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Guide to completing ACC12 File Summary form 
This guide is for internal use only. Please use when completing the ACC12 File 
Summary form.
1. Client details 
Client’s name 
Note whether there is a need to check pronunciation. 
Check claims history for aliases. Need to avoid barriers being 
raised, such as other injuries not being considered by assessors in 
Vocational Independence (VI) assessments.  
Also good to consider how any injuries sustained post incapacity 
were caused, ie what the activities were and whether they are 
Claim number 
Date of Birth (DOB) 
Note if the client is nearing New Zealand Superannuation 
Qualifying Age (NZSQA) to ensure election reminder (or decision 
letter) and WINZ letter are sent as appropriate. Consult Technical 
Claims Manager (TCM) if uncertain. Refer to Informe > 
Entitlements, rehabilitation, treatment > Weekly compensation > 
Cease due to upper age limits (NZSQA).  
Consider the cost effectiveness of providing vocational 
rehabilitation, in consultation with Team Manager (TM). 
Date of injury (DOI) 
If pre 01/07/92 consult TCM re cover criteria. Cover determination 
varies under different legislation. 
If not identified check reports on file, especially social 
rehabilitation reports. This should prompt us to arrange for 
Cultural Advisor to input into the initial panel review. 
Date of incapacity 
If later than date of injury (ie delayed incapacity) we need to 
check what ACC investigated to ensure entitlements were 
established correctly, ie what evidence confirms a causal link 
between the delayed incapacity and the injury sustained at the 
date of injury. 
Interpreter required  See Informe > Other claimant-related procedures > Interpreters 
this link provides information about using interpreters and 
language line. 
Primary contact / 
ACC Investigation Unit advise this is important if it’s difficult 
Primary contact’s 
getting hold of the client and/or they have a history of 
relationship to 
rescheduling appointments. 
Guide to completing ACC12 File Summary form                Last updated:  February 2011 

Preferred contact 
Be mindful of written communication if literacy issues are evident. 
Use telephone to explain any letters sent.  
If hearing impaired refer to Informe > Other claimant-related 
procedures > 
Interpreters for information regarding New Zealand 
Relay (NZ Relay) service.  
For sight impaired refer to Informe > Entitlements, rehabilitation, 
treatment > Rehabilitation > Social rehabilitation > Entitlements 
> Visual impairment services. 
Note if any difficulties with contact, such as no phone coverage, 
no access to telephone, PO boxes used. If history of mail going 
missing invite client to utilise the ACC free phone 0800 101 996. 
Use registered mail for important notices or appointments if 
Email: Many clients prefer to communicate by email and it does 
provide a paper trail. Need to be careful not to breach privacy, 
particularly if sending to a group/family email address. If in doubt 
use other methods of communication. 
2. Injury details 
Cause of injury 
What was the mechanism of injury/what are the accident details? 
Is there a causal link between this and the original diagnosis and 
current diagnosis? 
Original diagnosis 
Ensure it is clear what injury ACC accepted cover for.  
Current diagnosis 
If injury diagnosis has changed, ACC needs to ensure the ongoing 
incapacity still relates to the injury we accepted cover for. Watch 
for additional diagnoses on longer term claims, especially injury 
sites changing from one side to another or mental injury 
diagnoses being added, such as Post Traumatic Stress Disorder 
(PTSD) or Post Concussion Syndrome (PCS).  
Less severe injuries at date of accident (DOA) becoming more 
symptomatic could be signs of degenerative disease process.  
Injuries for which 
Review claim file and record details of any consequential 
cover has been 
injuries/new diagnoses, including mental injury, which have been 
accepted for cover. 
Current GP 
How involved is the GP? Do they see a regular GP or just any GP 
available, eg at a larger practice? 
3. Surgery funded by ACC 
Surgery type 
Include surgeries covered by other claims if to the same injury 
site, ie previous or new claims. These need to be taken into 
Guide to completing ACC12 File Summary form                Last updated:  February 2011 

