take more than 3.5 hours and less than 7.5 
2.0 Who provides this service?
hours
a The provider must be a non-treating practitioner who is a 
• The Client's injury is of unusual complexity or there are 
medical specialist.
co-morbidities that appear to be affecting the Client's 
recovery from injury or
b Wherever possible, MCRs and Medical SDAs should be 
• The MCR will be undertaken in two parts whilst results 
purchased under the Clinical Services contract.
of investigations are obtained
c If there are no suitable specialists available under the 
Clinical Services contract, you can use a non-contracted 
medical specialist to provide the service.
5.0 Medical Single Discipline Assessments
a A Medical SDA is used to obtain recommendations for 
the best onward treatment or rehabilitation. These 
3.0 Referrals into the service
assessments are initiated by ACC and cannot be used to 
a Referrals for MCR's and Medical SDA's may only be 
determine cover and ongoing entitlements. Medical SDAs 
made by ACC.
must only be sought from a non-treating medical spe-
cialist.
b The provider may decline a referral if:
• they cannot meet the contractual timeframes
b Standard Medical SDA (CSA1)
• they do not have an appropriate medical specialist 
• Expected to take up to 2.5 hours
available in relation to the injury
c Complex Medical SDA (CSA2)
• they consider that the referral is more appropriately ma-
• Expected to take more than 2.5 hours and less than 4.5 
naged under the Vocational Medical Services contract 
hours
because:
• The Client's injury is of unusual complexity or there are 
a) it includes consideration of a client's employment as a 
co-morbidities that appear to be affecting the Client's 
major factor of the assessments
recovery from injury or
b) an assessment by an occupational medicine specialist 
• The Medical SDA will be undertaken in two parts whilst 
or work restrictions, limitations for work, the ability to 
results of investigations are obtained
engage in employment or the ability to participate in 
vocational rehabilitation is required
c The provider must notify ACC if the referral is declined.
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6.0 Exceptional MCR and SDA's
b Providers are required to provide a report to ACC within 
a
eight business days of the clinical examination.
In rare cases, the client may be exceptionally complex 
 
and exceed the cost available under complex assess-
c For the reporting requirements for Medical Case Reviews 
ments. ACC may then request the provider to undertake 
and Medical Single Discipline Assessments please refer 
an Exceptional MCR or Medical SDA.
to the Clinical Services Operational Guidelines
b Exceptional MCRs and Medical SDAs have to be ap-
Clinical Services Operational Guidelines
proved by the Secondary and Tertiary Portfolio team via 
[email address]. Enter 'Approval for Excep-
tional MCR/MDSA' in the subject line.
c The attached table shows the expected assessment 
durations.
Assessment Duration.png
7.0 Non-Contracted Purchasing
a If a medical specialist opinion is needed and there is no 
suitable specialist available under the Clinical Services 
contract, you can use a non-contracted medical specialist 
to provide the service. They must be a non-treating med-
ical specialist.
b Non-contracted purchasing is done via a letter of agree-
ment (LOA).
• Pricing for non-contracted MCRs and MSDAs should be 
the same as the equivalent contracted rate eg. we would 
expect the same rate for a non-contracted standard MCR 
(MCR11) as you would pay for a contracted standard 
MCR (CSM1).
• If you are considering an hourly-rate code or a fixed fee 
under such a code, a rate of between $500 and $600 per 
hour + GST is suitable for a Vocationally Registered Phy-
sician. The price should be agreed before the client is for-
mally referred, although the specialist may request a 
notes review prior to proposing a fee.
c If you frequently need to use the same non-contracted 
specialist encourage them to apply for the Clinical Ser-
vices contract or become a 'Named Provider' on an exist-
ing Clinical Services contract. Contact your local Engage-
ment and Performance manager if you need more infor-
mation about this.
8.0 Disbursements
a If you need to purchase travel, accommodation or clinic 
rooms for MCRs or Medical SDAs done outside of the 
region in which the specialist provider resides, you may 
use the following non-contracted travel, accommodation 
and clinic codes as there are no provisions in the Clinical 
Services contract for these expenses.
b For contracted MCR/SDA:
• ACCOM1 - Accommodation for Medical Assessor (paid 
at cost)
• TRAVA1 - Air travel for Medical Assessor (paid at cost)
• TRAVD1 - Travel distance (distance travelled)
• TRAVR1 - Hire of rooms for consultation or assessment 
(paid at cost)
• TRAVT3 - Travel time (agreed hourly rate)
c For non-contracted MCR/SDA (purchased via Letter of 
Agreement):
• MCRD (travel, accommodation or room hire paid at 
cost)
9.0 Timeframes and Reporting Requirements
a Clinical examination must be completed within eight busi-
ness days of receiving a referral, unless otherwise 
agreed with ACC.
ACC > Claims Management > Manage Claims > Service Pages > Specialist Care and Rehabilitation > Secondary and Tertiary Care > Clinical services > Medical Case Review
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Client Legislative Rights and Responsibilities Policy v14.0
 
Summary
Privacy Act 2020
https://www.westlaw.co.nz/maf/wlnz/app/document?tocGuid=AUNZ_NZ_LEGCOMM_TOC%7C%7CI497641cabd5811eab306d55769e1257b&parentguid=AUNZ_NZ_LEGCOMM_TOC%7C%7CIecc15b11bbde11eab3b38541a7309177&epos=1&startChunk=1&tocDs=AUNZ_NZ_LEGCOMM_TOC&endChunk=1&isTocNav=true&ipuser=true&docguid=I497643cebd5811eab306d55769e1257b&resultType=list
Objective
Health Information Privacy Code 1994.
This page describes the rights and responsibilities of clients 
https://privacy.org.nz/forums-and-seminars/health-information-privacy-code/
when they make a claim with us. It includes specific legislation, 
protection of information, representation and human rights 
issues. This information will help you to comply with the legis-
5.0 Information about our decisions
lative requirements when dealing with client claims.
a The client has the right to access all the information 
about decisions we make on their rehabilitation. We need 
[Out of Scope]
Owner
to clearly explain why we consider any course of action 
appropriate.
Expert
Policy
6.0 Informing the client
1.0 Rules
a Use the VIIS01 Getting ready to work again after an 
a The following rules cover:
injury information sheet to provide the client with infor-
• client rights
mation about their rights and responsibilities for their 
• client responsibilities
vocational rehabilitation.
• cultural differences
• communication
• guidelines for human rights issues
VIIS01 Vocational Independence Factsheet
• guidelines for privacy issues.
b Use the guidelines below for when and how to inform 
clients of their general rights and responsibilities.
NG GUIDELINES Client Legislative Rights and 
2.0 Cost of support
Responsibilities
a Clients have the right to have the support they are eli-
ACC165 Declaration of rights and responsibilites
gible for funded by ACC to the maximum extent possible. 
We'll cover the majority of costs of required assessments 
and other necessary rehabilitation interventions. Some-
7.0 Reasonable time to consider
times, however, the regulated limit of our contribution 
a We must allow the client a reasonable amount of time to 
does not match the entire amount charged by the pro-
consider information we provide to them, before they 
vider and so the client must also make a contribution, as 
make any decisions based on it. We need to provide 
a part-charge or surcharge.
them with the relevant information as early as possible 
and make sure they fully understand it before we ask 
A part-charge may be incurred when:
them to decide or agree to it.
• the client’s general practitioner (GP) charges more for a 
consultation than we're able to pay under the regulations. 
The client can be charged by the provider for the addi-
8.0 Challenging decisions
tional amount
a The client has the right to challenge any decision they 
• the client was intending to pay a particular treatment 
disagree with, or the results of any assessment. If they 
cost, but an injury has increased the treatment neces-
do we must look seriously at whether agreement is poss-
sary. We'll pay only for that proportion of the treatment 
ible. This can include getting opinions from others or revi-
that is necessary to address the injury
siting the decision-making process. We must make a se-
rious effort to reach agreement and will only defend our 
• the client wants a more expensive intervention than we 
decision at review if agreement is unable to be reached.
consider is necessary to address the injury. We'll pay the 
basic cost sufficient to address the assessed need, and 
the client can choose to pay for an ‘upgrade’.
3.0 Representation and support
a The client has the right to bring friends, family members, 
whānau or other representatives with them for support 
whenever they meet with us or with an assessor or ser-
vice provider. They don't have to explain or justify their 
reasons for this.
4.0 Information protection
a All information about the client is protected under the:
ACC > Claims Management > Manage Client Information > Operational Policies > Client rights > Client Legislative Rights and Responsibilities Policy
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9.0 Client’s responsibility to participate in rehabil-
13.0 How to comply with this policy
itation
a You must:
  a The client is responsible for as much of their own rehabil-
itation as they can achieve, considering the injury. In 
• actively recognise, acknowledge and respect the differ-
terms of the rehabilitation process, we expect them to:
ences between people, regardless of their age, gender, 
ethnicity, religion, socio-economic status, sexual orien-
• participate in all stages of developing their Recovery 
tation or ability
Plan
• identify your own response to these differences
• attend assessment appointments
• work collaboratively and cooperate with people who are 
• carry out their part of any agreed interventions
different from you in these ways
• avoid activities that they agree are counterproductive to 
• behave in a way that doesn’t discriminate against them 
achieving the outcome.
because of these differences.
We enable them to do this by discussing the outcome 
and each planned intervention as the rehabilitation 
14.0 Communication issues
progresses and asking them to agree to their Recovery 
a
Plan. This represents their commitment to meet the 
ACC is committed to communicating with clients so we:
responsibilities they've agreed to. If the client refuses to 
participate, without reasonable grounds, we aren’t ob-
• empower them to identify their own cultural identity and 
liged to provide those interventions to them.
communication needs
• identify sources of cultural expertise and support for 
them, such as their extended family, religious groups, 
community groups, national organisations etc
10.0 If the client does not meet their responsibilities
• ensure we spell and pronounce their names correctly
a We can withhold support for the client if, without good 
• ensure that any information exchanged has been clearly 
reason, they:
understood by all parties involved.
• fail to comply with any requirements of the legislation 
related to their claim
15.0 Guidelines for human rights issues
• refuse to undergo medical or surgical treatment that will 
a
assist their recovery from injury
All legislation and civil practice, including our case 
• fail to comply with what they agreed in their Recovery 
management processes, must comply with the public law 
Plan.
rights contained in the:
• Human Rights Act 1993
• New Zealand Bill of Rights Act 1990.
11.0 Cultural differences - ACC policies
You must be sufficiently familiar with this legislation to 
a We have established partnership relationships with Māori 
ensure you comply with it.
who have participated, and continue to participate in 
developing, monitoring and evaluating all areas of our 
case management processes. This includes:
16.0 Code of Health and Disability Rights
• developing culturally appropriate practices and proce-
dures, eg it's appropriate to involve the client’s whānau in 
Code of Health and Disability Services Consumers’ 
developing a Recovery Plan
Rights
• encouraging more Māori participation in our organi-
https://www.hdc.org.nz/your-rights/about-the-code/code-of-health-and-disability-services-consumers-rights/
sation
• prioritising our resource allocations to take account of 
Māori health needs and perspectives
17.0 Guidelines for privacy issues
• reporting on indicators about our responsiveness to 
a The Privacy Act 2020 and Health Information Privacy 
Māori in the annual service agreement report to the 
Code 1994 (the Code) control how we deal with personal 
Minister for ACC.
information about the client, including:
• how we collect, store and dispose of information
12.0 How this affects what we do
• how we access the information
a Our policies recognise the multicultural nature of our so-
• who has access to the information
ciety. This is important in how we manage clients’ cases, 
• the client’s right to access the information and correct it.
particularly rehabilitation, because we have to be able to 
show we’ve taken account of each client’s cultural differ-
The Privacy Act covers all personal information while the 
ences.
Code focuses on personal health information.
By being aware of and accepting our differences, we can 
They govern all situations where we:
respond appropriately to meet our requirements and 
clients’ needs under the legislation.
• collect information about the client from them
• collect information about the client from others
• provide information about the client to others
• use information about the client for our own processes 
and procedures.
Privacy Act 2020
https://www.westlaw.co.nz/maf/wlnz/app/document?tocGuid=AUNZ_NZ_LEGCOMM_TOC%7C%7CI497641cabd5811eab306d55769e1257b&parentguid=AUNZ_NZ_LEGCOMM_TOC%7C%7CIecc15b11bbde11eab3b38541a7309177&epos=1&startChunk=1&tocDs=AUNZ_NZ_LEGCOMM_TOC&endChunk=1&isTocNav=true&ipuser=true&docguid=I497643cebd5811eab306d55769e1257b&resultType=list
ACC > Claims Management > Manage Client Information > Operational Policies > Client rights > Client Legislative Rights and Responsibilities Policy
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18.0 Dealing with requests for information
a If you receive a request for personal information about a 
 
