Treatment Injury ECA Referral tool and Notice of Decision (ECA)
Anon made this Official Information request to Accident Compensation Corporation
This request has an unknown status. We're waiting for Anon to read a recent response and update the status.
From: Anon
Dear ACC,
To avoid any doubt, this request is made under the Code and OIA.
Background:
Section 62(1) of the AC Act states:
62 Decision on claim for treatment injury
(1) When investigating a claim for cover for a treatment injury, the Corporation may seek clinical advice if the Corporation considers the advice will assist it in determining the claim.
Section 63 states:
The Corporation must tell the claimant that he or she has the right to apply for a review of any of the Corporation’s decisions on the claim, including a decision under section 58, and must do so at a time appropriate to enable the claimant to exercise the right.
Section 64(1) states:
(1) The Corporation must give notice of its decision on a claim to the claimant.
Request 1: I request the a copy of ACC's template notice of the decision to seek external clinical advice. Please provide the template notice in a searchable pdf format.
Request 2: I request a complete copy of the Treatment Injury ECA Referral tool, current and archived, going back to 01/01/2019. [Please refer to the procedure Seek External Clinical Advice, step 1(b).]
Please provide the complete Treatment Injury ECA Referral tool in an excel spreadsheet format, or a searchable pdf format, which can readily be converted to an excel spreadsheet.
Thank you.
An
From: Government Services
Accident Compensation Corporation
Kia ora,
Thank you for contacting ACC’s Government Services inbox.
If your request falls within scope of the Official Information Act, we
will endeavour to respond as soon as possible, and no later than 20
working days after receipt of your request. If we are unable to respond
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or [2][email address].
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Ngâ mihi,
Government Services
PO Box 242 / Wellington 6011 / New Zealand / [5]www.acc.co.nz
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From: Government Services
Accident Compensation Corporation
Kia ora Anon
Please find attached our response to your official information request
dated 27 May 2024. If you have any questions about the response you can
contact us at this [1]address, for all other matters please use our
contact form at: [2]https://www.acc.co.nz/contact/ alternatively give us
a call on 0800 101 996.
If you are having trouble viewing the PDF, please ensure you have the
latest version of Adobe Acrobat Reader. To download this freeware please
click [3]here.
Ngâ mihi
Christopher Johnston (he/him)
Manager | OIA Services
* PO Box 242, Wellington 6011
ACC cares about the environment – please don’t print this email unless it
is really necessary. Thank you.
show quoted sections
From: Anon
Dear Government Services,
I would like to modify my request given ACC does not have a template for letters decisions issued under section 62 of the Act.
I request copies of 3 different decision s 62 letters (ACC decision to seek External Clinical Advice) and the attachments, which were issued to claimants over for each of the past 10 years (thus a total of 30 letters). Ideally, these will be issued by different Specialist (or Treatment Injury) Cover Assessors.
To protect the privacy of the claimant, I request their names, claim number, and other unique identifiers to be be redacted.
This will help to see whether there is consistency between the approach of conveying a decision, as defined under the Act.
Thanks,
An
From: Government Services
Accident Compensation Corporation
Kia ora,
Thank you for contacting ACC’s Government Services inbox.
If your request falls within scope of the Official Information Act, we
will endeavour to respond as soon as possible, and no later than 20
working days after receipt of your request. If we are unable to respond
within the statutory timeframe, we will notify you of an extension.
The information you have requested may involve documents which contain the
names and contact details of individuals. Please let us know whether you
are seeking that information as part of your request. We may need to
consult before deciding whether we can release this information, and this
may take a bit more time. If we do not hear from you, we will assume that
you do not require it.
For more information about Official Information Act requests, please
visit: [1]Ombudsman New Zealand | Tari o te Kaitiaki Mana Tangata.
If your request relates to your claim, or you’d like more information
about lodging a claim, please contact ACC’s claims team at 0800 101 996
or [2][email address].
For personal information requests or privacy matters,
please visit [3]Request for personal information (acc.co.nz).
For general queries, please visit: [4]Contact us (acc.co.nz).
Ngâ mihi,
Government Services
PO Box 242 / Wellington 6011 / New Zealand / [5]www.acc.co.nz
ACC cares about the environment – please don’t print this email
unless it is really necessary. Thank you.
