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ACC Denies PTSD Claim: Residency Key to Mental Injury Coverage

by Priya Shah – Business Editor

Court of Appeal Rules Against ACC Cover for Pre-Adoption Injury Manifesting Later

The New Zealand Court of Appeal has delivered a definitive ruling, stating that the Accident Compensation Corporation (ACC) is not liable to fund treatment for mental injuries that manifested after a person’s adoption, if the causative physical injury occurred outside of New Zealand and before the adoption.

Background and Legal Interpretation

The decision stems from a case involving a New Zealander whose mental injury, a consequence of a physical injury sustained overseas before his adoption, later required ACC-funded treatment. The Court of Appeal’s interpretation of the relevant legislation emphasizes that ACC cover is intended for injuries where the causative event occurred within new zealand, or if abroad, when the individual was ordinarily resident in New Zealand at the time of the cause.

The court’s reasoning suggests that extending cover to events outside New Zealand, over which the scheme has no influence, would be an inappropriate burden. A key statement from the judgment reads: “In our view, it is clear that Parliament intended to provide cover for mental injuries suffered because of physical injuries where the causative physical injuries occurred in New Zealand or, if suffered outside New Zealand, when the person was ordinarily resident in New Zealand when the cause occurred.”

family’s Disappointment and Legal Implications

The parents of the man involved have expressed deep disappointment,stating the decision is “deeply unfair to their son.” In a statement to NZME, they highlighted his status as a new Zealander, adopted under New Zealand law, and having known no other home. They pointed to the Adoption Act, which dictates an adoptee is to be treated as a natural-born child in every respect, arguing that the denial of ACC-funded treatment for a condition that manifested later in life, due to an injury before adoption, contradicts this principle.

Beatrix Woodhouse,the family’s lawyer,confirmed that the Court of Appeal represents the final avenue for ACC claims in this matter. She noted that the decision establishes a significant legal precedent for cases wiht similar factual circumstances.

ACC’s Response

Stewart McRobie, ACC’s deputy chief executive for corporate and finance, acknowledged the Court of Appeal’s decision and stated that ACC was seeking clarification of the law.He also expressed empathy for the claimant and their family regarding the impact of the ruling.

About the reporter

Shannon Pitman, a Whangārei-based reporter for Open Justice, covered this story. She focuses on courts in the Te Tai Tokerau region, is of Ngāpuhi/ Ngāti Pūkenga descent, and joined NZME in 2023 after five years in digital media.

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