The Review Process
What does the review process involve?
Generally the ACC Review process is available to anyone who has a claim with ACC and disputes a decision that ACC has made about their case.
FairWay Resolution Limited (FairWay) is the company set up to deal with the review process. For an excellent detailed description of everything you need to know about review please see the hyperlink below
Who are FairWay?
FairWay handles the administrative side of the review process and appoints an independent reviewer to hear the review. FairWay was previously (until November 2013) known as Dispute Resolution Services Limited (DRSL). It was formerly a subsidiary of the Accident Compensation Corporation (ACC). It was set up in 1999 and became a stand-alone entity offering ACC Reviews and other dispute resolution services to the public and private sector market. In 2011 DRSL became a separate organisation no longer owned by ACC.
FairWay is required to be totally autonomous of ACC and guarantees total independence in its work. Under section 138(1) of the Act the reviewer must act independently.
FairWay has offices in Auckland, Wellington, and Christchurch and also holds hearings in many other locations throughout New Zealand. In July of 2017 FairWay became a privately owned Limited Company.
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.
Do you as the claimant have to attend the review hearing?
No. No one can make you attend the review hearing. Legal arguments and a signed witness statement are offered in support of your case in your absence if you choose not to attend. However Declined ACC considers it is important for you as the claimant to attend.
Declined ACC recommends that clients attend the review hearing. In very rare circumstances the reviewer will allow the claimant to give evidence 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 Declined ACC to ask the reviewer in advance if he or she would be prepared to accept evidence from you over the telephone.
What will Declined ACC do to help you before the hearing?
Declined ACC 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 (compiled from the information you have provided) and legal submissions. Ultimately Declined ACC will do everything to ensure that your case is advanced in the best possible way.
Will you get further evidence from my treatment provider?
Normally in all cases it is recommend 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 varies according to the level of specialisation of the treatment provider. The upper limit which can be awarded for a report from a specialist is $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 is within the recoverable amount. It is Declined ACC’s normal practice to request that your treatment provider waits for payment until such time as the hearing has taken place, allowing the payment to be made by ACC and avoiding you as the client being out of pocket.
What does your advocate do at the hearing?
With the permission of the reviewer, your advocate introduces your evidence. This will be in the form of the statement drafted on your behalf from the information you have provided. Your advocate will make legal arguments which will follow the written legal submissions prepared in advance of the hearing. Your advocate will also respond to ACC submissions and deal with any other matters.
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 requested at the end of the hearing. These expenses are capped and are at the reviewer’s discretion.
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 works hard to ensure that your case is prepared as fully and promptly as possible.
The actual hearing itself is normally scheduled for one hour. In most cases however, the hearing is usually finished in less than the full hour.