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information. If you believe you have received this email in error, please
advise us immediately by return email or telephone and then delete this
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recipient, you are not authorised to use or copy this message or any
attachments or disclose the contents to any other person."
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From: Anon
Dear Accident Compensation Corporation,
I noticed that the ACC Business Rule (SupNot-003) titled "Written communication of decisions" states:
A written communication relating to a decision about a claim of a client must always be sent via one of the following:
- Letter
- Email
I appreciate that the process document "Seek external clinical advice" may not be accurate or , currents you stated other policies and processes do not refer to the current rules.
However, section 62 is titled a "decision" and thus, in accordance with ACC's business rule and the Act (s 564), the notice must be in writing (not a phone call) and must include information on review rights.
Other rule and processes specifically state that emails should be on templates found in EOS.
Thus, ACC must have a letter template in EOS or elsewhere for decisions sent pertaining to external clinical advisors (s 62). Perhaps you just didn't ask the correct group who handles the creation of template letters for decisions, or alternatively, we've identified a gap in ACC's processes and a template must be developed.
Yours faithfully,
Anon
From: Government Services
Accident Compensation Corporation
Kia ora,
Thank you for contacting ACC’s Government Services inbox.
If your request falls within scope of the Official Information Act, we
will endeavour to respond as soon as possible, and no later than 20
working days after receipt of your request. If we are unable to respond
within the statutory timeframe, we will notify you of an extension.
The information you have requested may involve documents which contain the
names and contact details of individuals. Please let us know whether you
are seeking that information as part of your request. We may need to
consult before deciding whether we can release this information, and this
may take a bit more time. If we do not hear from you, we will assume that
you do not require it.
For more information about Official Information Act requests, please
visit: [1]Ombudsman New Zealand | Tari o te Kaitiaki Mana Tangata.
If your request relates to your claim, or you’d like more information
about lodging a claim, please contact ACC’s claims team at 0800 101 996
or [2][email address].
For personal information requests or privacy matters,
please visit [3]Request for personal information (acc.co.nz).
For general queries, please visit: [4]Contact us (acc.co.nz).
Ngâ mihi,
Government Services
PO Box 242 / Wellington 6011 / New Zealand / [5]www.acc.co.nz
ACC cares about the environment – please don’t print this email
unless it is really necessary. Thank you.
Disclaimer:
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information. If you believe you have received this email in error, please
advise us immediately by return email or telephone and then delete this
email together with all attachments. If you are not the intended
recipient, you are not authorised to use or copy this message or any
attachments or disclose the contents to any other person."
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http://www.acc.co.nz/
From: Government Services
Accident Compensation Corporation
Kia ora Anon
Section of 6 of the Accident Compensation Act 2001 (the AC Act), defines
the interpretation of the word ‘decision’ or ‘Corporation’s decision’ as
decision or Corporation’s decision includes all or any of the following
decisions by the Corporation:
(a) a decision whether or not a claimant has cover:
(b) a decision about the classification of the personal injury a claimant
has suffered (for example, a work-related personal injury or a motor
vehicle injury):
(c ) a decision whether or not the Corporation will provide any
entitlements to a claimant:
(d) a decision about which entitlements the Corporation will provide to a
claimant:
(e )a decision about the level of any entitlements to be provided:
(f) a decision relating to the levy payable by a particular levy payer:
(g) a decision made under the Code about a claimant’s complaint
Seeking advice in the investigation of cover or entitlement is not
included in the above list. Therefore, any notice that may be given to
claimants when we seek external clinical advice is not a decision under
the Act and section 64 does not therefore apply.
Ngā mihi
Christopher Johnston (he/him)
Manager | OIA Services
* PO Box 242, Wellington 6011
ACC cares about the environment – please don’t print this email unless it
is really necessary. Thank you.
------------------- Original Message
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From: Anon
Dear Government Services,
Section 62 of the Act is titled "Decision on claim for treatment injury". This section is followed by sections 63 and 64, which are titled "Corporation must tell claimant about review rights" and "Corporation must give notice of decisions". Section 64 specifies the decision with review rights, must be in writing.
Neither the NZ Courts nor Parliament have restricted to definition of decision to the definition you provided. The leading authority on the interpretation of a a "decision" is the High Court decision in Hawea, which states:
[18] To make a decision is to make up one’s mind, to make a judgement, to come to a conclusion or resolution… It cannot become a “decision” simply because the ACC may say so. The substance has to be analysed.