account when considering injury causation – BMA input may be 
Comment on End of 
Review the End of Care Reports to note outcome, functional 
Care Report - 
improvements and compliance with treatment. Compare how the 
client presented when discharged by the surgeon to how they 
present now. 
4. Treatment reports 
Comments / 
Try to summarise comments in a way that both you as the case 
owner, and other staff reading your summary, can get an idea of 
the key findings or recommendations of the reports listed. 
Pain management 
It’s important to note the type of provider used, eg whether there 
is psychologist, medical specialist, occupational therapist (OT) or 
physiotherapist involvement.  
Comment on engagement with programmes and outcome. 
Social rehabilitation 
Where social rehabilitation needs have been assessed or 
assistance is being provided this can provide information 
regarding the client’s activities and support systems. 
Vocational rehabilitation 
Consider the timing and appropriateness of these interventions. 
Indicate in the Comments / Summary section how engaged the 
client was or whether any barriers were raised.  
Good to list all attempts made here and, in particular, training 
courses and whether these were included if an IOA was updated 
or repeated. 
Other treatment 
Consider if there are multiple medical reports and how the 
medical evidence is weighted overall. Conflicting medical opinion 
is more common with longer term claims and may require some 
further clarification.  
Need to consider if the most appropriate specialist has been 
consulted. Good to have Branch Advisory Psychologist (BAP) 
review the claim if any psychology involvement.  
Clarify main cause of incapacity if multiple injuries, or if the 
diagnosis has changed or other diagnoses have been added over 
the years. 
Note what medications they are currently prescribed. Are they 
ACC funded? If taking multiple medications, do they relate to the 
injury for which they are claiming incapacity? 
Medications may uncover non-injury related health issues. These 
are good to consider in vocational rehabilitation as some 
medications may be contraindicated with certain working 
environments, eg driving or operating heavy machinery, working 
Guide to completing ACC12 File Summary form                Last updated:  February 2011 

at heights etc.  
Check if ACC funded medications are the most appropriate and 
cost effective options. If pain is a barrier to rehabilitation and no 
analgesia is being utilised, the best approach and further options 
should be discussed with the advisory panel. 
5. Work history details 
Was the client an 
If not, consult TCM to consider if Section 105 of the AC Act 
earner at date of 
applies. Circumstances such as purchase of time out, cover, or 
injury (DOI)? 
loss of potential earnings may apply although fairly uncommon.  
Occupation at time 
If the client was employed in more than one occupation are they 
of injury 
incapacitated for them all? 
Was the client’s 
If no work site assessment has been completed we may want to 
pre-injury work 
consider using work type detail sheets. May also need to have 
panel provide advice re s103 considerations, depending on pre-
injury role. 
Did the client 
The s103 test relates to the employment at the time of the 
remain in the same 
personal injury, not the employment held at date of first 
occupation at DOI 
incapacity (DOFI) or date of subsequent incapacity (DOSI). 
Has the client 
Time to check we have applied abatement correctly. What is 
worked in any 
preventing this client from increasing their work hours or return to 
capacity since the 
injury? / Details of 
work since injury 
6. Vocational rehabilitation details 
Initial Occupational 
Always consider whether the work types recommended are 
Assessment (IOA) 
realistic considering the client, their history and their training, 
skills and experience. Ensure literacy/numeracy issues have been 
Date of IOA 
Note currency and quality of IOA. Consider consulting TM or TCM 
re whether to update or repeat IOA if there are quality issues. 
Educational details 
Good to cross reference stated assets and strengths in CV with 
any perceived barriers from client or others. CVs are valuable for 
validating strengths and transferable skills.  
Consider questioning if literacy is raised as a barrier as 
qualifications gained may contradict this.  
Guide to completing ACC12 File Summary form                Last updated:  February 2011 

