There are lots of different agencies that investigate prevention, causation and management of injury. Dealing with them can be confusing and frustrating but it is important to be as polite and respectful as possible when dealing with people at the different agencies.
If you find yourself getting frustrated or unable to keep your cool, or its difficult to communicate what you are trying to say in a way they understand, you should consider getting assistance from a lawyer or advocate. The personal injury system is complicated and inaccessible and its very hard to find your way around yourself.
The ACC investigation
The idea behind ACC is to get you what you need quickly, but first ACC needs to work out whether or not you come within the boundaries of ACC’s legislation. Sometimes this happens automatically but it’s often more complicated than you think. That’s the problem with assessing “causation”. This causation assessment underpins most of ACC's decisions. When we did our research into Solving the Problem with access to justice, we wrote a chapter detailing the problems with assessing causation and how these can be overcome.
ACC does an investigation and its focus is on obtaining medical evidence from experts. Often this is your treatment provider but if ACC thinks your case might cost a lot of money, they will seek specialist reports before ACC agrees to cover your injury. They ask whether or not there is an injury that meets the legal tests that ACC has to follow.
This is sometimes referred to as an investigation about whether the injury is “caused by accident”, but there are lots of different legal tests in the ACC legislation that include injuries caused at work, by medical treatment, or from some criminal behaviour, and some gradual process injuries.
Minor injuries are normally accepted automatically. Sometimes when a person has are serious problems, these investigations take many months or longer a person does not get the help they need until the investigation is completed.
These investigations are very expensive and they result in lots of dispute about the why people need help. ACC makes up to 300,000 decisions a year not to help people.
If we are going to get medical evidence in tens of thousands of cases each year, then we need to find a way to do this well. Currently, ACC’s medical evidence process cause disputes. We have said that the independent assessors should be contracted to a Personal Injury Commissioner and not ACC.
One of the benefits of expanding to all disability is that we can save the cost of these expensive investigations and spend that money helping people. For more information on this research and to have your say, please visit the expansion to disability page.
Other regulatory investigations
There are many other agencies that investigate how a person was injured, but when they are doing an investigation, these agencies are normally looking at different things to what ACC is looking at in its investigation. This means we have to undertake multiple investigations which can be frustrating for injured people and others involved in the events surrounding the injury. These investigations are not normally based on ACC’s claim datasets. Instead, they are based on complaints processes and sometimes compulsory reporting.
Each of these agencies has their own process. Normally it involves an investigation into what other people did that caused your injury and then if agreement can’t be reached, a way to test the results of that investigation through a legal dispute. The person who caused the injury might then have to undergo some education or training, or they might be held accountable, and in some cases they might be blamed for the injury. Some of these are described below.
Worksafe for work related injuries
Every year, around 200,000 New Zealanders are injured at work. If you’re injury relates to your work, then Worksafe can investigate although they can only investigate a small percentage of injuries each year. There are different legal tests to meet, but the Worksafe process can also result in additional compensation in some cases.
Criminal Law for violence, sexual assault and traffic accidents
Every year, around 50,000 people are injured on our roads. Some of these can result in criminal prosecutions of the person who caused the accident.
There are tens of thousands of cases each year where people are injured through violence or sexual assault but many people do not get the assistance they need. It is really important to get the help you need to avoid problems developing later in life.
There are a number of options available for you to discuss with the Police. If the person who caused the injury is prosecuted and pleads guilty or is found guilty then a process called 'sentencing' allows the court to court award additional compensation and reparation. A similar outcome can be achieved through restorative justice.
Around 50,000 people are injured through treatment each year. There are three routes that an injured person can be follow. You can contact the treatment provider or their employer (for example the District Health Board), you can ask the Health and Disability Commissioner to investigate or you can complain to professional body for example (Medical Council, Physiotherapy Board).
We have explained some of the most commonly used agencies in New Zealand. It is important to remember that our Personal Injury System is complex and there are numerous other agencies that are involved in the investigation of injuries in New Zealand. These include the Coroner, the Traffic Accident Investigation Commission, the New Zealand Transport Agency.