The High Court and Parliament have also stated that the definition in section 6 of the Act is not restrictive, but is a general description.
ACC is also required under the Code (rights 1, 2, 5, 6, and 7) and the Health Information Privacy Code (rules 3, 5, 10 and 11) , and internal policies, rules, and processes, required ACC to notify claimants of decisions regarding disclosure of their health information, to explain what information will be disclosed, explain how it will be used, seek the claimants consent and provide an explanation of what the potential outcomes would be if no consent is provided. This must be done prior to disclosing any information. Further, ACC has a process stating that ACC needs to provide claimants with a choice of provider, which means providing a written notice to the claimant.
So again, please provide me with a copy of ACC's decision letter regarding seeking external clinical assessment (sections 62 of the Act), which must be in writing (section 64 of the Act; rights 1, 2, 5, 6, 7 of the Code; and rules 3, 5, 10 and 11 of the HIPC).
I request 3 examples of such letters, issued by the Specialist Cover Assessors, for the past 10 years. Please ensure that the claimant's personal identifiers are redacted.
If your response is that ACC has no such letters on file, then I request the following.
For each year from 1999 to present (20 years), the
(a) number of claims where a claimant's medical information was been disclosed to an external clinical advisers under section 62 of the Act - a requisite for all treatment injury claims according to ACC's internal processes; and
(b) number of claims where the claimant was notified by letter of ACC's decision to seek external clinical advice under section 62 of the Act, prior to disclosing the claimants information; and
(c) number of claims where the claimant was notified by email (instead of a letter) of ACC's decision to seek external clinical advice under section 62 of the Act, prior to disclosing the claimants information; and
(d) number of claims where the claimant was notified by phone (and not provided any written notice) of ACC's decision to seek external clinical advice under section 62 of the Act, prior to disclosing the claimants information; and
(e) number of claims where the claimant where the claimant never received any notice of ACC's decision to seek external clinical advice under section 62 of the Act, prior to disclosing the claimants information.
To avoid any doubt, part (e) is not zero.
For each of the past 20 years, I request 3 copies of each letter by mail and letter by email, notifying the claimant of ACC's decision to seek external clinical advice under section 62 of the Act, which includes ACC's obligatory information under the HIPC. Please redact the claimants' personal identifiers (name, email, address, and claim number) to ensure their privacy is protected.
For each of the years, I request a copy of the script ACC employees were supposed to follow when notifying claimants of ACC's decision to seek external clinical advice under section 62 of the Act, which includes ACC's obligatory information under the HIPC.
Thanks,
An
From: Government Services
Accident Compensation Corporation
Kia ora,
Thank you for contacting ACC’s Government Services inbox.
If your request falls within scope of the Official Information Act, we
will endeavour to respond as soon as possible, and no later than 20
working days after receipt of your request. If we are unable to respond
within the statutory timeframe, we will notify you of an extension.
The information you have requested may involve documents which contain the
names and contact details of individuals. Please let us know whether you
are seeking that information as part of your request. We may need to
consult before deciding whether we can release this information, and this
may take a bit more time. If we do not hear from you, we will assume that
you do not require it.
For more information about Official Information Act requests, please
visit: [1]Ombudsman New Zealand | Tari o te Kaitiaki Mana Tangata.
If your request relates to your claim, or you’d like more information
about lodging a claim, please contact ACC’s claims team at 0800 101 996
or [2][email address].
For personal information requests or privacy matters,
please visit [3]Request for personal information (acc.co.nz).
For general queries, please visit: [4]Contact us (acc.co.nz).
Ngâ mihi,
Government Services
PO Box 242 / Wellington 6011 / New Zealand / [5]www.acc.co.nz
ACC cares about the environment – please don’t print this email
unless it is really necessary. Thank you.
Disclaimer:
"This message and any attachments may contain confidential and privileged
information. If you believe you have received this email in error, please
advise us immediately by return email or telephone and then delete this
email together with all attachments. If you are not the intended
recipient, you are not authorised to use or copy this message or any
attachments or disclose the contents to any other person."
References
Visible links
1. https://www.ombudsman.parliament.nz/
2. mailto:[email address]
3. https://www.acc.co.nz/contact/request-fo...
4. https://www.acc.co.nz/contact/
5. http://www.acc.co.nz/
http://www.acc.co.nz/
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