client, from anyone other than the client, you must 
comply with the requirements of the Privacy Act when 
you respond.
19.0 Specific requirements
a When dealing with personal information about a rehabil-
itation client you must:
• ask the client to provide the information themselves 
wherever possible, to make sure that it’s as accurate as 
possible
• ask the client to confirm that any information provided 
by anyone else is accurate and complete, and to correct 
it if it’s incorrect
• record any client-requested correction you disagree with 
and the reasons why you did not make the change
• only collect information for the purpose of processing 
the claim
• dispose of securely, preferably by shredding, any infor-
mation that is no longer required
• store all personal information securely, so that only 
authorised people can access it
• not give anyone permission to access the information 
unless they’re permitted to under the Privacy Act
• ask the client for written authority to let someone else 
have access to the information.
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Client Choice of Providers Policy v14.0
 
b
Summary
These preferences should be accommodated where 
possible. For example:
Objective
• a female client with a medical misadventure birthing 
It is ACC's responsibility to choose an appropriate provider for a 
injury may wish to be assessed by a female specialist
client who is referred for the following:
• Māori or Pacific peoples may wish to be assessed by a 
• medical specialist assessments
Māori or Pacific provider.
• social rehabilitation assessments
• vocational rehabilitation: initial occupational and medical 
assessments
4.0 If a client objects to the provider we have 
• vocational independence: occupational and medical assess-
ments.
chosen
a If a client has concerns about the provider they’ve been 
These assessments help determine cover or entitlements.
referred to, but does not nominate another provider, then 
we must offer the client a choice of at least two alter-
AC Act 2001, Section 72(1)(d) states that clients have a respon-
native providers, if there are two available, and give the 
sibility to undergo assessments conducted by a registered 
client five days to select one of the alternative providers.
health professional specified by ACC.
If the client does not respond with their choice of provider 
Owner
[Out of Scope]
within the five-day timeframe, we will continue to use the 
Expert
provider initially selected.
If the client nominates their own provider we must objec-
Policy
tively consider the request. See attached table.
1.0 Client selection not limited for other services
a The guidelines governing other areas of client choice are 
broader and allow the client greater flexibility to choose 
their own provider in the following areas:
• treatment that a client receives from a health provider, 
such as a General Practitioner, physiotherapist, acupunc-
turist, etc
• home-based care, such as home help, attendant care, 
Client object to provider.PNG
etc
Contracted Suppliers by Geographic Area of Cov-
erage
• audiologists who are required to fit hearing aids
• counselling.
5.0 When a client will not comply with our choice of 
provider
2.0 Considering client preferences
a If, after the considerations above have been taken into 
a Always remember ACC’s obligations under the Code of 
account, we are unable to reach agreement with the 
ACC Claimants’ Rights and Claims (the ACC Code). 
client then we may consider whether to decline the 
Refer to Working with the Code of ACC Claimants’ Rights 
client’s entitlement as a last resort. See Decline entitle-
Policy.
ment when client is non-compliant .
Working with the Code of ACC Claimants’ Rights 
You must document all considerations and actions in 
Policy
detail.
Part 3 Code of ACC Claimants' Rights, and claims
https://www.legislation.govt.nz/act/public/2001/0049/latest/DLM100959.html
Decline Entitlement When Client is Non-compliant 
Policy
3.0 Clients may prefer a particular provider
a These are based on:
6.0 Consider alternatives when a lack of provider 
may cause an unreasonable delay
• their values
a AC Act 2001, Section 54 requires ACC to make decisions 
• their personal circumstances
in a timely manner. If there are difficulties finding an 
• their culture
appropriate provider within the client’s locality, then con-
• the nature of the assessment itself
sider:
• transporting the client to a location or city where there is 
a greater number of available providers
• fully investigating appropriate providers who will travel 
to the client.
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b Before asking a provider to travel to a client’s location, 
consider:
 
• any cultural or other specific requirements the client 
has, eg disability, language requirements, etc
• the provider’s skills and competencies relevant to the 
client’s particular needs.
AC Act 2001, Section 54
https://www.legislation.govt.nz/act/public/2001/0049/latest/DLM100981.html
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link to page 16 link to page 16 link to page 16
 
 
  
 
 
This legislation is administered by the Office of the Privacy Commissioner. For more information please see: 
Website: https://privacy.org.nz 
Contact phone: 0800 803 909 
Contact address: PO Box 10094, Wellington 6143 
 
Health Information Privacy Code 2020 
 
This  Code of Practice  is made under  section 32 of the Privacy Act 2020  by  the  Privacy 
Commissioner 
 
I, JOHN EDWARDS, Privacy Commissioner, having given notice in accordance with section 
33(3) of the Privacy Act 2020 of my intention to issue a code of practice and having satisfied 
the requirements of the subsection, now issue under section 32  of the Act the Health 
Information Privacy Code 2020. 
 
Issued by me at Wellington on 28 October 2020. 
 