Voluntary activities 
Consider functional demands of such activities in relation to 
or hobbies relevant 
current incapacity for work. It’s important to verify that the client 
to vocational 
is aware they need to tell us about their activities, including non-
paid work. This should be flagged to reiterate during re-
engagement appointments/interviews. 
Barriers to 
Review IOA report and note any barriers to vocational 
rehabilitation or work. 
Review IOA report and note recommendations made for 
vocational rehabilitation. Cross reference with work types cleared 
for vocational 
in the IMA and vocational rehabilitation already completed. 
Initial Medical 
Ensure that any recommendations made in this report have been 
Assessment (IMA) 
considered and completed or rationale provided for not 
Date of latest IMA 
Note currency of IMA. Consider whether any surgeries or other 
interventions have occurred subsequent to the IMA which may 
have impacted on the findings. Consider whether a new IMA may 
be required. 
Review IMA for rehabilitation recommendations. Cross reference 
with rehabilitation interventions already completed. 
Are there any non-
Consider what the substantive cause of incapacity is. If necessary, 
injury related issues  consult with Branch Medical Advisor (BMA), BAP, TCM or case 
noted in the IMA? 
conference with all. 
Work type options 
Check quality of IMA and client sentiments as an indicator of 
identified as 
motivation and confidence. 
suitable in the 
latest IMA 
7. Activities of daily living details 
Current social 
Note what activities are not being attempted by the client. More 
importantly, note what activities they are able to manage 
entitlements being 
functionally and how this capacity might transfer into a work 
Caring for young children and large properties requires a good 
level of functional ability. The client may want to consider a 
lifestyle choice of working and being available for vocational 
rehabilitation, or declining to participate in rehabilitation or return 
to work and choosing to have their entitlements declined. 
Previous significant 
Good to acknowledge progress made in the past with increasing 
social rehabilitation 
independence. If the client has had extensive Training for 
Independence (TI) programmes, need to consider this in referrals 
for further social rehabilitation. 
Guide to completing ACC12 File Summary form                Last updated:  February 2011 

For example, what were the goals that were worked on and how 
can these assist in vocational rehabilitation, eg use of public 
transport, computer training in the home etc? What equipment 
has been funded by ACC? 
If the client lives with other people, how many vehicles do they 
limitations in 
own, ie do they have access to transport or has this access 
accessing transport  
Current living 
Since DOA have responsibilities of other household members 
arrangements and 
changed? Consider ‘Added worker effect’ - this is described as the 
tendency of other household members capable of work to enter 
the labour market. Good to consider this if barriers are raised re 
childcare or transport. 
Consider impact of dependents (may include children, parents, 
other relatives.) Note age of children and consider whether it is 
reasonable for them to be responsible for assisting with household 
tasks, eg teenagers.  
Consider level of dependency and any changes to childcare 
responsibilities post injury. Is childcare logistics a barrier for 
return to work (RTW)? What were their childcare arrangements 
before the injury? 
Consider other household members receiving entitlements. Good 
to know if a spouse is also receiving ACC or Ministry of Social 
Development (MSD) entitlements. 
8. Individual rehabilitation plan details 
IRP outcome date /  Note Individual Rehabilitation Plan (IRP) outcome date and next 
Date of next 
monitoring step date for consideration in prioritising actions and 
monitoring step 
timing of interventions.  
Have the GP and 
Check to ensure the GP, and employer if applicable, have been 
employer been 
invited to participate in IRP.  
invitied to 
participate in the 

Has the IRP been 
Check the quality of the IRP and note areas to discuss with the 
updated to include 
client in next negotiation.  
suitable work types  IRPs are important for ensuring we are agreed on the goal of their 
rehabilitation, and can be used as evidence in litigation. 
for rehabilitation? 

Is there a history 
Consider this in planning future meetings and approaches. 
of unreasonable 
failure or refusal to 

negotiate or 
comply with ACC’s 

Guide to completing ACC12 File Summary form                Last updated:  February 2011 

Is there a history 
What were the circumstances? 
of deemed IRPs? 
9. Claims history 
Total number of 
Be thorough. We do not want to miss any as this can be raised as 
a barrier for Vocational Independence (VI) assessments. 
Previous incapacity 
Good to know if the client has had a history with ACC. What was 
for work on any 
the relationship like? How did they return to independence from 
that claim or was the incapacity transferred to this claim? Is there 
any residual incapacity from other claims to consider? Is their 
incapacity still assigned to the correct claim? 
Previous work 
It’s important to consult your TCM about these clients. Previous 
capacity (WCAP), 
decisions are important for determining what work types were 
Work Rehabilitation 
considered sustainable and what pre-injury work type the client 
Assessment Process  was incapacitated from. We need to confirm what job or work 
(WRAP) or 
type the client has incapacity for, and their entitlement to loss of 
Independence (VI) 
For example, a client might start working in a job very similar to 
decisions on any 
pre-injury work type once weekly compensation entitlement ends. 
If they have a subsequent injury, what work are they now 
incapacitated for / receiving loss of earnings for? 
Hearing loss claim 
This has been a significant barrier and cause of quashed VI 
decisions, due to ACC not considering all injury claims and 
contraindications for work types.  
Usually there is an audiology report available on these claims 
which should be included in referrals to assessors for IMA or 
Mild traumatic brain 
Consider presentation at time of injury. Severity of Traumatic 
Brain Injury is categorised as Mild, Moderate and Severe. Some 
moderate, and all severe, brain injuries are managed by our 
National Serious Injury Service (NSIS).  
Cumulative effects of subsequent brain injuries are thought to 
result in increased difficulties and more moderate incapacity and 
may need further investigation. If a diagnosis of Post Concussion 
Syndrome (PCS) has been made we may need to investigate 
Utilise BAP to provide advice for traumatic brain injuries. 
Sensitive claims 
Need to consider this in regards to VI assessments. 
Liaise with Sensitive Claims unit to forward relevant assessment 
reports to providers.  
Liaise with Sensitive Claims unit to determine appropriate 
Guide to completing ACC12 File Summary form                Last updated:  February 2011 

