Published: Mar 03 2025
Ensuring ACC Properly Considers Medical Evidence to allow it to revise its decisions Under Section 65
When it comes to ACC claims, medical evidence plays a crucial role in determining both cover and entitlements. However, claimants often experience frustration when medical information seems overlooked or inadequately considered. Under the Accident Compensation Act 2001, section 65 provides a pathway for claimants to request a revision of ACC’s decisions—cover and entitlement—when relevant medical evidence has not been properly obtained or considered.
What Exactly Does Section 65 Allow
Section 65 allows claimants to request ACC to
Obtain additional relevant medical evidence ACC must actively seek out all necessary medical information related to your injury or condition if you believe something critical has been missed.
Reconsider previous decisions ACC is required to reassess both cover and entitlement decisions if new or overlooked medical evidence is brought to their attention.
Common Pitfalls in ACC’s Medical Evidence Handling
We often see ACC claimants commonly encounter issues such as –
ACC relying on outdated or incomplete medical information.
Ignoring or inadequately considering specialist advice or new medical evidence from your treating providers.
ACC medical advisors providing assessments without fully reviewing available medical records.
How to Hold ACC Accountable under Section 65
If you believe ACC has not properly considered critical medical evidence, here’s how to invoke section 65:
Request Additional Evidence Formally ask ACC to obtain additional or updated medical evidence.
Seek Reassessment Clearly outline why previously provided or new medical evidence necessitates a revision of the cover or entitlement decision.
Make a Code of Claimant Rights Complaint If ACC fails to adequately respond or revise the decision based on new medical evidence, file a formal complaint under the ACC Code of Claimant Rights to address ACC’s obligations under Section 65.
Outcomes You Can Expect
Successfully arguing section 65 may lead to
ACC revisiting and potentially changing cover or entitlement decisions.
ACC authorizing and funding further medical assessments or specialist reviews.
How ACC Advisor Subscribers Can Take Action
ACC Advisor subscribers are uniquely positioned with tools to navigate these issues effectively:
Medico-Legal Chatbot Our AI-powered chatbot helps articulate clearly why additional medical evidence necessitates a revision of your claim.
Customized Support Subscribers receive personalized guidance on how to leverage Section 65 effectively.
Remember, detailed and complete medical evidence is essential for fair ACC decisions. Section 65 empowers you to ensure ACC fully considers your case, whether for cover or entitlements. ACC Advisor is here to support your rights every step of the way.