THE SEAL of the 
) 
Privacy Commissioner was 
)   
 
[L.S.] 
affixed to this code of practice 
) 
by the Privacy Commissioner 
) 
 
 
John Edwards 
Privacy Commissioner 
 
Contents 
Page 
Part 1: Preliminary 
1 
Title 
2 
2 
Commencement 
2 
3 
Interpretation 
2 
1 

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link to page 32  
 
Health Information Privacy Code 2020 
 
 
4 
Application of code 
4 
 
Part 2: Health information privacy rules 
5 
Health information privacy rules 
5 
 
Rule 1:  Purpose of collection of health information 
6 
 
Rule 2:  Source of health information 
6 
 
Rule 3:  Collection of health information from individual 
7 
 
Rule 4:  Manner of collection of health information 
8 
 
Rule 5:  Storage and security of health information 
8 
 
Rule 6:  Access to personal health information 
8 
 
Rule 7:  Correction of health information 
9 
 
Rule 8:  Accuracy etc of health information to be checked before use or 
 
disclosure 
10 
 
Rule 9:  Retention of health information 
10 
 
Rule 10: Limits on use of health information 
10 
 
Rule 11: Limits on disclosure of health information 
11 
 
Rule 12: Disclosure of health information outside New Zealand 
14 
 
Rule 13: Unique identifiers 
15 
 
Part 3: Miscellaneous 
6 
Charges 
16 
7 
Complaints of breach of code 
16 
8 
Revocation 
17 
 
Schedule 1 - Specified Health Agencies 
18 
Schedule 2 - Agencies approved to assign NHI number 
19 
Schedule 3 - Use and disclosure of information derived from newborn babies' blood spot 
samples 
20 
 
 
Code of Practice 
1 
Title 
This code of practice is the Health Information Privacy Code 2020. 
2 
Commencement 
This code comes into force on 1 December 2020.  
3 
Interpretation 
(1) 
In this code,— 
disability services includes goods, services, and facilities— 
(a)  provided to people with disabilities for their care or support or to promote their 
inclusion and participation in society, and independence; or 
2 

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Health Information Privacy Code 2020 
 
 
(b)  provided for purposes related to or incidental to the care or support of people 
with disabilities or to the promotion of the inclusion and participation in 
society, and independence of such people 
ethics committee means— 
(a)  the Ethics Committee of the Health Research Council of New Zealand or an 
ethics committee approved by that committee; or 
(b)  the National Advisory Committee on Health and Disability Support Services 
Ethics; or 
(c)  an ethics committee required to operate in accordance with the currently 
applicable Operational Standard for Ethics Committees promulgated by the 
Ministry of Health; or 
(d)  an ethics committee established by, or pursuant to, any enactment 
health agency means an agency referred to in subclause 4(2) and, for the purposes of 
rules 5 to 12, is to be taken to include— 
(a)  where an agency holds health information obtained in the course of providing 
health or disability services but no longer provides such services — that agency; 
and 
(b)  with respect to any health information held by a health agency (being a natural 
person) at the time of the person’s death — their personal representative 
health information means information to which this code applies under clause 4(1) 
health practitioner has the meaning given to it by section 5(1) of the Health Practitioners 
Competence Assurance Act 2003 
health professional body means an authority empowered to exercise registration and 
disciplinary powers under the Health Practitioners Competence Assurance Act 2003 
health services means personal health services and public health services 
health training institution means a school, faculty, or department referred to in 
subclause 4(2)(d) 
personal health services means goods, services and facilities provided to an 
individual  for the purpose of improving or protecting the health of that individual, 
whether or not they are also provided for another purpose,  and includes goods, 
services, and facilities provided for related or incidental purposes 
principal caregiver, in relation to any individual, means the friend of the individual 
or the member of the individual’s family group or whãnau who is most evidently and 
directly concerned with the oversight of the individual’s care and welfare 
public health services means goods, services, and facilities provided for the purpose 
of improving, promoting, or protecting public health or preventing population-wide 
disease, disability, or injury, and includes— 
(a)  regulatory functions relating to health or disability matters; and 
(b)  health protection and health promotion services; and 
3 

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Health Information Privacy Code 2020 
 
 
(c)  goods, services and facilities provided for related and incidental functions or 
purposes 
representative, in relation to an individual, means— 
(a)  where that individual is dead, that individual’s personal representative; or 
(b)  where the individual is under the age of 16 years, that individual’s parent or 
guardian; or 
(c)  where that individual, not being an individual referred to in subclauses  (a) or 
(b), is unable to give their consent or authority, or exercise their rights, a person 
appearing to be lawfully acting on the individual’s behalf in the individual’s 
interests 
rule means a health information privacy rule set out in clause 5 
the Act means the Privacy Act 2020. 
(2) 
A term or expression defined in the Act and used, but not defined, in this code has the 
same meaning as in the Act. 
4 
Application of code 
(1) 
This code applies to the following information or classes of information about an 
identifiable individual— 
(a)  information about the health of that individual, including their medical history; 
or 
(b)  information about any disabilities that individual has, or has had; or 
(c)  information about any health services or disability services that are being 
provided, or have been provided, to that individual; or 
(d)  information provided by that individual in connection with the donation, by that 
individual, of any body part or any bodily substance of that individual or 
derived from the testing  or examination of any body part, or any bodily 
substance of that individual; or 
(e)  information about that individual which is collected before or in the course of, 
and incidental to, the provision of any health service or disability service to that 
individual. 
(2) 
This code applies in relation to the following agencies or classes of agency—  
Health and disability service providers 
(a)  an agency which provides health or disability services; or 
(b)  within  a larger agency, a division or administrative unit (including an 
individual) which provides health or disability services to employees of the 
agency or some other limited class of persons; or 
(c)  a person who is approved as a counsellor for the purposes of the Accident 
Compensation Act 2001; or 
 
 
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Health Information Privacy Code 2020 
 
 
Training, registration, and discipline of health professionals, etc 
(d)  a school, faculty or department of a tertiary educational institution  which 
provide the training or a component of the training necessary for the registration 
of a health practitioner; or 
(e)  an agency having statutory responsibility for the registration of any health 
practitioners; or 
(f)  a health professional body; or 
(g)  persons appointed or designated under the Health and Disability Commissioner 
Act 1994; or 
Health insurance, etc 
(h)  an agency which provides health, disability, accident or medical insurance, or 
which provides claims management services in relation to such insurance, but 
only in respect of providing that insurance or those services; or 
(i)  an accredited employer under the Accident Compensation Act 2001; or 
Other 
(j)  an agency which provides services in respect of health information, including 
an agency which provides those services under an agreement with another 
agency; or 
(k)  a district inspector, deputy district inspector or official visitor appointed 
pursuant to section 94 of the Mental Health (Compulsory Assessment and 
Treatment) Act 1992; or 
(l)  a district inspector or deputy district inspector appointed pursuant to section 144 
of the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003; or 
(m)  an agency which manufactures, sells, or supplies medicines, medical devices or 
related products; or 
(n)  an agency which provides health and disability services consumer advocacy 
services; or 
(o)  the department responsible for the administration of the Coroners Act 2006, but 
only in respect of information contained in documents referred to in section 
29(1) of that Act; or 
(p)  the agencies specified in Schedule 1. 
 
