Frequently Asked Questions
Do you as the claimant have to use an advocate?
No. There is no need for you to have an advocate. However by instructing Declined ACC we believe you give yourself the best chance of your review being successful. This is through Declined ACC being aware of the process, the case law and ensuring that your case is presented as well as it can be.
Do you as the claimant have to attend the review hearing?
No. No one can make you attend the review hearing. Declined ACC can make legal argument and present a witness statement in support of your case in your absence if you choose not to attend. However Declined ACC think it is important for claimants to attend and give evidence and always recommend that clients attend the review hearing.
In very rare circumstances the reviewer will allow evidence from the claimant to be given over the telephone. If there is some reason you would not be able to attend a review hearing but want to give evidence then you need to give notification as soon as possible. This will enable a request to be made to the reviewer in advance for permission to give your evidence over the telephone.
Where will the review hearing take place?
The review hearing will usually take place at the most convenient FairWay hearing location for you. FairWay hold review hearings in approximately 25 locations throughout New Zealand.
What will Declined ACC do to help you before the hearing?
DeclinedACC will prepare your case fully and properly. This may involve obtaining further medical evidence, negotiating with ACC, participating in mediation, liaising with FairWay and writing both an evidential statement for you and legal submissions. Ultimately everything is done to ensure that your case is advanced in the best possible way.
What will your Advocate do at the hearing?
With the permission of the reviewer your advocate will introduce your evidence. This will be in the form of the statement drafted on your behalf. We will make legal arguments which will follow the written legal submissions prepared in advance of the hearing. We will also respond to ACC submissions and deal with any other matters.
How can you represent me when we are based in different parts of the country?
Declined ACC represents clients throughout New Zealand. With modern communications it is not necessary for us to meet up. The vast majority of Declined ACC’s business is conducted through email or over the telephone. For efficiency, your advocate attends the hearing by telephone, as do, in most cases, the ACC representative. It is likely therefore that you will be the only person physically at the review with the reviewer. You may take a friend or relative along with you for support if you wish.
Who is the reviewer?
The reviewer is an employee or contractor for FairWay. He or she will have been appointed under Part 5 of the Accident Compensation Act 2001. Reviewers have a duty to Act independently under section 138 of that Act. Most reviewers are legally qualified or have significant experience in this area of the law.
How much will Declined ACC charge you?
This section of our website is currently undergoing an update – please contact us for specific costing details. Apologies for any inconvenience caused by the information not being available on line presently.
How long does the process take?
The time the process takes can vary. Once an application for a review has been filed the reviewer controls the process. The reviewer has an obligation under the Act to adopt an investigative approach and to conduct the review in a timely and informal manner.
The reviewer must set a hearing date within 3 months of the review application being lodged. The case need not be heard within that first 3 months, but a date must be set within that period.
A claimant can agree to waive that time limit and there are circumstances where it is advisable to do this, for example if further medical evidence is needed.
After the review hearing has concluded the reviewer has a statutory obligation to provide their decision within 28 days.
There is no precise answer therefore as to how long the process takes.
Declined ACC does everything possible to ensure that your case is prepared as fully and promptly as possible.
The actual hearing itself is usually scheduled for 1 hour. In most cases however, the hearing is completed in less that the full hour.
Will you get further evidence from my treatment provider?
Normally in all cases it is recommended to obtain further evidence from your treating surgeon or treatment provider. Declined ACC believes that their evidence is pivotal in determining declined treatment cases.
Your treatment provider may charge a fee for providing a further report. Although you would be responsible for that fee initially Declined ACC would seek to recover this from ACC. The amount the reviewer can award for such fees is limited to $1090.84 which usually covers the cost of the report. Declined ACC would not request a report from your treatment provider without obtaining your prior approval and checking the likely cost falls within the recoverable amount. It is usual practice to request that the treating surgeon defers payment of their report fee until the time of the hearing. This means that you as the client are not out of pocket in the meantime.
To attend the hearing you may lose earnings and incur travel costs. Can you reclaim these?
The reviewer is able to make an award for lost earnings or travel expenses in attending the hearing. This is usually asked for at the end of the hearing. These expenses are capped and are at the reviewer’s discretion.
What happens if the reviewer decides in my favour?
If the reviewer finds in your favour then ACC will have to fund the treatment you sought.
What happens if the reviewer decides in ACC’s favour?
If the reviewer finds in ACC’s favour then effectively they are saying ACC’s decision was correct.
You have a right of appeal to the District Court. Although we can act on your behalf in any appeal the costs rules are different – please contact us directly for specific costs details regarding appeals.
Do you deal with disputes involving accredited employers?
Yes, absolutely. We have experience of dealing with accredited employers. If you work for an accredited employer and have an accident at work or a new accident which isn’t work related, your employer may manage the ACC claim itself or instruct an agent to do so.
I have been declined by ACC for something other than surgery….can you still help me?
Yes, certainly. Our recent expansion has seen a widening of the expert knowledge on offer – we routinely deal with a wide range of ACC issues, including declined cover, weekly compensation and other entitlements . If you have an issue which you are wishing to review ACC’s decsion on then please get in touch at jonathan@declinedacc.co.nz or maryanne@declinedacc.co.nz.
If the question you would like answered is not here please email maryanne@declinedacc.co.nz