26 January 2016
Lee M
[FYI request #3500 email]
Dear Lee M
Official Information Act Requests
Thank you for your request of 19 December 2015 (at 8.51pm) asking for information under
the Official Information Act 1982 (the Act). Your questions and ACC’s responses are set out
below. Due to the similarity in subject matter and the response given, some answers have
been grouped.
Question 1
1. Are Branch Medical Advisor "opinions" ever requested by ACC management and/or staff
purely in response to a client submitting new medical evidence, and solely for the purpose of
using the "opinions" document at a review hearing, not for the purpose of an ACC case
owner/case manager reviewing a decision to decline cover or an entitlement? If so, please
provide me with a copy of the ACC policy, procedure, guideline or rule that allows for this.
There is no ACC policy that matches the scenario you mention, therefore this part of your
request is declined under section 18(e) of the Act. In general, however, the Accident
Compensation Act 2001 (AC Act) contains provisions that allow for reconsideration of
cover decisions and entitlements.
Under section 65, for example, ACC may revise decisions if it considers a decision has
been made in error, whatever the reason for the error. A revision may amend the original
decision, or revoke the original decision and substitute it with a new decision. ACC also
has powers under section 117 of the AC Act to suspend, cancel or decline entitlements if
it is not satisfied on the basis of the information in its possession that a claimant is entitled
to continue to receive that entitlement. Branch Medical Advisors are ACC staff themselves
and their role is to provide expert medical opinion on claim matters, which may include
decisions made under sections 65 and 117.
Questions 2-3
2. Where a review application has been made by a client, but the review has not yet
proceeded, and a client finds 'errors of fact' in a Branch Medical Advisor "opinion" that does
not amount to a difference of opinion but is proven factual y inaccurate and/or misleading by
medical or other evidential record/s, is the ACC required to correct same if so requested by a
client, and do so before the review hearing takes place? If not, please provide me with a
copy of the ACC policy, procedure, guideline or rule that would allow the ACC to refuse such
a request.
3. In the abovementioned circumstances, would it be ACC policy to refuse to correct the
'errors of fact' on the basis that the review is underway, and whether or not a review hearing
date has not been set down? If so, please provide me with a copy of the ACC policy,
procedure, guideline or rule that allows for this?
If the Branch Medical Advisor’s opinion is
not part of the review documentation or
submissions, ACC wil correct the information in accordance with its policy contained on
this page on its external website
http://www.acc.co.nz/privacy/privacy-notice/WPC120353 and in accordance with the Privacy Act 1993 and Health Information Privacy Code 1994,
found on this site:
www.legislation.govt.nz. If the Branch Medical Advisor’s opinion forms part of the review submissions, ACC has no
legislative obligation to correct the information once it is held by the reviewer. ACC is
guided in this respect by the definition of “agency” in section 2(1)(b)(vi ) of the Privacy Act
1993 which states that an agency
does not include “in relation to its judicial functions, a
Tribunal”. Therefore, when FairWay Resolution Limited is acting in its capacity as a
reviewer of ACC decisions, it is acting in a judicial capacity and is a tribunal within the
meaning of section 2(1)(b)(vi ). To clarify, this means that it is not subject to the
Correction principle of the Privacy Act 1993 or Rule 7 of the Health Information Privacy
Code 1994. As mentioned previously, legislation can be located on this site:
www.legislation.govt.nz. Your request for policies, procedures, guidelines, rules, etc around correction of ACC
client information is therefore refused under section 18(d) of the Act because the
information is publicly available.
Questions 4-5
4. Would it be ACC policy to refuse to correct factual y inaccurate and misleading
information - proven by medical or other evidential records - where a client complains to the
ACC about same? If so, please provide me with a copy of the relevant policy, procedure,
guideline or rule.
5. Would it be ACC policy to refuse to add correction statements to the original documents
which they seek to correct where a client requests this? If so, please provide me with a copy
of the relevant policy, procedure, guideline or rule.
ACC will correct the information in accordance with its policy contained on this page on its
external website
http://www.acc.co.nz/privacy/privacy-notice/WPC120353 (and in
accordance with the Privacy Act 1993 and Health Information Privacy Code 1994). Your
request for policies, procedures, guidelines, rules, etc is therefore refused under section
18(d) of the Act because the information is publicly available.
6. What other course of action is available to a client who wants to ensure that the
information made available to Fairway Resolution Limited and its reviewers by the ACC is
factually accurate and not misleading (given that the ACC provides a copy of the client claim
file to Fairway Resolution Limited very early on in the review process with ACC claims
records being added to al the time right up to the day the review hearing takes place)?
The hearing itself is an opportunity for the client to present their own information and
views to the reviewer. Applicants for review have the right to contest evidence of medical
specialists in that hearing and contest the evidence put before FairWay Resolution Limited
when it is considering reviews.
ACC is happy to answer your questions
If you have any questions about the information provided, ACC will be happy to work with
you to answer these. You can contact us
at [email address] or in writing to
Government Services, PO Box 242, Wel ington 6140.
You have the right to complain to the Office of the Ombudsman about our decision to
withhold some of the information. You can call them on 0800 802 602 between 9am and
5pm on weekdays, or write to The Office of the Ombudsman, PO Box 10152, Wellington
6143.
Yours sincerely
Government Services
Government Services