Part 2: Health information privacy rules 
5 
Health information privacy rules 
The information privacy principles are modified in accordance with the Act by the 
following rules which apply to health information and health agencies— 
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Rule 1 
Purpose of collection of health information 
(1) 
Health information must not be collected by a health agency unless— 
(a)  the information is collected for a lawful purpose connected with a function or 
activity of the health agency; and 
(b)  the collection of the information is necessary for that purpose. 
(2) 
If the lawful purpose for which health information about an individual is collected 
does not require the collection of an individual’s identifying information, the health 
agency may not require the individual’s identifying information. 
Rule 2 
Source of health information 
(1) 
If a health agency collects health information, the information must be collected from 
the individual concerned. 
(2) 
It is not necessary for a health agency to comply with subrule (1) if the agency 
believes, on reasonable grounds,— 
(a)  that the individual concerned authorises collection of the information from 
someone else having been made aware of the matters set out in rule 3(1); or 
(b)  that the individual is unable to give their authority and the health agency having 
made the individual’s representative aware of the matters set out in rule 3(1) 
collects the information from the representative or the representative authorises 
collection from someone else; or 
(c)  that compliance would— 
(i)  prejudice the interests of the individual concerned; or 
(ii)  prejudice the purposes of collection; or 
(iii)  prejudice the health or safety of any individual; or 
(d)  that compliance is not reasonably practicable in the circumstances of the 
particular case; or 
(e)  that the collection is for the purpose of assembling a family or genetic history of 
an individual and is collected directly from that individual; or 
(f)  that the information is publicly available information; or 
(g)  that the information— 
(i)  will not be used in a form in which the individual concerned is identified; 
or 
(ii)  will be used for statistical purposes and will not be published in a form 
that could reasonably be expected to identify the individual concerned; or 
(iii)  will be used for research purposes (for which approval by an ethics 
committee, if required, has been given) and will not be published in a form 
that could reasonably be expected to identify the individual concerned; or 
(h)  that non-compliance is necessary— 
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(i)  to avoid prejudice to the maintenance of the law by any public sector 
agency, including prejudice to the prevention, detection, investigation, 
prosecution, and punishment of offences; or 
(ii)  for the protection of public revenue; or 
(iii)  for the conduct of proceedings before any court or tribunal (being 
proceedings that have been commenced or are reasonably in 
contemplation); or   
(i)  that the collection of the information is in accordance with an authorisation 
granted under section 30 of the Act. 
Rule 3 
Collection of health information from individual 
(1) 
If a health agency collects health information from the individual concerned, or from 
the individual’s representative, the health agency must take any steps that are, in the 
circumstances, reasonable to ensure that the individual concerned (and the 
representative if collection is from the representative) is aware of— 
(a)  the fact that the information is being collected; and 
(b)  the purpose for which the information is being collected; and 
(c)  the intended recipients of the information; and 
(d)  the name and address of— 
(i)  the health agency that is collecting the information; and 
(ii)  the agency that will hold the information; and 
(e)  whether or not the supply of the information is voluntary or mandatory and if 
mandatory the particular law under which it is required; and 
(f)  the consequences (if any) for that individual if all or any part of the requested 
information is not provided; and 
(g)  the rights of access to, and correction of, health information provided by rules 6 
and 7. 
(2) 
The steps referred to in subrule (1) must be taken before the information is collected 
or, if that is not practicable, as soon as practicable after it is collected. 
(3) 
A health agency is not required to take the steps referred to in subrule (1) in relation 
to the collection of information from an individual, or the individual’s representative, 
if that agency has taken those steps on a recent previous occasion in relation to the 
collection, from that individual or that representative, of the same information or 
information of the same kind, for the same or a related purpose. 
(4) 
It is not necessary for a health agency to comply with subrule (1) if the agency 
believes on reasonable grounds,— 
(a)  that compliance would— 
(i)  prejudice the interests of the individual concerned, or 
(ii)  prejudice the purposes of collection; or 
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(b)  that compliance is not reasonably practicable in the circumstances of the 
particular case; or 
(c)  that non-compliance is necessary to avoid prejudice to the maintenance of the 
law by any public sector agency, including prejudice to the prevention, 
detection, investigation, prosecution, and punishment of offences. 
 
