Contributed by Morgan Speight and current to 6 March 2023
ACC has different rules about whether or not an injury will be covered, depending on whether or not the injury is "work related".
Definition of "work"
For the purposes of ACC cover, "work" means:
- A role that has physical and/or mental duties
- Does not distinguish whether you are an employee or are self-employed
- the location where you are earning money from engaging in employment
This definition
does not cover voluntary work, you will need to be making a financial profit from engaging in the work.
Note that the definition does not require you to be following orders when you are injured. This means that your injury will still be covered if you were injured whilst disobeying instructions, even if this is the reason that you were injured.
A work related injury is an injury that occurs when a person is:
- At a place for the purpose of working (includes a temporary worksite, moving places);
- Having a meal or rest break from work
- Whilst inside a vehicle that is:
- Used to transport the employee to or from work; and
- Supplied by the employer; and
- Under the direction of the employer
- Travelling to or from a treatment that is for a previous work-related personal injury
What kind of work injuries are covered by ACC?
Work related injury extends to cover the following, so long as they are related to that person's work:
- Accidents
- Gradual process injuries (such as gradual hearing loss from exposure to noise at work)
- Disease and infections - this includes COVID-19
- Heart attack or stroke - where the employee was exerting themselves more than they normally would in their job
- Mental injury
Mental Injury
If you receive a mental injury whilst at work ACC may be able to contribute towards your recovery.
Your mental injury will qualify if, whilst working you:
- Directly witnessed an event that caused you to develop a mental injury;
- Directly witnessed the aftermath of an event that caused you to develop a mental injury.
- Witnessing the event could reasonably be expected to cause mental injury to a person
Directly witnessing an event means that you were personally present to see the event. Directly witnessing an event will not include seeing the event or its aftermath by witnessing it:
- On television;
- On a CCTV or similar camera
Illness, infection, disease or allergy
If you become sick or develop an allergy because of your job ACC may be able to cover you.
Under section 30 (3) (b) of the Act, if the illness, infection, disease or allergy is:
- Described in Schedule 2 of the Accident Compensation Act 2001, and
- Caused by the work environment described in that Schedule
Then it is presumed that the condition was caused by your job and you will automatically be covered by ACC and you will not have to do anything further to prove that you should be covered. If ACC disagrees and believes that your condition was caused by something other than your job, it will be ACC's responsibility to prove that the condition was not caused by your job, or that it does not meet the definition set out in Schedule 2.
If your condition is not listed and defined in Schedule 2 then it will need to satisfy the 'causation test' set out in section 30 (2) of the Accident Compensation Act 2001.
The test looks at:
- The risk of a person doing the same kind of job as you developing the illness, infection, disease or allergy that you have (Person A)
- The risk of a person who does not to the same kind of job as you developing the illness, infection, disease or allergy that you have (Person B)
If Person A is significantly more likely to develop the illness, infection, disease or allergy than Person B, then the condition is a personal injury as defined in section 30 (1) and will be covered by ACC.
For the purposes of this test Person B must not have a similar employment type as Person A –
Cullen v Accident Rehabilitation and Compensation Insurance Corporation [2004] NZAR 481;
[2004] NZHC 262. An example of this would include not comparing a doctor’s likelihood of contracting an illness or infection against the likelihood of a nurse contracting that same condition.
Gradual Process Injury
A gradual process condition is often referred to as being 'wear and tear'. It is an injury that develops over time through repeated actions or motions, rather than being caused by a sudden event, or a short series of events. A gradual process condition will develop slowly.
To qualify for ACC cover the gradual process injury will need to have engaged in an action or activity that you do not often engage in outside of your work environment. This does not mean that you can never engage in this activity,
Section 30 (2) of the Accident Compensation Act 2001 sets out a test for whether the gradual process injury is eligible for cover; this test is further explained in
Knox v Accident Rehabilitation and Compensation Insurance Corporation [2000] NZHC 1215;
[2000] NZAR 609; (2001) 6 NZELC 98,619.
To qualify for cover your injury must have been substantially caused your employment, it compares
- The risk of a person doing the same kind of job as you developing the injury that you have (Person A)
- The risk of a person who does not to the same kind of job as you developing the injury that you have (Person B)
If Person A is significantly more likely to develop the injury than Person B, then the injury is a personal injury as defined in section 30 (1) and will be covered by ACC.
For the purposes of this test Person B must not have a similar employment type as Person A –
Cullen v Accident Rehabilitation and Compensation Insurance Corporation [2004] NZAR 481;
[2004] NZHC 262.
What date was your work injury suffered from?
Your work related injury is covered from the date that you are deemed to have suffered the injury.
Section 37 of the Accident Compensation Act 2001 sets out that you are deemed to have “suffered” the injury from:
- When you first sought treatment for the condition or injury (the case of Palmer v Accident Compensation Corporation [2008] NZACC 104 has said that having the injury or condition monitored will qualify as seeking treatment); or
- When you were first incapacitated by the condition or injury;
ACC will calculate the date of injury from the earlier of the two dates.