08 July 2024
Anthony Jordan
[FYI request #27208 email] Kia ora Anthony
Your Official Information Act request, reference: GOV-032983
Thank you for your email of 11 June 2024, asking for the following information under the Official
Information Act 1982 (the Act):
1/ Number of Concussion/Mild TBI claims that have been declined due to insufficient Proof of
Causation for Respective years 2010 to date
2/ Number of Concussion/Mild TBI Court Hearings that have gone in the ACC's favour due to
insufficient Proof of Causation for Resepive years 2010 to date
3/ Types of Clinical Evidence the ACC accept is Sufficient to Prove Causation Pertaining to
Concussion/Mild TBI
We are unable to answer questions one and two
To determine how many concussion claims have been declined due to insufficient proof of causation from
2010 to the date of your request, would require the manual review of over 7000 claims files. Therefore, we
are refusing your request under section 18(f) of the Act as it would require substantial collation and
research to provide this information. When making this decision we considered extending our timeframe
to respond and/or charging (as allowed under the Act). However, neither of these options has been offered
as we have determined that the resources required to extract the data would have a significant impact on
the everyday functions of the team(s) involved.
Clinical evidence used for poof of causation
Please see the attached document which sets out the criteria for accepting cover for concussion. Please
note that if the factors in the attached guidance are not there or are unclear, it doesn’t automatically mean
the claim will be declined, rather that internal clinical advice would be considered.
As this information may be of interest to other members of the public
ACC has decided to proactively release a copy of this response on ACC’s website. All requester data,
including your name and contact details, will be removed prior to release. The released response will be
made availab
le www.acc.co.nz/resources/#/category/12. If you have any questions about this response, please get in touch
You can email me a
t [email address]. If you are not happy with this response, you can also
contact the Ombudsman vi
a [email address] or by phoning 0800 802 602. Information
about how to make a complaint is available at
www.ombudsman.parliament.nz. Ngā mihi
Christopher Johnston
Manager Official Information Act Services
Government Engagement
GOV-032983 Page 1 of 1