Rule 4 
Manner of collection of health information 
(1) 
A health agency must collect health information only— 
(a)  by a lawful means; and 
(b)  by a means that, in the circumstances of the case (particularly in circumstances 
where personal information is being collected from children or young  
persons),— 
(i)  is fair; and 
(ii)  does not intrude to an unreasonable extent upon the personal affairs of the 
individual concerned. 
Rule 5 
Storage and security of health information 
(1) 
A health agency that holds health information must ensure— 
(a)  that the information is protected, by such security safeguards as are reasonable 
in the circumstances to take, against— 
(i)  loss; 
(ii)  access, use, modification, or disclosure that is not authorised by the 
agency; and 
(iii)  other misuse; 
(b)  that, if it is necessary for the information to be given to a person in connection 
with the provision of a service to the health agency, including any storing, 
processing, or destruction of the information, everything reasonably within the 
power of the health agency is done to prevent unauthorised use or unauthorised 
disclosure of the information; and 
(c)  that, where a document containing health information is not to be kept, the 
document is disposed of in a manner that preserves the privacy of the 
individual. 
(2) 
This rule applies to health information obtained before or after the commencement of 
this code. 
Rule 6 
Access to personal health information 
(1) 
An individual is entitled to receive from a health agency upon request— 
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(a)  confirmation of whether the health agency holds any health information about 
them; and 
(b)  access to their health information. 
(2) 
If an individual concerned is given access to health information, the individual must 
be advised that, under rule 7, the individual may request the correction of that 
information. 
(3) 
The application of this rule is subject to— 
(a)  Part 4 of the Act (which sets out reasons for refusing access to information and 
procedural provisions relating to access to information); and 
(b)  clause 6 (which concerns charges). 
(4) 
This rule applies to health information obtained before or after the commencement of 
this code. 
Rule 7 
Correction of health information 
(1) 
An individual whose health information is held by a health agency is entitled to 
request the agency to correct the information. 
(2) 
A health agency that holds health information must, on request or on its own 
initiative, take such steps (if any) that are reasonable in the circumstances to ensure 
that, having regard to the purposes for which the information may lawfully be used, 
the information is accurate, up to date, complete, and not misleading. 
(3) 
When requesting the correction of health information, or at any later time, an 
individual is entitled to— 
(a)  provide the agency with a statement of the correction sought to the information 
(a statement of correction); and 
(b)  request the agency to attach the statement of correction to the information if the 
agency does not make the correction sought. 
(4) 
If a health agency that holds health information is not willing to correct the 
information as requested and has been provided with a statement of correction, the 
agency must take such steps (if any) that are reasonable in the circumstances to ensure 
that the statement of correction is attached to the information in a manner that ensure 
that it will always be read with the information. 
(5) 
If a health agency corrects health information or attaches a statement of correction to 
health information, that agency must, so far as is reasonably practicable, inform every 
other person to whom the agency has disclosed the information. 
(6) 
Subrules (1) to (4) are subject to the provisions of Part 4 of the Act (which sets out 
procedural provisions relating to the correction of personal information). 
(7) 
This rule applies to health information obtained before or after the commencement of 
this code. 
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Rule 8 
Accuracy, etc, of health information to be checked before use or disclosure 
(1) 
A health agency that holds health information must not use or disclose that 
information without taking any steps that are,  in the circumstances, reasonable to 
ensure that  the information is accurate, up to date, complete, relevant and not 
misleading. 
(2) 
This rule applies to health information obtained before or after the commencement of 
this code. 
Rule 9 
Retention of health information 
(1) 
A health agency that holds health information must not keep that information for 
longer than is required for the purposes for which the information may lawfully be 
used. 
(2) 
Subrule (1) does not prohibit any agency from keeping any document that contains 
health information the retention of which is necessary or desirable for the purposes of 
providing health services or disability services to the individual concerned. 
(3) 
This rule applies to health information obtained before or after the commencement of 
this code. 
Rule 10 
Limits on use of health information 
(1) 
A health agency that holds health information that was obtained in connection with 
one purpose may not use the information for any other purpose unless the health 
agency believes on reasonable grounds,— 
(a)  that the use of the information for that other purpose is authorised by— 
(i)  the individual concerned; or 
(ii)  the individual’s representative where the individual is unable to give their 
authority under this rule; or 
(b)  that the purpose for which the information is to be used is directly related to the 
purpose in connection with which the information was obtained; or 
(c)  that the source of the information is a publicly available publication and that, in 
the circumstances of the case, it would not be unfair or unreasonable to use the 
information; or 
(d)  that the use of the information for that other purpose is necessary to prevent or 
lessen a serious threat to— 
(i)  public health or public safety; or 
(ii)  the life or health of the individual concerned or another individual; 
(e)  that the information— 
(i)  is to be used in a form in which the individual concerned is not identified; 
or 
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(ii)  is to be used for statistical purposes and will not be published in a form 
that could reasonably be expected to identify the individual concerned; or 
(iii)  is to be used for research purposes (for which approval by an ethics 
committee, if required, has been given) and will not be published in a form 
that could reasonably be expected to identify the individual concerned; or 
(f)  that the use of the information for that other purpose is necessary— 
(i)  to avoid prejudice to the maintenance of the law by any public sector 
agency, including prejudice to the prevention, detection, investigation, 
prosecution, and punishment of offences; or 
(ii)  for the conduct of proceedings before any court or tribunal (being 
proceedings that have been commenced or are reasonably in 
contemplation) or 
(g)  that the use of the information is in accordance with an authorisation granted 
under section 30 of the Act. 
(2) 
A health agency that holds health information that was obtained from the testing or 
examination of a blood sample collected in connection with the Newborn Metabolic 
Screening Programme shall not use that information unless is believes, on reasonable 
grounds, that the use is in accordance with Schedule 3. 
(3) 
This rule does not apply to health information obtained before 1 July 1993. 
Rule 11 
Limits on disclosure of health information 
(1) 
A health agency that holds health information must not disclose the information 
unless the agency believes, on reasonable grounds,— 
(a)  that the disclosure is to— 
(i)  the individual concerned; or 
(ii)  the individual’s representative where the individual is dead or is unable to 
exercise their rights under these rules; or 
(b)  that the disclosure is authorised by— 
(i)  the individual concerned; or 
(ii)  the individual’s representative where the individual is dead or is unable to 
give their authority under this rule; or 
(c)  that the disclosure of the information is one of the purposes in connection with 
which the information was obtained; or 
(d)  that the source of the information is a publicly available publication and that, in 
the circumstances of the case, it would not be unfair or unreasonable to disclose 
the information; or 
(e)  that  the information is information in general terms concerning the presence, 
location, and condition and progress of the patient in a hospital, on the day on 
which the information is disclosed, and the disclosure is not contrary to the 
express request of the individual or their representative; or 
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(f)  that the information to be disclosed concerns only the fact of death and the 
disclosure is by a health practitioner or by a person authorised by a health 
agency, to a person nominated by the individual concerned, or the individual’s 
representative, partner, spouse, principal caregiver, next of kin, whānau, close 
relative, or other person whom it is reasonable in the circumstances to inform; 
or 
(g)  that the information to be disclosed concerns only the fact that an individual is 
to be, or has been, released from compulsory status under the Mental Health 
(Compulsory Assessment and Treatment) Act 1992 and the disclosure is to the 
individual’s principal caregiver. 
(2) 
Compliance with subrule (1)(b) is not necessary if the health agency believes on 
reasonable grounds, that it is either not desirable or not practicable to obtain 
authorisation from the individual concerned and— 
(a)  that the disclosure of the information is directly related to one of the purposes in 
connection with which the information was obtained; or 
(b)  that the information is disclosed by a health practitioner to a person nominated 
by the individual concerned or to the principal caregiver or a near relative of the 
individual concerned in accordance with recognised professional practice and 
the disclosure is not contrary to the express request of the individual or their 
representative; or 
(c)  that the information— 
(i)  is to be used in a form in which the individual concerned is not identified; 
or 
(ii)  is to be used for statistical purposes and will not be published in a form 
that could reasonably be expected to identify the individual concerned; or 
(iii)  is to be used for research purposes (for which approval by an ethics 
committee, if required, has been given) and will not be  published in a 
form that could reasonably be expected to identify the individual 
concerned; or 
(d)  that the disclosure of the information is necessary to prevent or lessen a serious 
threat to— 
(i)  public health or public safety; or 
(ii)  the life or health of the individual concerned or another individual; or 
(e)  the disclosure of the information is necessary to enable an intelligence and 
security agency to perform any of its functions; or 
(f)  that the disclosure of the information is essential to facilitate the sale or other 
disposition of a business as a going concern; or 
(g)  that the information to be disclosed briefly describes only the nature of injuries 
of an individual sustained in an accident and that the individual’s identity and 
the disclosure is— 
(i)  by a person authorised by the person in charge of a hospital; and 
(ii)  to a person authorised by the person in charge of a news entity;  
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and for the purpose of publication or broadcast in connection with the news 
activities of that news entity and the disclosure is not contrary to the express 
request of the individual concerned or their representative; or 
(h)  that the disclosure of the information— 
(i)  is required for the purpose of identifying whether an individual is suitable 
to be involved in health education and so that individuals so identified 
may be able to be contacted to seek their authority in accordance with 
subrule (1)(b); and 
(ii)  is by a person authorised by the health agency to a person authorised by a 
health training institution; or 
(i)  that the disclosure of the information— 
(i)  is required for the purpose of a professionally recognised accreditation of 
a health or disability service; or 
(ii)  is required for a professionally recognised external quality assurance 
programme; or 
(iii)  is required for risk management assessment and the disclosure is solely to 
a person engaged by the agency for the purpose of assessing the agency’s 
risk; 
and the information will not be published in a form which could reasonably be 
expected to identify any individual nor disclosed by the accreditation quality 
assurance or risk management organisation to third parties except as required by 
law; or 
(j)  that non-compliance is necessary— 
(i)  to avoid prejudice to the maintenance of the law by any public sector 
agency, including prejudice to the prevention, detection, investigation, 
prosecution and punishment of offences; or 
(ii)  for the conduct of proceedings before any court or tribunal (being 
proceedings that have commenced or are reasonably in contemplation); or 
(k)  that the individual concerned is or is likely to become dependent upon a 
controlled drug, prescription medicine, or restricted medicine and the disclosure 
is by a health practitioner to a Medical Officer of Health for the purposes of 
section 20 of the Misuse of Drugs Act 1975 or section 49A of the Medicines 
Act 1981; or 
(l)  that the disclosure of the information is in accordance with an authorisation 
granted under section 30 of the Act 
(3) 
A health agency that holds health information that was obtained from the testing or 
examination of a blood sample collected in connection with the Newborn Metabolic 
Screening Programme shall not disclose that information unless it believes, on 
reasonable grounds, that the disclosure is in accordance with Schedule 3. 
(4) 
Disclosure under subrule (2) is permitted only to the extent necessary for the 
particular purpose. 
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(5) 
Where under section 22F(1) of the Health Act 1956, the individual concerned or a 
representative of that individual requests the disclosure of health information to that 
individual or representative, a health agency— 
(a)  must treat any  request by that individual as if it were a health information 
privacy request made under rule 6; and 
(b)  may refuse to disclose information to the representative if— 
(i)  the disclosure of the information would be contrary to the individual’s 
interests; or 
(ii)  the agency has reasonable grounds for believing that the individual does 
not or would not wish the information to be disclosed; or 
(iii)  there would be good grounds for withholding the information under Part 4 
of the Act if the request had been made by the individual concerned. 
(6) 
This rule applies to health information about living or deceased persons obtained 
before or after the commencement of this code. 
(7) 
Despite subrule (6), a health agency is exempted from compliance with this rule in 
respect of health information about an identifiable deceased person who has been 
dead for not less than 20 years. 
(8) 
This rule is subject to rule 12. 
Rule 12 
Disclosure of health information outside New Zealand 
(1) 
A health agency (A) may disclose health information to a foreign person or entity (B) 
in reliance on Rule 11(1)(b) or (c) or 11(2)(a), (c), (d), (f), (i) (j) or (l) only if— 
(a)  the individual concerned or, where the individual is dead or unable to exercise 
their rights under these rules, that individual’s representative authorises the 
disclosure to B after being expressly informed by A that B may not be required 
to protect the information in a way that, overall, provides comparable 
safeguards to those in the Act, as modified by this code; or 
(b)  B is carrying on business in New Zealand and, in relation to the information, A 
believes on reasonable grounds that B is subject to the Act, as modified by this 
code; or 
(c)  A believes on reasonable grounds that B is subject to privacy laws that, overall, 
provide comparable safeguards to those in the Act, as modified by this code; or 
(d)  A believes on reasonable grounds that B is a participant in a prescribed binding 
scheme; or 
(e)  A believes on reasonable grounds that B is subject to privacy laws of a 
prescribed country; or 
(f)  A otherwise believes on reasonable grounds that B is required to protect the 
information in a way that, overall, provides comparable safeguards to those in 
the Act, as modified by  this code (for example, pursuant to an agreement 
entered into between A and B); or 
(g)  that the disclosure of the information is in accordance with an authorisation  
granted under section 30 of the Act. 
14 

---

 
 
Health Information Privacy Code 2020 
 
 
(2) 
However, subrule (1) does not apply if the health information is to be disclosed to B 
in reliance on Rule 11(2)(d) or (j) and it is not reasonably practicable in the 
circumstances for A to comply with the requirements of subrule (1). 
(3) 
In this rule,— 
prescribed binding scheme means a binding scheme specified in regulations made 
under section 213 of the Act 
prescribed country means a country specified in regulations made under section 214 
of the Act that are made without any qualification or limitation relating to a class of 
person that includes B, or to a type of information that includes health information. 
Rule 13 
Unique Identifiers 
(1) 
A health agency (A) may assign a unique identifier to an individual for use in its 
operations only if that identifier is necessary to enable A to carry out 1 or more of its 
functions efficiently. 
(2) 
A may not assign to an individual a unique identifier that, to A’s knowledge, is the 
same unique identifier as has been assigned to that individual by another agency (B), 
unless— 
(a)  A and B are associated persons within the meaning of subpart YB of the Income 
Tax Act 2007; or 
(b)  the unique identifier is to be used by A for statistical or research purposes and 
no other purpose; or 
(c)  it is permitted by subrule (3) or (4). 
(3) 
The following agencies may assign the same National Health Index number to an 
individual— 
(a)  any agency authorised expressly by an enactment; or 
(b)  any agency or class of agencies listed in Schedule 2. 
(4) 
Notwithstanding subrule (2) any health agency may assign to a health practitioner as a 
unique identifier— 
(a)  the registration number assigned to that individual by the relevant health 
professional body; or 
(b)  the Common Provider Number assigned to that individual by the Ministry of 
Health. 
(5) 
To avoid doubt, A does not assign a unique identifier to an individual under subrule 
(1) by simply recording a unique identifier assigned to the individual by B for the sole 
purpose of communicating with B about the individual. 
(6) 
A must take any steps that are, in the circumstances, reasonable to ensure that— 
(a)  a unique identifier is assigned only to individuals whose identity is clearly 
established; and 
15 

---

 
 
Health Information Privacy Code 2020 
 
 
(b)  the risk of misuse of a unique identifier by any person is minimised (for 
example, by showing truncated account numbers on receipts or in 
correspondence). 
(7) 
A health agency may not require an individual to disclose any unique identifier 
assigned to that individual unless the disclosure is for one of the purposes in 
connection with which that unique identifier was assigned or for a purpose that is 
directly related to one of those purposes. 
(8) 
Subrules 13(1)  to  (6)(a) do not apply to unique identifiers assigned before 30  July 
1994. 
(9) 
However, subrule 13(2) applies to the assignment of a unique identifier on or after 30 
July 1994 even if the unique identifier is the same as that assigned by another agency 
before that date. 
 