responsibilities for rehabilitation planning and follow-up.  
Utilise BAP for advice. 
Subsequent claims 
Important to consider activity level post incapacity. How did they 
sustain subsequent injuries, ie where, what, how etc?  
Has the client had 
Consider previous relationship with ACC for re-engagement period 
any reviews or 
- it may suggest we need to take steps to improve our 
relationship in order to assist in progressing their rehabilitation. 
We may want to agree on the best methods for us to 
communicate, ie some ground rules etc. 
Rehabilitation can be significantly delayed by excessive litigious or 
vexatious behaviour. Consult TM for advice in what is reasonable. 
Has there been any 
Good to be well informed of any previous issues to assist in 
advocacy or legal, 
planning contacts and communication.  
Office of Complaints   
(OCI), ministerial or 
MP involvement 

with this claim? 
10. Financial details 
To answer the questions about compensation, extract relevant 
data from the Transaction Summary Report (Reporting Portal): 
  Access to 4.01 Transaction Summary Report from Reporting 

Go to: Start/Business Applications/ACC Reporting 
Portal/Operational Reports 

Under EOS Reports click 4.01 Payment Reports 

Fill in claim number then click Search 

Confirm the details are correct by clicking the tick box 
(bottom of screen) 

Click Next 

Enter From date (DOA) 

Click Run Report 

File Download PDF box will pop up 

Click Open 

Extract relevant data for the file summary 
If self employed, 
Ask the client, do not assume, and check IPS2 for any declared 
has their business 
Companies website 
You can also check to 
determine if a company has been opened in another name if you 
know the name of the previous company. 
Guide to completing ACC12 File Summary form                Last updated:  February 2011 

Have end of year 
Consult your TCM to ensure entitlements have been calculated 
financial accounts 
correctly both originally and ongoing. 
been reassessed to 
ensure correct 

payments of weekly 

(otherwise known 
as a “wash-up”)? 

11. Mandatory forms 
This is a good opportunity to ensure consent form and declaration of responsibilities are 
completed and current. 
12. Summary  
Answering the summary questions provides an opportunity to consider what information 
needs to be clarified or obtained and who you would like to consult for advice. 
Co-morbordities, other injuries and related issues could be such things as pre-existing 
physical or mental health issues, drug and/or alcohol dependence, smoking (prevents some 
surgery), obesity, convictions, history of violence or threatening behaviour, or any other 
issues which impact on their recovery and have not been detailed elsewhere in the 
13. Case manager’s recommendations and action plan 
This is an opportunity for the Case Manager to document their findings from the intensive 
file review and summary, and note their plan of action. This can be useful when consulting 
internal experts as it provides them the opportunity to endorse or suggest alternatives for 
ongoing management. 
14. Panel comments & recommendations 
This provides a collective space for various consultants to record their recommendations.  
Having reviewed other recommendations it enables a team to summarise and agree on a 
cohesive plan for ongoing rehabilitation or assessments. The option is to have the summary 
reviewed in a case conference approach or as individual consultations/referrals. 
15. Panel members’ signatures 
It’s useful to record who has been consulted – this is to avoid repetition and provide 
opportunity to refer back to this summary in the future. 
Guide to completing ACC12 File Summary form                Last updated:  February 2011