Part 3: Miscellaneous 
6 
Charges 
(1) 
For the purposes of charging under section 66 of the Act in relation to information 
privacy requests concerning health information, a health agency that is a private 
sector health agency must not require the payment, by or on behalf of any individual 
who wishes to make a request, of any charges in respect of a matter referred to in 
section 66(1)(b) and 66(2)(b) of the Act except in accordance with this clause. 
(2) 
Where an individual makes an information privacy request to a health agency that is 
not a private sector agency, the agency may, unless prohibited by law other than the 
Act or this code, make a reasonable charge— 
(a)  where, on a particular day, that agency has made health information available to 
that individual in response to a request, for making the same or substantially the 
same health information available in accordance with any subsequent request 
within a period of 12 months after that day; or 
(b)  for providing a copy of an x-ray, a video recording, an MRI scan photograph, a 
PET scan photograph or a CAT scan photograph. 
(3) 
Where an agency intends to make a charge under subclause (2) and the amount of the 
charge is likely to exceed $30, the agency must provide the individual with an 
estimate of the charge before dealing with the request. 
7 
Complaints of breach of code 
(1) 
Every health agency must designate a person or persons to deal with complaints 
alleging a breach of this code and facilitate the fair, simple, speedy, and efficient 
resolution of complaints. 
(2) 
Every health agency to which this subclause applies must have a complaints 
procedure which provides that— 
(a)  when a complaint of a breach of this code is received— 
16 

---

 
 
Health Information Privacy Code 2020 
 
 
(i)  the complaint is acknowledged in writing within 5 working days of 
receipt, unless it has been resolved to the satisfaction of the complainant 
within that period; and 
(ii)  the complainant is informed of any relevant internal and external 
complaints procedures; and 
(iii)  the complaint and the actions of the health agency regarding that 
complaint are documented; and 
(b)  within 10 working days of acknowledging the complaint, the agency must— 
(i)  decide whether it— 
(A)  accepts that the complaint is justified; or 
(B)  does not accept that the complaint is justified; or 
(ii)  if it decides that more time is needed to investigate the complaint— 
(A)  determine how much additional time is needed; and 
(B)  if that additional time is more than 20 working days, inform the 
complainant of that determination and of the reasons for it; and 
(c)  as soon as practicable after the agency decides whether or not it accepts that a 
complaint is justified, it must inform the complainant of— 
(i)  the reasons for the decision; and 
(ii)  any actions the agency proposes to take; and 
(iii)  any appeal procedure the agency has in place; and 
(iv)  the right to complain to the Privacy Commissioner. 
(3) 
Subclause (2) applies to any health agency specified in clause 4(2)(a), (c), (d), (e), (h), 
(i) and (j) or items 1 and 5 of Schedule 1. 
(4) 
Nothing in this clause is to limit or restrict any provision of Part 4  of the Act or 
sections 49 to 53. 
8 
Revocation 
The Health Information Privacy Code 1994 is revoked. 
 
17 

---

 
 
Health Information Privacy Code 2020 
 
 
Schedule 1 
Specified Health Agencies 
(1) 
Accident Compensation Corporation 
(2) 
Health Research Council 
(3) 
Institute of Environmental Science and Research Limited 
(4) 
Ministry of Health 
(5) 
New Zealand Health Partnerships Limited 
(6) 
The Interchurch Council on Hospital Chaplaincy 
 
 
18 

---

 
 
Health Information Privacy Code 2020 
 
 
Schedule 2 
Agencies Approved to Assign NHI Number 
(1) 
Accident Compensation Corporation 
(2) 
Department of Corrections Health Services 
(3) 
District Health Boards 
(4) 
Health Practitioners 
(5) 
Hospitals 
(6) 
Independent Practitioner Associations 
(7) 
MedicAlert Foundation – New Zealand Incorporated 
(8) 
Ministry of Health 
(9) 
New Zealand Blood and Organ Service 
(10)  New Zealand Defence Force Health Services 
(11)  Pharmaceutical Management Agency of New Zealand 
(12)  Primary Health Organisations 
(13)  Any health agency which has a contract with the Accident Compensation Corporation 
or a District Health Board or the Ministry of Health to provide health or disability 
services. 
 
 
19 

---

 
 
Health Information Privacy Code 2020 
 
 
Schedule 3 
Use and Disclosure of Information Derived from Newborn Babies’ Blood 
Spot Samples 
Schedule 3 sets standards for how health information derived from the blood spot samples 
collected for the Newborn Metabolic Screening Programme may be used and disclosed. 
All uses and disclosures of derived information must be— 
(a)  for one of the permitted primary or permitted secondary purposes; or 
(b)  authorised by the individual concerned or their representative; or 
(c)  authorised by a close available relative where the individual is deceased or 
under 16. 
(1) 
Interpretation 
In this Schedule,— 
close available relative  has the meaning given to it by section 10 of the Human 
Tissue Act 2008 
derived information  means health information that was obtained from testing or 
examination of a blood sample collected in connection with the Newborn Metabolic 
Screening Programme 
permitted primary purpose  means a purpose directly connected with conducting 
and administering the Newborn Metabolic Screening Programme, including to— 
(a)  conduct initial and repeat screening for metabolic or genetic disorders of blood 
samples taken from newborn babies; 
(b)  conduct quality assurance and audit; and 
(c)  develop new screening procedures 
permitted secondary purpose means to— 
(a)  assist the New Zealand Police in an investigation where biological material, a 
body part or a body has been discovered and no other avenue of identifying a 
person who is deceased or missing is practicable; or 
(b)  conduct testing, intending to benefit the individual concerned or their  family, 
that is authorised by— 
(i)  the individual concerned or their representative; or 
(ii)  a close available relative where the individual is dead or under 16; or 
(c)  conduct an inquiry pursuant to Part 3 of the Coroners Act 2006; or 
(d)  comply with a search warrant or court order; or 
(e)  comply with a notice in writing from the chairperson of a mortality review 
committee pursuant to Schedule 5 of the New Zealand Public Health and 
Disability Act 2000; or 
(f)  carry out research for which approval by an ethics committee and the Ministry 
of Health has been given. 
20 

---

 
 
Health Information Privacy Code 2020 
 
 
(2) 
Use and disclosure of derived information 
Any health agency that holds derived information about an individual must not use or 
disclose the information unless it believes, on reasonable grounds, that— 
(a)  the individual concerned or their  representative has authorised the use or 
disclosure of derived information about that individual; or 
(b)  where the individual is deceased or under 16, a representative or close available 
relative has authorised the use or disclosure of the individual’s derived 
information; or 
(c)  the derived information is to be used or disclosed for a permitted primary 
purpose or a permitted secondary purpose. 
 
Made at Wellington on 28 October 2020. 
 
 
John Edwards 
Privacy Commissioner  
 
  
 
 
 
Issued under the authority of the Privacy Act 2020. 
Date of notification in Gazette: 2 November 2020 
This legislation is administered by the Office of the Privacy Commissioner. 
  
 
21 

---

 
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---

ACC7395 
  Referral for medical single discipline 
assessment or medical review 
We’re referring a client to you for a medical review or assessment. Please refer to the information on this form 
when you do the assessment. 
This referral is for a: 
 Medical Case Review 
 Medical Single Discipline Assessment. 
Please quote purchase order number [PO number auto] when invoicing ACC for this service. 
1. Client details 
Client name: [Client full name auto]  
ACC claim number: [Claim number auto] 
Date of birth: [Client DOB auto] 
NHI number: [NHI number auto] 
Email address: [Client email auto] 
Ethnicity: [Ethnicity auto] 
Phone number: [Client home phone auto] 
Mobile phone: [Client Mobile Phone Auto] 
Postal address: [Additional Recipient Reference Auto] 
[Client Address Line 1 Auto], [Client Address Line 2 Auto], [Suburb Auto], [Town Or City Auto], [Post Code 
Auto] 
Residential address (if different from above):            
 
2. Assessor details  
Medical assessor name: [Vendor name auto] 
Speciality: [Enter appropriate speciality or sub-
speciality] 
Phone number: [Vendor phone number auto] 
Email address: [Vendor email auto] 
Date of referral: [Referral to assessor date auto] 
 
3. Appointment details 
Date and time: [insert date and time] 
Location: [insert location] 
 
4. ACC details 
ACC contact person: [Case owner name auto] 
ACC branch: [ACC office auto] 
Contact phone number: [Case owner phone auto] 
Email address: [Case owner email auto] 
 
5. Injury details 
Injury description: [Covered injury description and side auto] 
Date of injury: [DOI auto] 
Additional injury details (if needed):            
How this injury happened (mechanism of injury): [insert method of injury (MOI)] 
Read code 
Description 
Side and site 
ACC7395 
September 2016 
Page 1 of 2 

---

ACC7395 Referral for medical single discipline assessment or 
  medical review 
[Read code 
[Description auto] 
[Insert injury side and site(s)] 
auto] 
[Read code 
[Description auto] 
[Insert injury side and site(s)] 
auto] 
 
6. Service approved 
Service code  Service description 
Qty.  
Unit of 
Unit price, 
Unit price, 
measure 
excl. GST  
incl. GST  
[service code  [service description auto] 
[QTY 
[unit auto] 
$[8888.88 
$[8888.88 
auto] 
auto] 
auto] 
auto] 
 
7. Matters to be addressed 
Please address the following matter(s) in your assessment report. 
1.             
2.             
3.             
4.             
5.             
 
8. Relevant documents 
When completing the assessment, please refer to the documents included with the referral. These are listed 
on the attached ACC6246 Relevant documents list. 
 
9. Additional comments 
Other relevant advice and notes about this client’s case. 
           
When we collect, use and store information, we comply with the Privacy Act 2020 and the Health Information Privacy 
Code 2020. For further details see ACC’s privacy policy, available at www.acc.co.nz. We use the information collected on 
this form to fulfil the requirements of the Accident Compensation Act 2001. 
ACC7395 
September 2016 
Page 2 of 2 

---

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  Al  about 
Medical case reviews 
This information sheet explains how a medical case review helps us answer important questions 
about the link between your covered injury and your current condition. 
 
Sometimes we need to understand the difference between your injury and any other conditions you 
might have. This is because we can only pay for treatment and other support if your condition is 
caused by your injury. 
 
A medical case review (MCR) is an assessment that helps us to identify your medical condition and 
understand: 
•  whether your current condition is or may still be a result of your injury  
•  how your injury affects you at the moment 
•  whether your injury is improving or likely to improve. 
How we decide if an assessment is needed 
If we think you may need an assessment, we’l  talk with you first about how you’re recovering from 
your injury and look at the information we hold about it. If we stil  need more information to help 
answer our questions, we’l  arrange an assessment for you. 
If an assessment is needed 
Before the appointment, we’l  talk to you about which doctor we think is most suitable to do the 
assessment. If you’re not comfortable with our choice, you’l  be able to discuss your preferences with 
us. Wherever possible, we’ll look at alternative options for you. 
 
If you’re getting treatment, weekly compensation or any other support from us, it’s your responsibility 
to go to the appointment that’s arranged for you. Once your appointment is confirmed, please: 
•  make sure the time, date and place suit you 
•  let your ACC contact know immediately if you’re unable or need help to attend. 
Preparing for the appointment 
The appointment involves a discussion and may include a physical examination. Please make sure 
you: 
•  wear comfortable clothes 
•  arrange to take a family or whānau support person with you if you want to 
•  arrange transport well ahead to get to the assessment on time 
•  take any previous X-rays or MRI reports along with you to the appointment. 
During the appointment 
The doctor wil  talk with you about your general health and your injury. If they need to physical y 
examine you, the type of examination wil  depend on the type of condition you’re having assessed. 
They’l  need to do a thorough examination to understand your condition.  
 
If you don’t understand any of the questions they ask you, or the reasons for the type of examination, 
let the doctor know your concerns and ask them to help you understand. 
What happens after the assessment? 
The doctor wil  write a report answering our questions and send it to us, then your ACC contact will 
send a copy to you and your treating doctor. We’l  use this report, along with your previous medical 
records, to review your current condition. If the report has new information about your injury we’ll 
meet with you and discuss how any decisions we’ve made may affect you. 
SMRIS02 – Jul 16  
This information may change and should only be used as a guide 
Page 1 of 2 

---

  Al  about Medical case reviews continued 
 
There are several possible outcomes for you after looking at the report. If: 
•  you’re stil  unable to work because of your covered injury, we’l  work with you to update your 
Individual Rehabilitation Plan and rehabilitation options 
•  you’re capable of working but the effects of your injury make you unable to do the job you had 
before your injury, we’l  support you to find another type of work 
•  it’s clear that you’ve recovered from your injury, we’l  review any ongoing ACC support, including 
weekly compensation 
•  you’re unable to work because of an il ness or another reason unrelated to your injury, we’l  be 
unable to provide further support but we may help you to apply for other assistance. 
 
The outcome of the assessment may affect your cover and entitlements. 
We welcome your feedback and comments 
If you want to provide further comments on the report, we’l  be happy to send these to the doctor to 
consider. If you don’t agree with the opinion provided in the report or past reports, we’re unable to 
change these. However, you can provide additional information or a statement of correction about 
any points that you disagree with and we’l  attach this to the report. 
 
If you’re unhappy with any of our decisions, you have the right to ask for a review within three months 
of the decision being made. 
We’re here to help 
For help with our services, language or cultural support you can call the person who has been 
helping you at ACC, phone 0800 101 996 or visit www.acc.co.nz. 
SMRIS02 – Jul 16  
This information may change and should only be used as a guide 
Page 2 of 2 

---

 
Cl
  ient Face to Face Meetings 
Kanohi te kanohi 
 
 
Why do we meet client’s face to face? 
Face to face meetings are when we meet with a client in person because it wil  benefit them and their 
recovery. For some clients, meeting in person allows us to create a relationship with a better 
understanding of their situation, culture, whānau and what’s important to them.  
 
Examples of when we may meet with a client face to face include: 
•  if the client wants their family/whānau or support people present for a conversation 
•  if the client has a cultural or disability need that is better met through face to face interaction  
•  if obstacles and flags are impacting on recovery or rehabilitation 
•  if the client is unclear or having difficulty understanding ACC processes, documentation, etc. 
•  with clients that we are having difficulty engaging with or who are not complying with rehabilitation 
•  to discuss steps in ACC’s Vocational Independence pathway 
•  to explain decisions made regarding supports 
•  when a recovery team member believes that it would add value to the client’s experience and 
recovery outcomes 
•  when a client requests a face to face meeting and this kind of meeting wil  add value to their 
recovery outcomes. 
At this point in time, we do not use video calling options as an alternative to face to face meetings with 
clients or providers. 
Deciding whether to meet face to face 
Some clients may want as much information as possible early following injury, and others might feel 
overwhelmed and need information delivered in smaller chunks. Face to face can be a good way to 
explain how we can support someone, how we work, and establish a relationship.  
 
Our approach, or decision to meet in person, wil  often depend on the needs of our client and their 
whānau. Before arranging a meeting, we need to be clear on why we’re holding it and whether it wil  add 
value. In many cases, you can provide the same value and level of client experience over the phone.   
 
With a national approach to managing claims, we want to be more focused on meeting our client’s needs 
over the phone where possible. This wil  ensure we only interact with clients in person when we know 
that face to face wil  add real value and we avoid unnecessary changes in contact people. 
 
You should consider the following principles when deciding whether to hold a face to face meeting: 
  •  Customer centricity – We understand the circumstances and needs of our client, and their request 
to meet in person. We consider their needs, how best to meet them, and respond in the most 
efficient and appropriate way. 
 
•  Everyday counts – Everyone’s time is precious. We strive to effectively and efficiently resolve and 
support our clients' needs via phone or email. We use our skills, knowledge and available resources 
to determine if there is a need to meet in person. 
 •  Wellbeing – Health and Safety is always front of mind. Face to face meetings wil only happen at 
appropriate times, in appropriate locations, when it is safe and beneficial. Where there are safety 
concerns, consider how we can use alternatives (e.g. via provider, phone) to provide a similar 
experience that meets their needs. 
 
 
 
 

---

  •  Cultural awareness – We meet the diverse needs of our clients and communities and are culturally 
sensitive when responding to face to face requests and during all engagements. We acknowledge 
that whakawhanaungatanga (the process of establishing links, making connections and relating to 
the people we meet in a culturally appropriate way) is an important process. We recognise this is 
particularly important for clients with high or life-long needs, and their whānau.  
 
One of the ways we show cultural awareness is by asking the client whether there is anyone else 
they would like to attend a face to face meeting. For some clients, community support is key to their 
recovery, and we need to proactively provide clients choice and control to include others in their 
recovery journey.  
 
Considerations for face to face meetings 
Face to face is offered in cases where there are actual or 
Rehabilitation opportunities  
potential rehabilitation opportunities. Meeting should benefit the 
client’s recovery. 
Consider where to meet that wil  feel comfortable to the client 
Location 
(within health and safety requirements). Consider the ongoing 
need to meet in person and whether moving the client to a local 
team is appropriate. 
Consider what language assistance or support the client might 
Support people 
want or need during the interaction. Ask whether there is anyone 
else (e.g. family or community support) who should be invited to 
the meeting. 
 
Face to face is not required when a client: 
•  needs to resolve an issue regarding a provider  
•  needs support fil ing out a form 
•  needs technical support e.g. MyACC  
•  requires medical advice 
 
Al  these scenarios can be resolved over the phone, with a customer host, or by a treating provider.   
Who should meet with the client? 
If a face to face meeting wil  add value to the client’s recovery, then a suitably trained individual with the 
right skil s, in the right location wil  be assigned to have the face to face meeting. 
 
If a client supported in Enabled or Assisted asks to meet in person, consider if they are currently in the 
best team to support their needs. Follow the Choosing the Right Recovery Team guidelines to help you 
decide.   
 
If the client is best supported in Enabled or Assisted, the Recovery Assistant wil  complete a General 
task in detailing why the face to face meeting is needed. This meeting request wil  be assigned to a 
Recovery Coordinator or Partner in the client’s location. For more information on how to request a face to 
face meeting, see the Face to Face Meeting Request template. 
 
The task wil  also be used when: 
•  A client in Supported has a Recovery Coordinator who is not local to the client and face to face is 
required.  
•  Cover Assessment request face to face for a client whose claim is being assessed. 
 
 
 
 
 

---

  In all other cases, it’s likely to be the client’s primary point of contact (Recovery Coordinator or Recovery 
Partner) who would meet with them face to face. If you have any concerns about meeting a client speak 
to your leader for support. 
Preparing to meet a client face to face 
When arranging a meeting it’s important to assess Health and Safety risks, consider the client’s needs 
and attend wel -prepared. 
  
Review the claim 
It is imperative that we review the client party record and claim details before arranging any meetings. 
This should include understanding the client’s journey, but also checking if the client has any active care 
indicators or other flags that might indicate face to face is not appropriate. 
 
On the day of meeting, it is important to review this information again, in case there has been a change. 
  
Health and Safety 
The person meeting with the client is responsible for ensuring they are safe. Determine the most efficient 
way to meet, the most appropriate location, representation, and time. We must follow our Safe Kiwis – 
Managing aggressive and threatening behaviours document when meeting clients onsite and should 
refer to the Assessing risk when meeting at external locations process if planning to meet offsite.  
 
If your client or another attendee has demonstrated concerning behaviour, or has an active client care 
indicator, then the meeting must be by appointment only and held in an ACC meeting room with a CCTV 
camera, with another responsible staff member present. Ensure your leader and other staff are aware of 
the meeting. 
 
Al  staff should be familiar with ACC Client Meeting Precautions in the Safe Kiwis – Managing aggressive 
and threatening behaviours document.  
 
Cultural needs 
Cultural frameworks are in place to guide appropriate engagement at the right time, e.g. 
whakawhanāungatanga. If you or your client have identified there are cultural needs to be considered 
when meeting in person, then you can find resources to support the interaction in the Supporting the 
Diverse Needs of our Clients guidelines.  
 
If a client requires language assistance, we should be using a qualified interpreting service where 
possible. This ensures that our clients receive an accurate translation of our message. See the Working 
with an interpreter process for more information. 
 
If you need additional support preparing for a face to face meeting, or advice on responding to the 
cultural needs of your client, speak to a Practice Mentor for guidance. 
 
Attendees  
Ensure you have asked if there is a support person or someone acting on behalf of the client who wil  be 
present. If the client hasn’t identified anyone, you should ask whether they would want anyone else to 
attend (e.g. someone from their whānau, church, or broader community).  
 
You should also let the client know of any additional people who wil  attend and why. For example, 
interpreters, providers, internal colleagues.  
 
Preparation  
Consider the purpose of the meeting and what the outcome should be for the client, their support people, 
and ACC. Review information beforehand, prepare any relevant resources, and involve the right people 
in your planning. 
 
 
 
 

---

  
Fol owing a face to face meeting 
During a face to face meeting it is important to confirm any actions to be completed after the meeting, 
and who wil  do these. After the meeting, it’s important to document the relevant information discussed 
and any key actions in the client’s Recovery Plan.  
 
Face to face meetings are recorded as a personal Contact in Eos. You should identify the contact as a 
face to face meeting in the contact description.  
You should set out your contact notes as follows: 
•  Who attended the meeting 
•  Why you met (e.g. ‘Face to face meeting with James to discuss XYZ’) 
•  Key details from the meeting – keep it SIMPLE 
•  What you agreed and any actions 
 
Only include key quotes, if relevant. A full transcript is not needed! 
 
If the meeting involves a Provider or other external party, be sure to follow up for relevant materials. 
These should be in addition to your notes – they are not a replacement. This ensures we have a clear 
record of what is required from ACC and what was agreed with the client. 
 
Refer to the Recovery Management guidelines and note taking for more information.   
 
If you have conducted the meeting on behalf of a colleague or another team, make sure you update 
client records and provide a verbal update if required.   
 
 
 
 
 

---

 
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Document Outline

• Privacy check before disclosing information Policy
• Disclosure of care indicator information to third parties Policy
• Medical Case Review and Medical Single Discipline Assessment Service Page
• Client Legislative Rights and Responsibilities Policy
• Client Choice of Providers Policy
• Health Information Privacy Code 2020
  • Health Information Privacy Code 2020
    • 1 Title
    • 2 Commencement
    • 3 Interpretation
    • 4 Application of code
    • Part 2: Health information privacy rules
      • 5 Health information privacy rules
      • Rule 1 Purpose of collection of health information
      • Rule 2 Source of health information
      • Rule 3 Collection of health information from individual
      • Rule 4 Manner of collection of health information
      • Rule 5 Storage and security of health information
      • Rule 6 Access to personal health information
      • Rule 7 Correction of health information
      • Rule 8 Accuracy, etc, of health information to be checked before use or disclosure
      • Rule 9 Retention of health information
      • Rule 10 Limits on use of health information
      • Rule 11 Limits on disclosure of health information
      • Rule 12 Disclosure of health information outside New Zealand
      • Rule 13 Unique Identifiers
    • Part 3: Miscellaneous
      • 6 Charges
      • 7 Complaints of breach of code
      • 8 Revocation
  • Specified Health Agencies
  • Schedule 2 Agencies Approved to Assign NHI Number
  • Schedule 3 Use and Disclosure of Information Derived from Newborn Babies’ Blood Spot Samples
• WRGP - Medical Case Review Providers
• Manage Participants
• ACC7395 Referral for medical single discipline assessment
• SMR12 Medical Case - client
• SMRIS02 Medical case reviews - client
  • This information sheet explains how a medical case review helps us answer important questions about the link between your covered injury and your current condition.
  • Sometimes we need to understand the difference between your injury and any other conditions you might have. This is because we can only pay for treatment and other support if your condition is caused by your injury.
  • A medical case review (MCR) is an assessment that helps us to identify your medical condition and understand:
  • How we decide if an assessment is needed
    • If we think you may need an assessment, we’ll talk with you first about how you’re recovering from your injury and look at the information we hold about it. If we still need more information to help answer our questions, we’ll arrange an assessment fo...
  • If an assessment is needed
    • Before the appointment, we’ll talk to you about which doctor we think is most suitable to do the assessment. If you’re not comfortable with our choice, you’ll be able to discuss your preferences with us. Wherever possible, we’ll look at alternative op...
    • If you’re getting treatment, weekly compensation or any other support from us, it’s your responsibility to go to the appointment that’s arranged for you. Once your appointment is confirmed, please:
  • Preparing for the appointment
    • The appointment involves a discussion and may include a physical examination. Please make sure you:
  • During the appointment
    • The doctor will talk with you about your general health and your injury. If they need to physically examine you, the type of examination will depend on the type of condition you’re having assessed. They’ll need to do a thorough examination to understa...
    • If you don’t understand any of the questions they ask you, or the reasons for the type of examination, let the doctor know your concerns and ask them to help you understand.
  • What happens after the assessment?
    • The doctor will write a report answering our questions and send it to us, then your ACC contact will send a copy to you and your treating doctor. We’ll use this report, along with your previous medical records, to review your current condition. If the...
    • There are several possible outcomes for you after looking at the report. If:
    • The outcome of the assessment may affect your cover and entitlements.
  • We welcome your feedback and comments
    • If you want to provide further comments on the report, we’ll be happy to send these to the doctor to consider. If you don’t agree with the opinion provided in the report or past reports, we’re unable to change these. However, you can provide additiona...
    • If you’re unhappy with any of our decisions, you have the right to ask for a review within three months of the decision being made.
  • We’re here to help
    • For help with our services, language or cultural support you can call the person who has been helping you at ACC, phone 0800 101 996 or visit www.acc.co.nz.
• NG Guidelines Client Face to Face Meetings
  • Why do we meet client’s face to face?
  • Deciding whether to meet face to face
    • Considerations for face to face meetings
  • Who should meet with the client?
  • Preparing to meet a client face to face
    • Review the claim
    • Health and Safety
    • Cultural needs
    • Attendees
    • Preparation
  • Following a face to face meeting
• Privacy Authority Principles

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